Adverse Event Reduction

Structured Interdisciplinary  Bedside Rounds (SIBR® rounds) play a pivotal role in reducing adverse events within hospitals by fostering collaboration and enhancing communication among healthcare professionals from various disciplines.

When doctors, nurses, pharmacists, therapists, and other experts come together to discuss a patient’s care, they bring a diverse range of perspectives and expertise to the table. This interdisciplinary approach allows for a comprehensive assessment of the patient’s condition and the identification of potential risks and complications that might otherwise go unnoticed.

Through the exchange of insights and information, team members collectively develop a shared mental model of the patient’s plan for care and discharge supporting more holistic care plans, and can more closely monitor the patient’s progress, and promptly address any issues that may arise.

This proactive and collaborative approach significantly reduces the likelihood of adverse events, such as medication errors or infections, and ensures that patients receive the highest quality of care possible, ultimately enhancing patient safety and outcomes in the hospital setting.

Mechanisms of Action

SIBR rounds bring the care team together each day to discuss key changes in patient status, new pertinent information, and emerging evidence.

Within 3-4 minutes every participant has heard from their colleagues, the patient, and their family (if present). Everyone leaves the bedside with their key questions answered and a cohesive holistic plan for the day and plan for discharge shared amongst the team.

Team members, patients, and family members know what their tasks are until the team meets again and how they can each progress the patient to a safe and early discharge.

The incorporation of a quality-safety checklist into our bedside handover process and again in SIBR rounds ensures that common causes of hospital acquired complications are identified and mitigated early; 3 times per day at a minimum. This prevents non-response to treatment or deterioration that can delay patient recovery and discharge.

SIBR team rounds with daughter, physician, nurse, pharmacist & care manager

Get the detailed Adverse Event outcomes

All the information needed to speak confidently about the outcomes.

Mortality Outcomes

Providence St Vincent’s
Gen med
🡇 42% aOR
Emory University Hospital
Acute Medical Unit
🡇 52% (p=0.004)
Presbyterian St Luke’s 
Medical Telemetry
🡇 50%
Pasqua Hospital
Gen med
🡇 28%

Falls Outcomes

Westmead Hospital
Aged Care Units
🡇 30% (p<0.001)
LIJ Valley Stream 
🡇 82%
Brisbane, Australia
Hem Onc/BMT
🡇 20%
Berkshire Medical Center
Progressive Care Unit
🡇 51%

Code Blues Outcomes

Temple Health
Cardiology Unit
🡇 40%

Skin Integrity Outcomes

LIJ Valley Stream 
🡇 43%
Brisbane, Australia
Hem Onc/BMT
🡇 47%

Lines & IV Access Outcomes

Presbyterian St Luke’s 
Medical Telemetry
🡇 18.9% central line days
Presbyterian St Luke’s
Medical Telemetry
🡇 31.9% foley line days

VTE Prophylaxis Outcomes

Hem Onc/BMT
Medical Telemetry
🡅 332% 

Calls for Clinical Review Outcomes

Orange Hospital, Australia
Acute Medical Unit
🡇 56% 

Interpretation of results

SIBR seems quite strong at improving clinical outcomes. This is what one might expect from ensuring that nurse-physician communication is face-to-face every day – not through the chart – and ensuring that nurses review a quality-safety checklist at the bedside every day, giving the whole care team a chance to review all the predictable, preventable risk-states of hospitalized patients.

It’s well-documented that most harm events involve communication lapses, and SIBR appears to proactively address many of those lapses. SIBR also provides physicians with clinically relevant nursing, pharmacy, and family information that may otherwise go unnoticed, helping the team recognize early signs of deterioration and protect against normalization of deviance.

This is the best model for coordinating care that I’ve ever seen. Patients spend less time in the hospital, get better quicker, and don’t bounce back.

This helped us establish a culture of safety. Now we have a unit where patients don’t die and don’t even fall.

– Hospitalist group leader