Clinicians' perceptions of rounding processes and effectiveness of clinical communication.

care planning communication coordination interdisciplinary multidisciplinary teamwork ward round

Journal

Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 10 03 2019
revised: 30 06 2019
accepted: 20 07 2019
pubmed: 7 8 2019
medline: 29 7 2021
entrez: 7 8 2019
Statut: ppublish

Résumé

Ward rounds present opportunities for medical officers, nurses, allied health clinicians, and patients to interact and plan patient care. A recent literature review found eight types of rounding processes. Different purposes, varying levels of representation from clinical professions, and understanding of each others' roles revealed a complex activity. A shared understanding of rounding processes facilitates positive teamwork and improves patient care. We examined how clinicians perceive the nature of rounding processes they undertake within their practice, multidisciplinary team attendance at rounds, and the effectiveness of team communication. We surveyed frontline professionals in two acute care and two rehabilitation wards from a metropolitan teaching hospital. There were 77 participants representing medical officers, nurses, and allied health clinicians. Participants selected the type of rounding processes undertaken on their ward from a list of six defined types, then answered questions about who participated in the rounds and their perceptions of the effectiveness of multidisciplinary communication. Survey findings were analysed using descriptive statistics and comparison. Overall, professionals were inconsistent in the identification of number and types of rounds. Participants nominated processes more consistently within individual clinical disciplines than by clinical speciality. Medical officers identified rounds most consistently, while some nurses were unable to identify any rounding processes undertaken. The perceptions clinicians had of their own attendance at rounds differed from that of their colleagues. Despite variation in perceptions about rounds, professionals reported effective multidisciplinary communication patterns overall. Rounds are a common yet complex activity. Rounds are revealed to be a taken-for-granted organizational activity with diversity in function, attendance, and participation, yet rounding processes are perceived and experienced differently between health professions. These differences impact on multidisciplinary attendance at rounds amongst peers. Making and communicating explicit round expectations and roles for clinicians supports coordinated teamwork and care planning.

Identifiants

pubmed: 31385440
doi: 10.1111/jep.13248
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

801-811

Informations de copyright

© 2019 John Wiley & Sons, Ltd.

Références

Walton V, Hogden A, Johnson J, Greenfield D. Ward rounds, participants, roles and perceptions: literature review. International Journal of Health Care Quality Assurance. 2016;29(4):364-379. https://doi.org/10.1108/IJHCQA-04-2015-0053
Hale G, McNab D. Developing a ward round checklist to improve patient safety. BMJ Quality Improvement Reports. 2015;4(1). https://doi.org/10.1136/bmjquality.u204775.w2440
Cohn A. The ward round: what it is and what it can be. British Journal Of Hospital Medicine 2014;75:C82-C5. Available from: https://doi.org/10.12968/hmed.2014.75.Sup6.C82
Shanker PS. Ward rounds in medicine. Rajiv Gandhi University of Health Sciences Journal of Medical Sciences. 2013;3:135-137.
Royal College of Physicians and Royal College of Nursing. Ward rounds in medicine principals for best practice. 2012.
Sweet GS, Wilson HJ. A patient's experience of ward rounds. Patient Education and Counseling. 2011;84(2):150-151. https://doi.org/10.1016/j.pec.2010.08.016.
Clark KW, Moller S, O'Brien L. Electronic patient journey boards a vital piece of the puzzle in patient flow. Australian Health Review. 2014;38(3):259-264. https://doi.org/10.1071/AH13192.
Wölfel T, Beltermann E, Lottspeich C, Vietz E, Fischer MR, Schmidmaier R. Medical ward round competence in internal medicine - an interview study towards an interprofessional development of an Entrustable Professional Activity (EPA). BMC Medical Education. 2016;16(1):174. https://doi.org/10.1186/s12909-016-0697-y
Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine. 2009;360(5):491-499. https://doi.org/10.1056/NEJMsa0810119
Najafi N, Monash B, Mourad M, et al. Improving attending rounds: qualitative reflections from multidisciplinary providers. Hospital Practice. 2015;43(3):186-190. https://doi.org/10.1080/21548331.2015.1043181
Gonzalo JD, Kuperman E, Lehman E, Haidet P. Bedside interprofessional rounds: perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians. Journal Of Hospital Medicine. 2014;9(10):646-651. https://doi.org/10.1002/jhm.2245
Baathe F, Ahlborg G Jr, Lagström A, Edgren L, Nilsson K. Physician experiences of patient-centered and team- based ward rounding-an interview based case-study. Journal of Hospital Administration. 2014;3:127-142. https://doi.org/10.5430/jha.v3n6p127
Zwarenstein M, Rice K, Gotlib-Conn L, Kenaszchuk C, Reeves S. Disengaged: a qualitative study of communication and collaboration between physicians and other professions on general internal medicine wards. BMC Health Services Research. 2013;13(1):1-9. https://doi.org/10.1186/1472-6963-13-494
Bååthe F, Ahlborg G Jr, Edgren L, Lagström A, Nilsson K. Uncovering paradoxes from physicians' experiences of patient-centered ward-round. Leadership in Health Services. 2016;29(2):168-184. https://doi.org/10.1108/LHS-08-2015-0025
NSW Health. Clinical Excellence Commission-In Safe Hands 2016 [cited 2016]. Available from: http://www.cec.health.nsw.gov.au/quality-improvement/team-effectiveness/insafehands.
Stein J, Payne C, Methvin A, et al. Reorganizing a hospital ward as an accountable care unit. Journal of Hospital Medicine. 2015;10(1):36-40. https://doi.org/10.1002/jhm.2284
Darbyshire D, Barrett C, Ross D, Shackley D. Measuring ward round quality in urology. International Journal of Risk & Safety in Medicine. 2015;27:23-33. https://doi.org/10.3233/JRS-150640
Royal College of Physicians and Royal College of Nursing. Ward rounds in medicine principals for best practice. London: RCP, 2012; 2012.
Stickrath C, Noble M, Prochazka A, et al. Attending rounds in the current era: What is and is not happening. JAMA Internal Medicine. 2013;173(12):1084-1089. https://doi.org/10.1001/jamainternmed.2013.6041
NSW Department of Health. Multidiciplinary ward rounds A Resource. 2011.
Taylor SJ, Bogdan R, DeVault M. Introduction to Qualitative Research Methods. New Jersey: John Wiley and Sons; 2015. Available from: https://books.google.com.au/books?id=RkCCCgAAQBAJ&dq=qualitative+analysis+methodology&lr=lang_en
Baxter P, Jack S. Qualitative case study methodology: study design and implementation for novice researchers. The qualitative report. 2008;13:544-559.
NSW Health. Electronic Patient Journey Board (EPJB) 2015. Available from: http://www.health.nsw.gov.au/pfs/Pages/epjb.aspx. Accessed 10/7/2016.
Tang CJ, Zhou WT, Chan SW-C, Liaw SY. Interprofessional collaboration between junior doctors and nurses in the general ward setting: a qualitative exploratory study. Journal of Nursing Management. 2018;26(1):11-18. https://doi.org/10.1111/jonm.12503
Lalley C, Malloch K. Workarounds: The hidden pathway to excellence. Nurse Leader. 2010;8(4):29-32. https://doi.org/10.1016/j.mnl.2010.05.009.
Debono DS, Greenfield D, Travaglia JF, et al. Nurses' workarounds in acute healthcare settings: a scoping review. BMC Health Services Research. 2013;13(1):175. https://doi.org/10.1186/1472-6963-13-175
Swenne CL, Skytt B. The ward round-patient experiences and barriers to participation. Scandinavian Journal of Caring Sciences. 2014;28:297-304. https://doi.org/10.1111/scs.12059
Pryor J. A nursing perspective on the relationship between nursing and allied health in inpatient rehabilitation. Disability & Rehabilitation. 2008;30:314-322. Available from: https://doi.org/10.1080/09638280701256900
Liu W, Manias E, Gerdtz M. Medication communication during ward rounds on medical wards: power relations and spatial practices. Health. 2013;17(2):113-134. https://doi.org/10.1177/1363459312447257
Bryman A. Social Research Methods. 4th ed. New York: Oxford University Press; 2012.

Auteurs

Victoria Walton (V)

Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia.

Anne Hogden (A)

Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia.

Janet C Long (JC)

Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.

Julie Johnson (J)

Centre for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

David Greenfield (D)

Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia.

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