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Cross-Discipline Perceptions of Interdisciplinary Rounding as a Method of Improving Teamwork and Patient Safety in an Academic, Tertiary Care Labor and Delivery Unit
Abstract Number: T-05
Abstract Type: Original Research
Introduction: The Institute of Medicine has recommended that organizations establish strategies to develop interdisciplinary team management, acknowledging that teamwork is critical to the delivery of safe and effective healthcare. Recently, certain knowledge, skills, and attitudes (KSAs) have been observed to be essential for highly functioning teams.  In 2005, physician and nursing leaders on our labor and delivery suite (L&D) initiated structured, twice daily interdisciplinary rounds (IDRs). We hypothesized that these IDRs promote important KSAs necessary for teamwork and patient safety.
Methods: We developed a 25-item questionnaire to evaluate whether specific KSAs were present in our IDRs using a 5-point Likert scale (1=strongly agree 2=agree 3=neutral 4=disagree 5=strongly disagree), thus generating a total response score that ranged from 25-125 for each respondent. Four of the 25 items queried KSAs directly associated with patient safety. Participants included all L&D midwives (MW), nurses (RN), anesthesiologists (ANES), obstetricians (OB), and trainees involved in the IDRs. The primary outcome was the mean total response scores (MTRS) based on professional roles, total years of practice and L&D years of practice. ANOVA test with Bonferroni correction was used to assess the intergroup differences in MTRS. All analyses were performed with questions assigned equal weight and response direction.
Results: To date, 157 of 190 providers have responded. The MTRS(SD) per item for all questions and the patient safety subset were 2.0(0.6) and 2.0(0.7) respectively. Compared to OB and RN providers, MTRS were significantly higher for ANES providers (p<0.001 and p<0.005, respectively). There were no differences in MTRS amongst OB, RN and MW providers. Providers with total years of practice <10, vs. >10, had higher MTRS (p=0.016). Providers with L&D years of practice <10, vs. >10, had similar MTRS. (see Figure)
Discussion: Among all L&D providers, our results indicate that IDRs promote specific KSAs essential for teamwork and patient safety. Although all providers agree that IDRs effectively promote KSAs, ANES providers and staff with fewer than 10 years of practice indicated this significantly less strongly. Further investigation into why these differences exist, and which KSAs have the most relevance to improving IDRs, may ultimately benefit both the providers and patients.
1. Baker DP et al. Jt Comm J Qual Patient Saf. 2005;31(4):185-202