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Impact of structured interdisciplinary bedside rounding on patient outcomes at a large academic health centre
  1. Padageshwar R Sunkara1,
  2. Tareq Islam1,
  3. Abhishek Bose2,
  4. Gary E Rosenthal1,
  5. Parag Chevli1,
  6. Hanumantha Jogu1,
  7. Luqman Arafath TK1,
  8. Chi-Cheng Huang1,
  9. Dipendra Chaudhary1,
  10. Daniel Beekman1,
  11. Abhishek Dutta1,
  12. Suma Menon1,
  13. Jaime L Speiser3
  1. 1 Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
  2. 2 Division of Cardiology, Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
  3. 3 Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
  1. Correspondence to Dr Padageshwar R Sunkara, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA; padageshwar{at}gmail.com

Abstract

Background Effective communication between healthcare providers and patients and their family members is an integral part of daily care and discharge planning for hospitalised patients. Several studies suggest that team-based care is associated with improved length of stay (LOS), but the data on readmissions are conflicting. Our study evaluated the impact of structured interdisciplinary bedside rounding (SIBR) on outcomes related to readmissions and LOS.

Methods The SIBR team consisted of a physician and/or advanced practice provider, bedside nurse, pharmacist, social worker and bridge nurse navigator. Outcomes were compared in patients admitted to a hospital medicine unit using SIBR (n=1451) and a similar control unit (n=770) during the period of October 2016 to September 2017. Multivariable negative binomial regression analysis was used to compare LOS and logistic regression analysis was used to calculate 30-day and 7-day readmission in patients admitted to SIBR and control units, adjusting for covariates.

Results Patients admitted to SIBR and control units were generally similar (p≥0.05) with respect to demographic and clinical characteristics. Unadjusted readmission rates in SIBR patients were lower than in control patients at both 30 days (16.6% vs 20.3%, p=0.03) and 7 days (6.3% vs 9.0%, p=0.02) after discharge, while LOS was similar. After adjusting for covariates, SIBR was not significantly related to the odds of 30-day readmission (OR 0.81, p=0.07) but was lower for 7-day readmission (OR 0.70, p=0.03); LOS was similar in both groups (p=0.58).

Conclusion SIBR did not reduce LOS and 30-day readmissions but had a significant impact on 7-day readmissions.

  • healthcare quality improvement
  • hospital medicine
  • patient-centred care
  • transitions in care
  • teamwork
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Footnotes

  • Correction notice The article has been corrected since it published online first. The co-author's (Abhishek Bose) affiliation has been amended.

  • Collaborators Nicole Puccinelli-Ortega.

  • Contributors Authorship awarded based on the contributions made to the manuscript.

  • Funding This study was funded by Health Resources and Services Administration (grant number: UD7HP28691).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Wake Forest University Institutional Review Board—IRB00044853.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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