Morning Patient Rounds Improve Communication, Teamwork

July 15, 2019
interdisclipinary rounds NHRMC tower 2018 for CL

Patients in the hospital interact with many types of healthcare professionals during their stay. Meanwhile, as test results or new information surface, the answers to big questions – like what is the next step for my care, or when can I go home – can change.

At New Hanover Regional Medical Center, clinical teams meet with their patients each morning, providing an opportunity for patients and their family members to ask questions and hear the doctor, nurse, pharmacist and case manager discuss updates to care and discharge plans.

The bedside meetings – called interdisciplinary rounds – are designed to increase communication between disciplines and with the patient and family, leading to improved care and increased satisfaction for physicians, staff and patients.

“Bedside rounds are an opportunity for all members of the care team to optimize teamwork and communication with the patient at the center of it all,” said Charmaine Lewis, MD, Quality Director for NHRMC Physician Group – New Hanover Regional Hospitalists.

Lewis, who has been practicing medicine for over 15 years, said the rounding harkens back to earlier times in medicine, before cell phones and pagers were so common, when doctors and nurses visited patients at the same time out of necessity so everyone knew what was happening. The daily face time helps the doctors, nurses and pharmacists build relationships with one another.

Before interdisciplinary rounds, nurses would update one another on patients and expected discharges, but those conversations didn’t include patients and families, physicians or pharmacists, who are now all part of the discussion.

“The bedside nurses, nurse aides and case managers spend less time collecting information,” said Gabby Pike, RN, Administrator of Adult Inpatient Services, who partnered with Dr. Lewis to implement the rounds. “They also participate in communicating the plan of care for the patient. As a result, the patient is also more informed, integrated and satisfied with their plans for treatment and discharge.”

At the bedside, the discussion has a focused script, with the entire team sharing goals and reviewing quality and safety elements. The improved communication can eliminate unnecessary delays in patients leaving the hospital.

Because every patient has a different circumstance, the care team can also identify and solve problems before they happen. That could mean ensuring that the patient has access to any needed medical equipment at home, such as a walker or oxygen, answering questions about medications, or setting up home health.

Involving the patients in the discussion also helps the care teams figure out how to overcome financial limitations or other barriers to ensure necessary care is received.

For patients without insurance, that could mean receiving medications at a reduced cost. Patients not already linked to a primary care doctor could get referred to NHRMC’s Transitional Care Clinic, which supports patients recovering from a hospital stay.

The bedside rounds have rolled out to the inpatient floors at NHRMC’s 17th Street campus, the Orthopedic Hospital and the Betty H. Cameron Women’s & Children’s Hospital, and will soon be implemented in the intensive care units.



Categories: Advances in Care

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