Patient Perceptions and Real-Time Observations of Bedside Rounding Team Communication: The Interprofessional Teamwork Innovation Model (ITIM)

摘要

Background: Interdisciplinary rounds are designed to address barriers to teamwork, communication, and quality patient care. This study used multiple methods (observations, patient surveys) in two hospital sites to examine communication and teamwork in the Interprofessional Teamwork Innovation Model (ITIM). Methods: Observations of 68 ITIM teams that completed 685 patient visits were conducted in a 302-bed communitybased acute care hospital (CH) and a 569-bed academic medical center (AMC) in one academic health care system. Patients were asked to complete surveys about their experience with their ITIM team. Results: Length of stay (LOS) in the CH was significantly and negatively associated with team structures and communication processes. LOS in the AMC was associated with communication processes. Geographic cohorting was a system factor associated with teamwork and communication processes that affect patient care and quality. A variety of communication processes were operating in ITIM teams, including soliciting questions from patients and staff, politeness, rapport, speaking percentages, and team-oriented communication. Patients were satisfied with their ITIM experience, indicating that their encounters were collaborative and supportive and contributed to their care experience. Conclusion: This multimethod study illustrates the value of system-level approaches to structured patient-centered team care delivery and understanding the complexity of communication in team-based patient care. Findings suggest that when patients feel they are given opportunities to ask questions, speak without being interrupted, and have their questions answered, they tend to be satisfied with their experience of care. Health care leaders may consider ITIM to advance their mission of improving patient experiences and quality of bedside care.