Department of Internal Medicine, University of Colorado Internal Medicine Residency Program, Denver, CO, USA.
Department of Hospital Medicine, Eastern Colorado VA Healthcare System, Aurora, CO, USA.
J Interprof Care. 2024 May-Jun;38(3):469-475. doi: 10.1080/13561820.2023.2176471. Epub 2023 Feb 22.
Bedside interdisciplinary rounds (IDR) improve teamwork, communication, and collaborative culture in inpatient settings. Implementation of bedside IDR in academic settings depends on engagement from resident physicians; however, little is known about their knowledge and preferences related to bedside IDR. The goal of this program was to identify medical resident perceptions about bedside IDR and to engage resident physicians in the design, implementation, and assessment of bedside IDR in an academic setting. This is a pre-post mixed methods survey assessing resident physicians' perceptions surrounding a stakeholder-informed bedside IDR quality improvement project. Resident physicians in the University of Colorado Internal Medicine Residency Program ( = 77 pre-implementation survey responses from 179 eligible participants - response rate 43%) were recruited via e-mail to participate in surveys assessing perceptions surrounding the inclusion of interprofessional team members, timing, and preferred structure of bedside IDR. A bedside IDR structure was created based on input from resident and attending physicians, patients, nurses, care coordinators, pharmacists, social workers, and rehabilitation specialists. This rounding structure was implemented on acute care wards in June 2019 at a large academic regional VA hospital in Aurora, CO. Resident physicians were surveyed post implementation ( = 58 post-implementation responses from 141 eligible participants - response rate 41%) about interprofessional input, timing, and satisfaction with bedside IDR. The pre-implementation survey revealed several important resident needs during bedside IDR. Post-implementation survey results revealed high overall satisfaction with bedside IDR among residents, improved perceived efficiency of rounds, preserved quality of education, and value added by interprofessional input. Results also suggested areas for future improvement including timeliness of rounds and enhanced systems-based teaching. This project successfully engaged residents as stakeholders in system-level interprofessional change by incorporating their values and preferences into a bedside IDR framework.
床边多学科查房（IDR）可改善住院环境中的团队合作、沟通和协作文化。在学术环境中实施床边 IDR 取决于住院医师的参与；然而，对于他们与床边 IDR 相关的知识和偏好知之甚少。该项目的目标是确定住院医师对床边 IDR 的看法，并让住院医师参与设计、实施和评估学术环境中的床边 IDR。这是一项前后混合方法调查，评估住院医师对知情利益相关者床边 IDR 质量改进项目的看法。科罗拉多大学内科住院医师培训计划中的住院医师（ = 179 名符合条件的参与者中有 77 名在实施前调查回复 - 回复率 43%）通过电子邮件招募，参与调查评估围绕纳入跨专业团队成员、时间安排和床边 IDR 首选结构的看法。床边 IDR 结构是根据住院医师和主治医生、患者、护士、护理协调员、药剂师、社会工作者和康复专家的意见创建的。这种查房结构于 2019 年 6 月在科罗拉多州奥罗拉的一家大型学术区域退伍军人事务医院的急性护理病房实施。住院医师在实施后（ = 141 名符合条件的参与者中有 58 名在实施后调查回复 - 回复率 41%）接受了关于跨专业输入、时间安排和对床边 IDR 的满意度的调查。在实施前的调查中发现了床边 IDR 期间住院医师的一些重要需求。实施后的调查结果显示，住院医师对床边 IDR 的总体满意度较高，认为查房效率提高，教育质量得到保持，跨专业输入增加了价值。结果还表明，未来需要改进的方面包括查房的及时性和增强系统为基础的教学。该项目通过将住院医师的价值观和偏好纳入床边 IDR 框架，成功地将他们作为利益相关者参与到系统层面的跨专业变革中。
