Acute Care/Hospitalization

Clinician communication through multidisciplinary rounds may improve with well-designed information tools

Communication among hospital staff is a key to patient safety. Multidisciplinary rounds (MDR) have become an important vehicle for communication and coordination of care among hospital clinicians. During rounds, care providers from different specialties meet to communicate, coordinate patient care, make joint decisions, and manage responsibilities. A new study suggests that communication through MDR may be improved by process-oriented information tools that aid information organization, communication, and work management. This could be achieved through automatic extraction of patient data from clinical information systems, displays and printouts in condensed forms, at-a-glance representations of the care unit, and temporary storing of work-process information, note the University of Maryland School of Medicine study authors.

Ayse P. Gurses, Ph.D., and Yan Xiao, Ph.D., reviewed research studies published from 1990 to 2005 about MDR on information needs, information tools used, impact of information tools, and evaluation measures. A total of 51 studies revealed that patient-centric tools (for example, medical charts, nursing flow sheets, and bedside patient monitoring devices), decision-support tools (for example, clinical pathways), and process-oriented tools (for example, a rounding list and daily goals form) helped with information organization and communication.

A rounding list is used for a summary view of up-to-date lists of patients and their active diagnoses, test results, and care plans; it is also used for note taking. A daily goals form is used to remind providers to define patient goals explicitly. It includes a to-do list for discharge, safety risks, ventilator management, scheduled laboratory tests, removal of catheters, and family issues. Information tools were also shown to improve the situation awareness of multidisciplinary care providers and efficiency of MDR and to reduce patient hospital stay. The study was supported in part by the Agency for Healthcare Research and Quality (HS11562).

More details are in "A systematic review of the literature on multidisciplinary rounds to design information technology," by Drs. Gurses and Xiao, in the May 2006 Journal of the American Medical Informatics Association 13(3), pp. 267-276.

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