PMID- 21482844
OWN - NLM
STAT- MEDLINE
DCOM- 20110603
LR  - 20220321
IS  - 1538-3679 (Electronic)
IS  - 0003-9926 (Linking)
VI  - 171
IP  - 7
DP  - 2011 Apr 11
TI  - Structured interdisciplinary rounds in a medical teaching unit: improving patient 
      safety.
PG  - 678-84
LID - 10.1001/archinternmed.2011.128 [doi]
AB  - BACKGROUND: Effective collaboration and teamwork is essential to providing safe 
      hospital care. The objective of this study was to assess the effect of an 
      intervention designed to improve interdisciplinary collaboration and lower the 
      rate of adverse events (AEs). METHODS: The study was a controlled trial of an 
      intervention, Structured Inter-Disciplinary Rounds, implemented in 1 of 2 similar 
      medical teaching units in a tertiary care academic hospital. The intervention 
      combined a structured format for communication with a forum for regular 
      interdisciplinary meetings. We conducted a retrospective medical record review 
      evaluating 370 randomly selected patients admitted to the intervention and 
      control units (n = 185 each) in the 24 weeks after and 185 admitted to the 
      intervention unit in the 24 weeks before the implementation of Structured 
      Inter-Disciplinary Rounds (N = 555). Medical records were screened for AEs. Two 
      hospitalists confirmed the presence of AEs and assessed their preventability and 
      severity in a masked fashion. We used multivariable Poisson regression models to 
      compare the adjusted incidence of AEs in the intervention unit to that in 
      concurrent and historic control units. RESULTS: The rate of AEs was 3.9 per 100 
      patient-days for the intervention unit compared with 7.2 and 7.7 per 100 
      patient-days, respectively, for the concurrent and historic control units 
      (adjusted rate ratio, 0.54; P = .005; and 0.51; P = .001). The rate of 
      preventable AEs was 0.9 per 100 patient-days for the intervention unit compared 
      with 2.8 and 2.1 per 100 patient-days for the concurrent and historic control 
      units (adjusted rate ratio, 0.27; P = .002; and 0.37; P = .02). The low number of 
      AEs rated as serious or life-threatening precluded statistical analysis for 
      differences in rates of events classified as serious or serious and preventable. 
      CONCLUSION: Structured Inter-Disciplinary Rounds significantly reduced the 
      adjusted rate of AEs in a medical teaching unit.
FAU - O'Leary, Kevin J
AU  - O'Leary KJ
AD  - Division of Hospital Medicine, Northwestern University Feinberg School of 
      Medicine, 211 E Ontario St, Seventh Floor, Chicago, IL 60611, USA. 
      keoleary@nmh.org
FAU - Buck, Ryan
AU  - Buck R
FAU - Fligiel, Helene M
AU  - Fligiel HM
FAU - Haviley, Corinne
AU  - Haviley C
FAU - Slade, Maureen E
AU  - Slade ME
FAU - Landler, Matthew P
AU  - Landler MP
FAU - Kulkarni, Nita
AU  - Kulkarni N
FAU - Hinami, Keiki
AU  - Hinami K
FAU - Lee, Jungwha
AU  - Lee J
FAU - Cohen, Samuel E
AU  - Cohen SE
FAU - Williams, Mark V
AU  - Williams MV
FAU - Wayne, Diane B
AU  - Wayne DB
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Intern Med
JT  - Archives of internal medicine
JID - 0372440
SB  - IM
CIN - Arch Intern Med. 2011 Apr 11;171(7):684-5. PMID: 21482845
MH  - Adult
MH  - Aged
MH  - Chicago
MH  - Female
MH  - Hospitals, Teaching/*standards/statistics & numerical data
MH  - Humans
MH  - *Interdisciplinary Communication
MH  - Male
MH  - Medical Errors/*prevention & control/statistics & numerical data
MH  - Middle Aged
MH  - Patient Care/*standards/statistics & numerical data
MH  - Patient Care Team
MH  - Retrospective Studies
MH  - *Teaching Rounds
EDAT- 2011/04/13 06:00
MHDA- 2011/06/04 06:00
CRDT- 2011/04/13 06:00
PHST- 2011/04/13 06:00 [entrez]
PHST- 2011/04/13 06:00 [pubmed]
PHST- 2011/06/04 06:00 [medline]
AID - 171/7/678 [pii]
AID - 10.1001/archinternmed.2011.128 [doi]
PST - ppublish
SO  - Arch Intern Med. 2011 Apr 11;171(7):678-84. doi: 10.1001/archinternmed.2011.128.