Effects of interdisciplinary rounds on length of stay in a telemetry unit.
Interdisciplinary rounds (IRs) have been proposed to improve staff communication and reduce LOS. There have been no studies of IRs on an inpatient telemetry ward. Patients on a telemetry unit of a community hospital were randomly assigned to either an IR intervention or standard care. Charts were reviewed to determine LOS, patient characteristics, and indirect indices of quality of care.


METHODS
Daily work rounds, in which resident physicians, nurses, and ancillary staff meet to discuss patients on the team.


RESULTS
84 patients were enrolled, 42 randomized to the intervention and 42 to standard care. There was no significant difference in LOS. Indirect measures of quality of care (dietician, pharmacist, or physical therapist visit) did not differ. In a multiple linear regression model, only abnormal laboratory data, the presence of dementia, and the presence of a home health aid significantly predicted LOS.


CONCLUSIONS
IRs did not decrease LOS in a telemetry ward. Whereas a potential benefit of IRs in other settings cannot be ruled out, this study emphasizes the importance of rigorous testing of strategies to enhance the quality or reduce the costs of inpatient care.
Wild
Dorothea
D
Preventive Medicine Residency Program, Griffin Hospital, Derby, Connecticut, USA. dorothea.wild@yale.edu
Nawaz
Haq
H
Chan
Wendy
W
Katz
David L
DL
D000368:Aged; D000369:Aged, 80 and over; D003237:Connecticut; D019091:Critical Pathways; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006744:Hospital Bed Capacity, 100 to 299; D006757:Hospital Units / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000592:standards; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000193:education; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000592:standards*; D011795:Surveys and Questionnaires; D013686:Telemetry / Q000379:methods; D013997:Time Factors