title: Improving teamwork: impact of structured interdisciplinary rounds on a hospitalist unit.
abstract: BACKGROUND
  Effective collaboration and teamwork is essential in providing safe and effective care. Research reveals deficiencies in teamwork on medical units involving hospitalists.
  
  
  OBJECTIVE
  The aim of this study was to assess the impact of an intervention, Structured Inter-Disciplinary Rounds (SIDR), on nurses' ratings of collaboration and teamwork.
  
  
  METHODS
  The study was a controlled trial involving an intervention and control hospitalist unit. The intervention, SIDR, combined a structured format for communication with a forum for regular interdisciplinary meetings. We asked nurses to rate the quality of communication and collaboration with hospitalists using a 5-point ordinal scale. We also assessed teamwork and safety climate using a validated instrument. Multivariable regression analyses were used to assess the impact on length of stay (LOS) and cost using both a concurrent and historic control.
  
  
  RESULTS
  A total of 49 of 58 (84%) nurses completed surveys. A larger percentage of nurses rated the quality of communication and collaboration with hospitalists as high or very high on the intervention unit compared to the control unit (80% vs. 54%; P = 0.05). Nurses also rated the teamwork and safety climate significantly higher on the intervention unit (P = 0.008 and P = 0.03 for teamwork and safety climate, respectively). Multivariable analyses demonstrated no difference in the adjusted LOS and an inconsistent effect on cost.
  
  
  CONCLUSIONS
  SIDR had a positive effect on nurses' ratings of collaboration and teamwork on a hospitalist unit, yet no impact on LOS and cost. Further study is required to assess the impact of SIDR on patient safety measures.
authors.affiliation: Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. keoleary@nmh.org
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: O'Leary
authors.forename: Corinne
authors.initials: C
authors.lastname: Haviley
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Slade
authors.forename: Hiren M
authors.initials: HM
authors.lastname: Shah
authors.forename: Jungwha
authors.initials: J
authors.lastname: Lee
authors.forename: Mark V
authors.initials: MV
authors.lastname: Williams
mesh_terms: D000328:Adult; D003142:Communication; D003299:Cooperative Behavior; D003953:Diagnosis-Related Groups; D004526:Efficiency; D017598:Efficiency, Organizational / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009738:Nursing Service, Hospital / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012449:Safety / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States