title: Bedside interprofessional rounds: perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians.
abstract: BACKGROUND
  Interprofessional collaboration improves the quality of care, but integration into workflow is challenging. Although a shared conceptualization regarding bedside interprofessional rounds may enhance implementation, little work has investigated providers' perceptions of this activity.
  
  
  OBJECTIVE
  To evaluate the perceptions of nurses, attending physicians, and housestaff physicians regarding the benefits/barriers to bedside interprofessional rounds.
  
  
  METHODS
  Observational, cross-sectional survey of hospital-based medicine nurses, attending physicians, and housestaff physicians. Descriptive, nonparametric Wilcoxon rank sum and nonparametric correlation were used.
  
  
  METHODS
  Bedside interprofessional rounds were defined as "encounters including 2 physicians plus a nurse or other care provider discussing the case at the patient's bedside." Eighteen items related to "benefits" and 21 items related to "barriers" associated with bedside interprofessional rounds.
  
  
  RESULTS
  Of 171 surveys sent, 149 were completed (87%). Highest-ranked benefits were related to communication/coordination, including "improves communication between nurses-physicians;" lowest-ranked benefits were related to efficiency, process, and outcomes, including "decreases length-of-stay" and "improves timeliness of consultations." Nurses reported most favorable ratings for all items (P < 0.05). Rank order for 3 provider groups showed high correlation (r = 0.92, P < 0.001). Highest-ranked barriers were related to time, including "nursing staff have limited time;" lowest-ranked barriers were related to provider- and patient-related factors, including "patient lack of comfort." Rank order of barriers among all groups showed moderate correlation (r = 0.62-0.82).
  
  
  CONCLUSIONS
  Although nurses perceived greater benefit for bedside interprofessional rounds than physicians, all providers perceived coordination/teamwork benefits higher than outcomes. To the extent the results are generalizable, these findings lay the foundation for facilitating meaningful patient-centered interprofessional collaboration.
authors.affiliation: Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
authors.forename: Jed D
authors.initials: JD
authors.lastname: Gonzalo
authors.forename: Ethan
authors.initials: E
authors.lastname: Kuperman
authors.forename: Erik
authors.initials: E
authors.lastname: Lehman
authors.forename: Paul
authors.initials: P
authors.lastname: Haidet
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D006801:Humans; D007388:Internal Medicine; D007400:Interprofessional Relations; D008505:Medical Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D010465:Perception; D056164:Teaching Rounds / Q000458:organization & administration*