title: Surgical Multidisciplinary Rounds: An Effective Tool for Comprehensive Surgical Quality Improvement.
abstract: An analysis of outcomes, quality, and survey data was carried out to evaluate the impact of surgical multidisciplinary rounds (SMDR) at a community teaching hospital. Surgical inpatients were reviewed over a 4-year period. Real-time changes to clinical care, documentation, and programs were enacted during the rounds. SMDR contributed to reductions in length of stay (6.1 to 5.1 days), postoperative respiratory failure (15.5% to 6.8%), deep venous thrombosis/pulmonary embolism (2.8% to 2.3%), cardiac complications (7.0% to 1.6%), and catheter-associated urinary tract infection (5.2% to 1.5%), and increased Surgical Care Improvement Program All-or-None compliance (95.6% to 98.7%). Additionally, SMDR increased awareness of Accreditation Council for Graduate Medical Education core competencies among surgical residents and was associated with enhanced job satisfaction among participants. Twice-weekly SMDR is an effective care paradigm that has changed culture, improved care coordination, and facilitated rapid, sustained process improvement along multiple patient safety indicators and core measures.
authors.affiliation: Berkshire Medical Center, Pittsfield, MA tcounihan@bhs1.org.
authors.forename: Timothy
authors.initials: T
authors.lastname: Counihan
authors.affiliation: Berkshire Medical Center, Pittsfield, MA.
authors.forename: Monique
authors.initials: M
authors.lastname: Gary
authors.affiliation: Berkshire Medical Center, Pittsfield, MA.
authors.forename: Enrique
authors.initials: E
authors.lastname: Lopez
authors.affiliation: Berkshire Medical Center, Pittsfield, MA.
authors.forename: Sharyl
authors.initials: S
authors.lastname: Tutela
authors.affiliation: Berkshire Medical Center, Pittsfield, MA.
authors.forename: Gray
authors.initials: G
authors.lastname: Ellrodt
authors.affiliation: Berkshire Medical Center, Pittsfield, MA.
authors.forename: Richard
authors.initials: R
authors.lastname: Glasener
mesh_terms: D001364:Awareness; D055499:Catheter-Related Infections / Q000517:prevention & control; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D011183:Postoperative Complications / Q000517:prevention & control; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative; D056164:Teaching Rounds / Q000458:organization & administration*
keywords: ACS-NSQIP; quality improvement; surgical multidisciplinary rounds