title: Cross-Disciplinary Perceptions of Structured Interprofessional Rounds in Promoting Teamwork Within an Academic Tertiary Care Obstetric Unit.
abstract: In 2005, physician and nursing leaders at Brigham and Women's Hospital initiated structured interprofessional rounds (SIPRs) on the labor and delivery (L&D) suite to improve team communication. We performed a cross-sectional analysis of providers' perceptions of SIPRs and their effectiveness in improving teamwork. We hypothesized that on average, providers would perceive SIPRs as being effective in promoting teamwork, but ratings would differ among professional groups.
  
  
  
  After a factor analysis and internal consistency assessment, a 19-item paper-based questionnaire was used to evaluate providers' perceptions using a 5-point Likert scale. Respondents included L&D nurses, midwives, obstetricians, and anesthesiologists who participate in SIPRs. The primary aim was to evaluate the providers' perceptions of SIPRs and their association with professional roles. The outcome was total response score for each provider, ranging from 19 to 95; perception of SIPRs as being effective in promoting teamwork was defined as having a total response score of >66.5 (mean score, >3.5 per question). A univariable linear regression model was performed, followed by a multivariable analysis adjusting for predictors that modified the outcome; predictors included years of professional practice, years of experience on the L&D suite, number of clinical work hours worked weekly, and principal shift assignment among nurses. The associations between these predictors and providers' perceptions were assessed as a secondary aim.
  
  
  
  A total of 234 practitioners responded (100% response rate). The mean total response score (SD) for all providers was 73.3 (9.5). After multivariable adjustment, the mean total response scores were significantly higher for obstetric providers than for anesthesia (Δ mean, 6.5, 95% CI, 0.3, 12.7 P = .036) and midwifery (Δ mean, 12.5, 95% CI, 2.0, 23.0, P = .009) providers. Providers scored significantly lower if they worked >60 clinical hours per week compared with ≤20 (Δ mean, -13.7, 95% CI, -25.3, -2.1, P = .009), 21-40 (Δ mean, -8.0, 95% CI, -15.8, -0.09, P = .049), or 41-60 hours (Δ mean, -8.1, 95% CI, -14.5, -1.7, P = .004). Duration of practice in professional role and experience on the L&D suite were not predictive of SIPRs ratings.
  
  
  
  On average, providers on the L&D suite perceive SIPRs as being effective in promoting teamwork. Perception ratings were significantly influenced by professional role and number of clinical hours worked weekly, suggesting that these factors should be explored in future research to minimize perception gaps and support a dynamic culture of interprofessional collaboration.
authors.affiliation: From the Departments of *Anesthesiology, Perioperative, and Pain Medicine; §Nursing; ‖Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts; †Harvard Medical School, Boston, Massachusetts; and ‡Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Chau
authors.forename: Mary A
authors.initials: MA
authors.lastname: Vijjeswarapu
authors.forename: Margaret
authors.initials: M
authors.lastname: Hickey
authors.forename: David
authors.initials: D
authors.lastname: Acker
authors.forename: Chuan-Chin
authors.initials: CC
authors.lastname: Huang
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Tsen
mesh_terms: D001291:Attitude of Health Personnel; D001900:Boston; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033183:Interdisciplinary Communication; D016014:Linear Models; D008505:Medical Staff, Hospital / Q000523:psychology*; D015999:Multivariate Analysis; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009775:Obstetrics and Gynecology Department, Hospital; D010348:Patient Care Team; D010465:Perception; D010561:Personnel Staffing and Scheduling; D010819:Physician's Role; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D056164:Teaching Rounds; D062606:Tertiary Care Centers; D016526:Workload; D017132:Workplace