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PSNet: Patient Safety Network
Journal Article

Structured interdisciplinary rounds in a medical teaching unit: improving patient safety.

O'Leary KJ, Buck R, Fligiel HM, et al. Arch Intern Med. 2011;171(7):678-684.

Interdisciplinary teamwork is a primary driver of safety culture, and lack of teamwork has been linked to poor clinical outcomes in surgery and the emergency department. Creating high-functioning teams is challenging in inpatient medicine wards, due to numerous barriers including variability in physician and nurse schedules and communication styles. This study, which built on prior work by the same authors, sought to improve interdisciplinary teamwork at a teaching hospital by creating structured, daily rounds where the entire care team discussed patients. The intervention resulted in a significant decrease in preventable adverse events compared with historical and concurrent controls. The accompanying editorial notes that the hospital where this study was conducted had several structural features that also encouraged interdisciplinary communication (such as an electronic health record), and that structured interdisciplinary rounds could have an even larger impact at hospitals lacking such features.