The residents participate in the weekly collaborative rounds. On the otolaryngology–head and neck surgery servcie, the responsible attending meets weekly with a multidisciplinary group regarding the admitted patients. The team comprises the attending physician, the otolaryngology physician assistants, a nurse manager from the floor, the social worker, a member of speech pathology, and on occasion a member of the physical therapy team.
When the multidisciplinary team meets regularly to discuss patients, the team knows what has to happen before discharge so the patient does not have to stay in the hospital longer than necessary while tests or procedures are ordered or post-acute services are put in place. Everyone on the multidisciplinary team is aware of any psychosocial or medical issues that may pose barriers to discharge and can develop a work plan to overcome them.
The patient and family are told the anticipated discharge date up front so they do not need to scramble to arrange picking up the patient or getting the home ready at the last minute.
Collaborative rounds offer an opportunity for colleagues to get together as a team and discuss what needs to be done for each patient to make sure that the patient will be ready for discharge when the physician writes the order. They keep everyone on the team focused on what is going on with the patients and what has to happen to ensure a safe and timely discharge.
The team discusses how each individual is contributing to the care of the patient and what needs to be done from their viewpoint to assist with the patient's discharge. In these meetings tasks are delineated for each member of the team and the role of each person is clearly defined. Studies have shown that residents achieve substantial improvements in core measure knowledge, systems-based care, and communication with involved disciplines after institution of multidisciplinary rounds (e.g., O'Mahony et al.).
Our collaborative rounds offer residents a means to become immersed in patient care that can effectively teach both system and evidence-based care with continual data feedback. The residents and other hospital staff will also develop core measure practices and foster positive relationships and mutual understanding among the members of the multidisciplinary team.
