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Cadet T, Cusimano J, McKearney S, Honaker J, O'Neal C, Taheri R, Uhley V, Zhang Y, Dreker M, Cohn JS. Describing the evidence linking interprofessional education interventions to improving the delivery of safe and effective patient care: a scoping review. J Interprof Care 2024; 38:476-485. [PMID: 38124506 PMCID: PMC11009096 DOI: 10.1080/13561820.2023.2283119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Abstract
Empirical evidence indicates that collaborative interprofessional practice leads to positive health outcomes. Further, there is an abundance of evidence examining student and/or faculty perceptions of learning or satisfaction about the interprofessional education (IPE) learning experience. However, there is a dearth of research linking IPE interventions to patient outcomes. The objective of this scoping review was to describe and summarize the evidence linking IPE interventions to the delivery of effective patient care. A three-step search strategy was utilized for this review with articles that met the following criteria: publications dated 2015-2020 using qualitative, quantitative or mixed methods; the inclusion of healthcare professionals, students, or practitioners who had experienced IPE or training that included at least two collaborators within coursework or other professional education; and at least one of ten Centers for Medicare & Medicaid Services quality measures (length of stay, medication errors, medical errors, patient satisfaction scores, medication adherence, patient and caregiver education, hospice usage, mortality, infection rates, and readmission rates). Overall, n=94 articles were identified, providing overwhelming evidence supporting a positive relationship between IPE interventions and several key quality health measures including length of stay, medical errors, patient satisfaction, patient or caregiver education, and mortality. Findings from this scoping review suggest a critical need for the development, implementation, and evaluation of IPE interventions to improve patient outcomes.
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Affiliation(s)
- Tamara Cadet
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph Cusimano
- Bernard J. Dunn School of Pharmacy, Shenandoah University, Winhester, VA, USA
| | - Shelley McKearney
- Interprofessional Education Collaborative, BS Seton Hall University, South Orange, NJ, USA
| | | | - Cynthia O'Neal
- School of Nursing, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Reza Taheri
- Pharmacy Practice Department, Chapman University, Irvine, CA, USA
| | - Virginia Uhley
- Department of Foundational Medical Studies, Department of Family Medicine and Community Health, Oakland University, Rochester, MI, USA
| | - Yingting Zhang
- Department of Medicine, Research Services Librarian Library Faculty, Robert Wood Johnson Library of the Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Margaret Dreker
- Hackensack Meridian School of Medicine, Seton Hall University, Nutley, NJ, USA
| | - Judith S Cohn
- Health Sciences Library, Information Services and Department of Health Sciences Libraries Department, George F. Smith Library of the Health Sciences, The State University of New Jersey, Newark, NJ, USA
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Buchanan CJ, Young E, Mastalerz KA. Engaging resident physicians in the design, implementation, and assessment of bedside interdisciplinary rounds. J Interprof Care 2024; 38:469-475. [PMID: 36814080 DOI: 10.1080/13561820.2023.2176471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/28/2022] [Accepted: 01/07/2023] [Indexed: 02/24/2023]
Abstract
Bedside interdisciplinary rounds (IDR) improve teamwork, communication, and collaborative culture in inpatient settings. Implementation of bedside IDR in academic settings depends on engagement from resident physicians; however, little is known about their knowledge and preferences related to bedside IDR. The goal of this program was to identify medical resident perceptions about bedside IDR and to engage resident physicians in the design, implementation, and assessment of bedside IDR in an academic setting. This is a pre-post mixed methods survey assessing resident physicians' perceptions surrounding a stakeholder-informed bedside IDR quality improvement project. Resident physicians in the University of Colorado Internal Medicine Residency Program (n = 77 pre-implementation survey responses from 179 eligible participants - response rate 43%) were recruited via e-mail to participate in surveys assessing perceptions surrounding the inclusion of interprofessional team members, timing, and preferred structure of bedside IDR. A bedside IDR structure was created based on input from resident and attending physicians, patients, nurses, care coordinators, pharmacists, social workers, and rehabilitation specialists. This rounding structure was implemented on acute care wards in June 2019 at a large academic regional VA hospital in Aurora, CO. Resident physicians were surveyed post implementation (n = 58 post-implementation responses from 141 eligible participants - response rate 41%) about interprofessional input, timing, and satisfaction with bedside IDR. The pre-implementation survey revealed several important resident needs during bedside IDR. Post-implementation survey results revealed high overall satisfaction with bedside IDR among residents, improved perceived efficiency of rounds, preserved quality of education, and value added by interprofessional input. Results also suggested areas for future improvement including timeliness of rounds and enhanced systems-based teaching. This project successfully engaged residents as stakeholders in system-level interprofessional change by incorporating their values and preferences into a bedside IDR framework.
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Affiliation(s)
- Cole J Buchanan
- Department of Internal Medicine, University of Colorado Internal Medicine Residency Program, Denver, CO, USA
| | - Eric Young
- Department of Hospital Medicine, Eastern Colorado VA Healthcare System, Aurora, CO, USA
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Katarzyna A Mastalerz
- Department of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Jenkins AM, Weber DE, Arfaa JJE, Arken A, Clark DL, Dobbs E, Lahbabi B, Myers K, Tu J, Clarke-Myers K. Using participatory research to identify actionable facilitators and barriers to effective inpatient interdisciplinary communication. J Hosp Med 2023; 18:130-138. [PMID: 36448186 DOI: 10.1002/jhm.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Communication failures occur often in the inpatient setting. Efforts to understand and improve communication often exclude patients or are siloed by discipline. OBJECTIVE We aimed to identify barriers and facilitators to effective communication within interdisciplinary inpatient internal medicine (IM) teams using a participatory research approach. DESIGN We conducted a single-center participatory mixed methods study using group-level assessment (GLA) and concept mapping to iteratively engage stakeholders. Stakeholder groups included patients/families, IM faculty, IM residents, nurses and ancillary staff, and care managers. Stakeholder-specific GLA sessions were conducted. Participants responded to prompts addressing interdisciplinary communication then worked in small groups to synthesize the qualitative data into unique ideas. A subset of each stakeholder group then sorted ideas through a concept mapping exercise. Multidimensional scaling and hierarchical cluster analysis were used to generate a concept map of the data. RESULTS Participants generated 97 unique ideas that were then sorted. The research team chose an eight-cluster concept map representing patient inclusion and engagement, processes and resources, team morale and inclusive dynamics, attitudes and behaviors, effective communication, barriers to communication, the culture of healthcare, and clear expectations. Three larger domains of patient inclusion and engagement, organizational conditions and role clarity, and team dynamics and behaviors were noted. CONCLUSION Use of a participatory research approach made it feasible to engage diverse stakeholders including patients. Our results highlight the need to identify context-specific facilitators and barriers of interdisciplinary communication. The importance of clear expectations was identified as a prioritized area to target communication improvement efforts.
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Affiliation(s)
- Ashley M Jenkins
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Danielle E Weber
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | | | | | - Danielle L Clark
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Emily Dobbs
- Department of Biology, Northern Kentucky University, Highland Heights, Kentucky, USA
| | - Betina Lahbabi
- University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Kurt Myers
- University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Jamie Tu
- University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Katherine Clarke-Myers
- Quality and Value, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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