Improving teamwork: impact of structured interdisciplinary rounds on a medical teaching unit

J Gen Intern Med. 2010 Aug;25(8):826-32. doi: 10.1007/s11606-010-1345-6. Epub 2010 Apr 13.


Background: Effective collaboration and teamwork is essential in providing safe and effective hospital care. Prior research reveals deficiencies in collaboration on medical teaching units.

Objective: The aim of this study was to assess the impact of an intervention, structured inter-disciplinary rounds (SIDR), on hospital care providers' ratings of collaboration and teamwork.

Methods: The study was a controlled trial comparing an intervention medical teaching unit with a similar control unit. The intervention, SIDR, combined a structured format for communication with a forum for regular interdisciplinary meetings. We surveyed providers on each unit and asked them to rate the quality of communication and collaboration they had experienced with other disciplines using a five-point ordinal scale. We also assessed the teamwork and safety climate using a validated instrument. Multivariable regression analyses were used to assess the impact on length of stay (LOS) and cost.

Results: One hundred forty-seven of 159 (92%) eligible providers completed the survey. Although resident physicians on each unit rated the quality of communication and collaboration with nurses similarly, a greater percentage of nurses gave high ratings to the quality of collaboration with resident physicians on the intervention unit as compared to the control unit (74% vs. 44%; p = 0.02). Providers on the intervention unit rated the teamwork climate significantly higher as compared to the control unit (82.4 +/- 11.7 vs. 77.3 +/- 12.3; p = 0.01). The difference was explained by higher teamwork climate ratings on the part of nurses on the intervention unit (83.5 +/- 14.7 vs. 74.2 +/- 14.1; p = 0.005). Ratings of the safety climate were not significantly different between units. Adjusted LOS and hospital costs were not significantly different between units.

Conclusions: SIDR had a positive effect on nurses' ratings of collaboration and teamwork on a medical teaching unit. Further study is required to assess the impact of SIDR on patient safety measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chicago
  • Cooperative Behavior
  • Data Collection
  • Education, Medical / economics
  • Education, Medical / organization & administration
  • Education, Medical / statistics & numerical data*
  • Faculty, Medical / statistics & numerical data
  • Female
  • Hospitals, Teaching
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nurses / standards
  • Patient Care Team / organization & administration*
  • Patient Care Team / standards
  • Patient Care Team / statistics & numerical data
  • Physicians / standards
  • Regression Analysis
  • Schools, Medical / economics
  • Schools, Medical / organization & administration*
  • Students, Medical / statistics & numerical data
  • Surveys and Questionnaires
  • Teaching Rounds / methods*
  • Teaching Rounds / statistics & numerical data