Surgical Multidisciplinary Rounds: An Effective Tool for Comprehensive Surgical Quality Improvement

Am J Med Qual. Jan-Feb 2016;31(1):31-7. doi: 10.1177/1062860614549761. Epub 2014 Sep 10.

Abstract

An analysis of outcomes, quality, and survey data was carried out to evaluate the impact of surgical multidisciplinary rounds (SMDR) at a community teaching hospital. Surgical inpatients were reviewed over a 4-year period. Real-time changes to clinical care, documentation, and programs were enacted during the rounds. SMDR contributed to reductions in length of stay (6.1 to 5.1 days), postoperative respiratory failure (15.5% to 6.8%), deep venous thrombosis/pulmonary embolism (2.8% to 2.3%), cardiac complications (7.0% to 1.6%), and catheter-associated urinary tract infection (5.2% to 1.5%), and increased Surgical Care Improvement Program All-or-None compliance (95.6% to 98.7%). Additionally, SMDR increased awareness of Accreditation Council for Graduate Medical Education core competencies among surgical residents and was associated with enhanced job satisfaction among participants. Twice-weekly SMDR is an effective care paradigm that has changed culture, improved care coordination, and facilitated rapid, sustained process improvement along multiple patient safety indicators and core measures.

Keywords: ACS-NSQIP; quality improvement; surgical multidisciplinary rounds.

MeSH terms

  • Awareness
  • Catheter-Related Infections / prevention & control
  • Hospitals, Teaching / organization & administration
  • Humans
  • Patient Care Team / organization & administration*
  • Postoperative Complications / prevention & control
  • Quality Assurance, Health Care / organization & administration
  • Quality Improvement / organization & administration*
  • Quality Indicators, Health Care / statistics & numerical data
  • Surgical Procedures, Operative*
  • Teaching Rounds / organization & administration*