Effects of interdisciplinary rounds on length of stay in a telemetry unit

Abstract

Interdisciplinary rounds (IRs) have been proposed to improve staff communication and reduce LOS. There have been no studies of IRs on an inpatient telemetry ward. Patients on a telemetry unit of a community hospital were randomly assigned to either an IR intervention or standard care. Charts were reviewed to determine LOS, patient characteristics, and indirect indices of quality of care.

Intervention: Daily work rounds, in which resident physicians, nurses, and ancillary staff meet to discuss patients on the team.

Results: 84 patients were enrolled, 42 randomized to the intervention and 42 to standard care. There was no significant difference in LOS. Indirect measures of quality of care (dietician, pharmacist, or physical therapist visit) did not differ. In a multiple linear regression model, only abnormal laboratory data, the presence of dementia, and the presence of a home health aid significantly predicted LOS.

Conclusion: IRs did not decrease LOS in a telemetry ward. Whereas a potential benefit of IRs in other settings cannot be ruled out, this study emphasizes the importance of rigorous testing of strategies to enhance the quality or reduce the costs of inpatient care.