& Pain Well-performed interdisciplinary rounds as a strategy to increase quality of care in the intensive care unit

Abstract Introduction An interdisciplinary round is a patient-focused communication system aimed to agree to, understand and execute the appropriate plan of care for the patient by specialists from different disciplines. In the intensive care unit, interdisciplinary rounds are increasingly recommended because ineffective interdisciplinary communication among medical teams is a leading cause of preventable patient harm and a source of ­severe­conflicts.­ In recent years, intensive care unit management and staff have conducted these interdisciplinary rounds by bringing different disciplines in the same meeting to discuss diagnosis and disease management of the intensive care unit patient. Nevertheless,­ it­proves­difficult­to­adequately­ perform these meetings, because each profession within the intensive­care­unit­has­a­unique­perspective and professional culture. Previous studies about interdisciplinary rounds were in particular survey studies, which described the differences between doctors and nurses regarding status/authority, gender, training and patient care responsibilities. We therefore developed performance improvements, based on 60 videotaped interdisciplinary rounds, literature reviews and Delphi Rounds, aimed at supporting and ­increasing­the­quality­of­­performance­ in IDRs. We discuss here the applications of these performance improvements with reference to processes within interdisciplinary rounds as a strategy for improving ICU care. Conclusion This review discusses the observation and intervention applications of performance improvements for interdisciplinary rounds. Depending on the characteristics of the intensive­ care­ unit,­ such­ as­ staffing­ level­ and open versus closed unit type, work rounds being interdisciplinary rounds in crowded hallways, or teaching obligations, the intensive care unit staff have some options to choose for which instrument(s) to apply.