Impact of interdisciplinary rounds in the spinal cord injury unit on relational coordination for patients with pressure injury: A pilot study

• Published in: The journal of spinal cord medicine 2019-03, Vol.42 (2), p.245-250
• Main Authors: Wu-Fienberg, Yuewei, Henzel, Mary K, Richmond, Mary Ann, Becker, Devra B
• Format: Article
• Language: English
• Subjects: Adult; Communication; Female; Health Care Surveys; Hospital Departments - organization & administration; Hospital Departments - standards; Hospitals, Veterans; Humans; Interprofessional Relations; Male; Middle Aged; Patient Care Team - organization & administration; Patient Care Team - standards; Pilot Projects; Pressure Ulcer - therapy; Process Assessment, Health Care; Spinal Cord Injuries - therapy; Teaching Rounds - organization & administration; Teaching Rounds - standards; United States; United States Department of Veterans Affairs; Work Performance - standards
• ISSN: 1079-0268; 2045-7723
• DOI: 10.1080/10790268.2018.1443418

Multiple medical specialties are often involved in the management of patients with both spinal cord injuries (SCI) and pressure injuries (PIs), sometimes leading to inadequate communication. Our Veterans Affairs (VA) hospital has an interdisciplinary team for PI patients in the SCI unit. This team conducts monthly bedside rounds and journal clubs; there is no similar team for patients with PIs outside the SCI unit. This pilot study aims to determine whether such an interdisciplinary team improves care coordination among practitioners. Survey-based study. VA hospital. Healthcare providers who participate in interdisciplinary SCI rounds and who also care for patients with PIs outside the SCI unit. Interdisciplinary rounds, including monthly bedside rounds and journal clubs with variety of specialists take place within the SCI unit. There are no similar interdisciplinary rounds for patients with PIs outside of the SCI unit. The Relational Coordination (RC) survey is a validated tool for gauging team performance. Survey results quantified relational dynamics inside and outside the SCI unit across four communication domains (frequent communication, timely communication, accurate communication, and problem-solving communication) and three relationship domains (shared knowledge, mutual respect, and shared goals). Interdisciplinary rounds in the SCI unit was associated with significantly better RC with hospitalists, surgical specialists, infectious diseases, nursing, and pharmacy. This effect was primarily due to improvements in communication domains, without significant difference in relationship domains. Interdisciplinary rounds in the SCI unit significantly improves RC in the care of PI patients.