Enhancing patient satisfaction and experience through bedside interdisciplinary rounds: a quality improvement study

Abstract

Introduction

Interdisciplinary rounds (IDRs) involve collaborative patient care where healthcare professionals from various disciplines meet to discuss and plan patient management. In this project, bedside IDRs

were introduced at our hospital to enhance care quality, improve communication among medical teams and increase patient satisfaction.

Methodology

After educating the staff, bedside IDRs were implemented with a team consisting of hospitalists, medical residents, nurses, nurse leaders, nutritionists, case managers and social workers, who gathered at each patient’s bedside to discuss treatment plans and involve patients and their families in real-time discussions. Patient satisfaction was evaluated using Press Ganey (PG) scores over a 7-month period, comparing them with pre-implementation scores. Additionally, staff feedback on workflow and communication was gathered through pre- and postsurveys.

Results

Over 7 months, bedside IDRs led to significant improvements in patient satisfaction and physician-patient communication, as reflected in PG scores. Patients reported feeling more respected and listened to, with a greater understanding of their disease and treatment plan. Staff surveys showed notable improvements in inter-departmental communication and discharge planning effectiveness.

Discussion

Bedside IDRs improved key patient care aspects, including communication, respect and understanding of treatment plans. By involving the entire healthcare team in patient discussions, a more collaborative and patient-centred approach was fostered, leading to patients feeling heard and respected. A clearer, unified treatment plan improved patients’ understanding of their care. Despite initial coordination challenges, these were addressed with standardised scheduling. Overall, bedside IDRs resulted in better communication among providers, more comprehensive care plans, timely discharges and increased patient satisfaction, ultimately enhancing healthcare delivery.

Conclusion

Ultimately, bedside IDRs contributed to improved healthcare delivery, with positive outcomes on different aspects. These findings highlight the potential of bedside IDRs to improve the quality of care and patient satisfaction in hospital settings.

WHAT IS ALREADY KNOWN ON THIS TOPIC

• Bedside interdisciplinary rounds (IDRs) improve care coordination, but traditional non-bedside IDRs may limit patient engagement. This study examined whether bedside IDRs enhance patient satisfaction and communication.

WHAT THIS STUDY ADDS

• Bedside IDRs significantly improved patient satisfaction, treatment plan understanding and team communication while addressing implementation challenges like workflow coordination.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

• The findings support adopting bedside IDRs to enhance patient-centred care (by improving patient’s satisfaction and communication), suggesting further research on long-term impacts and scalability across healthcare settings.

Introduction

Interdisciplinary rounds (IDRs) refer to a collaborative approach to patient care, where professionals from various healthcare disciplines come together to discuss and plan patient management. The goal of these rounds is to use the expertise of different specialists and providers to ensure high-quality, coordinated and effective care.¹ The team can include a variety of healthcare professionals, such as attending physicians, residents, nurses, pharmacists, dietitians, case managers and social workers. This contrasts with other rounding methods, such as single-provider rounds, where each provider rounds independently, with communication with other healthcare staff occurring through different methods. Despite challenges like time constraints, limited patient coverage and hierarchical barriers, bedside IDRs are increasingly conducted across healthcare settings, with positive outcomes. Studies have found that bedside IDRs contribute to reductions in all-cause mortality, shorter lengths of stay, fewer readmissions and increased visits from physical therapists and nutritionists in the hospital.^{2 3} Other research has shown that IDRs can significantly reduce estimated costs, especially in critically ill patients.^{3 4} The medical experience for hospitalised patients is influenced by a variety of factors, both simple and complex. These factors include basic elements such as the quality of food, room environment, privacy and wait times, as well as more intricate aspects, such as communication quality between patients, their families and healthcare providers; the medical management plan; the holistic nature of care; and the availability of mental and social support. Thus, in our project, we implemented bedside IDRs as the primary rounding method in our hospital to improve care quality through enhancing communication within the medical team and patients and increase patient satisfaction, which would be monitored through monthly Press Ganey (PG) scores.

Methods

This project was conducted in the Department of Medicine at Monmouth Medical Center (MMC), New Jersey, USA, part of the Robert Wood Johnson Barnabas Health system. The project was overseen by the Institutional Review Board (IRB) at the research office of MMC. IRB approval was not required, as the study did not involve patients or the use of patient data. Pre-intervention data were collected between May and November 2023, while post-intervention data were collected between May and November 2024. Under the previous rounding system, hospitalists worked independently, caring for patients scattered across multiple floors throughout the hospital. To facilitate the implementation of bedside IDRs, it was essential for hospitalists to be present on a single floor during rounding times to collaborate with the rest of the team. As a result, the first step in our project involved restructuring the patient assignment system. We transitioned to a geographical distribution model, where each hospitalist was assigned to a specific floor, and nearly all medical patients on that floor were placed under their care. We educated all healthcare providers about the implementation of the new rounding method through face-to-face sessions and emails. A start date for the bedside IDRs was then established, where the hospitalist (main driver of the round), medical residents, primary nurse, nurse leader, nutritionists, case manager and social worker gathered at each patient’s bedside to discuss the case, formulate a treatment plan and review it with the patient and their family in real time and in a timely manner. This approach enabled the team to address all aspects of patient care at the bedside, providing them the opportunity to ask questions and receive immediate answers from the various team members. Throughout this process, we provided ongoing support to the medical staff and gathered feedback from them.

The PG is a widely used healthcare performance improvement tool that measures patient experience and clinical outcomes through surveys, usually sent to patients after being discharged to evaluate their hospitalisation experience. It provides hospitals with data and insights to identify areas for improvement, enhance patient satisfaction and optimise care delivery. By analysing feedback from patients and staff, PG helps healthcare organisations benchmark performance, drive quality initiatives and meet regulatory requirements. To evaluate the outcomes of implementing bedside IDRs, we monitored the PG reports for our hospital over 7 months after implementing the bedside IDRs and compared them with pre-implementation scores and reports. Additionally, we conducted brief pre- and post-online surveys to gather feedback from staff members regarding the impact of bedside IDRs on their workflow and communication.

Results

Over a period of 7 months, we observed improvements across several domains of the PG scores. First, there was a noticeable increase in the rate of physician communication with patients (figures1 2). Patients reported feeling more respected and treated with courtesy, with the percentile rising from the 27.9% before the implementation of bedside IDRs to 78.3% afterwards (figures1 2). Additionally, patients felt they were being better listened to by doctors, with improvements in this domain as well from 19.7% to 73.6% (figures1 2). Patients also indicated a clearer understanding of their disease and treatment plan, as doctors were now explaining things in ways that patients found easier to comprehend (figures1 2) (table 1). These improvements began to appear after about 1 month of implementing bedside IDRs and have been sustained as the bedside IDRs continue. Each domain increased by 52.9% on average (table 1).

Figure 1. Pre-interdisciplinary rounds (IDRs) Press Ganey (PG) scores for: (A) communication with doctors, (B) doctors treat you with courtesy/respect, (C) doctors listening carefully to you and (D) doctors explain in way you understand (May–November 2023).

Figure 2. Post-interdisciplinary rounds (IDRs) Press Ganey (PG) scores for: (A) communication with doctors, (B) doctors treat you with courtesy/respect, (C) doctors listening carefully to you and (D) doctors explain in way you understand (May–November 2024).

Table 1. Mean Press Ganey percentiles on different domains pre- and post-IDRs implementation.

Press Ganey (patient’s satisfaction) domains	Mean pre-IDRs percentile	Mean post-IDRs percentile	Absolute mean percentile difference
‘Communication with doctors’	19.4%	79.6%	+60.2
‘Doctors treat you with courtesy/respect’	27.9%	78.3%	+50.4
‘Doctors listen carefully to you’	19.7%	73.6%	+53.9
‘Doctors explain in way you understand’	26.7%	73.9%	+47.2

IDRs, interdisciplinary rounds.

In terms of staff satisfaction, comparisons of pre- and postsurveys revealed that 35% of staff reported below-average communication between healthcare providers prior to the bedside IDRs. This percentage increased to 100%, with all participants reporting improvements in interdepartmental communication after implementing bedside IDRs (figure 3). Furthermore, only 15% of staff initially felt that discharge planning was very effective, but this figure increased to 35% after bedside IDRs were implemented. Opinions on the timeliness of rounds were variable, with the majority of staff reporting that rounds only sometimes occurred on time. Staff also reported that the bedside IDRs negatively affected their workflow because of this. In response to this, we standardised the round to begin at 10:00 AM daily for all staff, which led to improved perceptions of workflow efficiency and timeliness. These changes resulted in a better patient flow, enhanced collaboration and higher satisfaction among all team members.

Figure 3. Staff assessment of communication quality between physicians, nurses, other care providers and patients before (left) and after (right) interdisciplinary rounds (IDRs) implementation.

Discussion

The medical experience for hospitalised patients is influenced by a variety of factors, both simple and complex. These factors include basic elements such as the quality of food, room environment, privacy and wait times, as well as more intricate aspects, such as communication quality between patients, their families and healthcare providers; the medical management plan; the holistic nature of care; and the availability of mental and social support. Bedside IDRs are a tool that can enhance the patient experience by addressing these more complex components of care delivery. Various methods exist to assess healthcare quality and patient satisfaction, with one of the most widely used tools being the PG score. This score offers valuable insight into patients’ perceptions of the care they receive, encompassing multiple domains such as communication, physician interactions and overall satisfaction. Each domain within the PG score is assigned a numerical value, where a score of 100 represents the highest possible level of satisfaction.

In this study, we specifically focused on domains related to physician communication and patient-physician interactions, as these are the aspects most likely to improve through the implementation of bedside IDRs. One of the most significant improvements observed was in the communication between patients and physicians. Following the introduction of bedside IDRs, patients reported a noticeable increase in their communication with healthcare providers. This enhancement can be attributed to the fact that bedside IDRs involve all members of the healthcare team, including physicians, nurses, case management, social workers and other specialists, who engage directly with the patient. During these rounds, each team member takes the time to address the patient’s questions, explain their diagnosis and treatment options and ensure that the patient’s concerns are thoroughly addressed. The increased involvement of various healthcare professionals not only improves the quality of information provided but also extends the time spent with the patient, allowing for more comprehensive discussions. This goes along with what was reported in the literature, where it was found in other studies that bedside IDRs have a positive effect on enhancing the teamwork among different care providers. It was also reported that by enhancing the teamwork and communication, patient safety improved.^{5 6}

In addition to improved communication, patients reported feeling that they were being listened to more attentively after the implementation of bedside IDRs. Traditionally, patients may feel that their concerns are not fully heard during individual provider rounds, where each physician focuses on their specific area of expertise without considering the patient’s broader perspective. In contrast, bedside IDRs involve all team members pausing to actively listen to the patient and their family, creating a more holistic and patient-centred approach to care. This inclusive process ensures that patients’ concerns are addressed in real time, with all team members contributing their expertise to offer clear, coordinated responses. The opportunity to ask follow-up questions and receive detailed answers further contributes to the patients’ sense of being understood and valued. Several studies have demonstrated that IDRs resulted in at least a twofold increase in the amount of time physicians spent with patients and their families, thus more time to listen, answer questions and to satisfy the patient needs.⁷

Another notable improvement was the patients' increased sense of being respected and treated with courtesy. During bedside IDRs, the healthcare team discusses the patient’s condition, treatment plan and progress in a collaborative manner, involving the patient in the decision-making process. This approach fosters a sense of partnership between the patient and the healthcare team, where the patient feels their input is valued. In comparison to traditional single-provider rounds, which may sometimes result in fragmented or inconsistent communication about the treatment plan, bedside IDRs promote a unified and comprehensive discussion of the patient’s care. The team’s collective input, along with the patient’s active involvement, contributes to a more personalised and respectful treatment plan, which patients appreciate.

Furthermore, patients expressed greater satisfaction with their understanding of the treatment plan. During single-provider rounds, patients often receive multiple, potentially conflicting recommendations from different healthcare providers, which can lead to confusion and uncertainty. With bedside IDRs, however, the healthcare team comes together to present a single, coherent treatment plan, ensuring that the patient receives a consistent message. This unified approach reduces the confusion often experienced with conflicting plans, leading to greater clarity for the patient. As a result, patients are more confident in their understanding of the care they will receive, which in turn increases their satisfaction with the overall care experience. Other published studies showed that bedside IDRs improved the communication between physicians and patients, where patients achieved better understanding of their disease and of the physician’s plan for them.^{8 9}

The initial implementation of bedside IDRs within a healthcare system may present several challenges. One significant hurdle encountered during the implementation phase was the coordination among various healthcare teams to ensure their availability at a mutually agreeable time for rounds. This issue was mitigated by establishing a standardised time for rounds, allowing each team member to adjust their schedule to accommodate this daily event. Over time, the feedback regarding bedside IDRs became increasingly positive. Key improvements reported included enhanced communication among healthcare providers, more comprehensive care plans, and better coordination of discharge planning.

Limitations

One of the limitations of this quality improvement project is the relatively short duration of only 7 months, which may not have been sufficient to fully assess the long-term impact and sustainability of the interventions. Additionally, the project did not evaluate other secondary outcomes, such as the effect of bedside IDRs on the cost or the potential impact on the duration of patient stay. These factors could provide valuable insights into the broader effects of the intervention.

Conclusion

In conclusion, the integration of bedside IDRs demonstrated a significant improvement on key dimensions of the patient experience, particularly in areas of communication, patient engagement, respect, clarity and understanding of treatment plans. By promoting a collaborative and coordinated care model, bedside IDRs empowered healthcare teams to address patient concerns more effectively and deliver a unified approach to care, ultimately enhancing patient satisfaction. Although initial implementation faced challenges, such as logistical coordination and resistance to change, these barriers were mitigated through standardised scheduling protocols and ongoing support. The findings underscore the value of bedside IDRs in improving healthcare delivery, evidenced by enhanced interprofessional communication, more comprehensive care planning and increased patient satisfaction. This study highlights the potential of bedside IDRs as a transformative strategy to elevate the quality of care and patient-centred outcomes in hospital settings. Further research is warranted to explore the long-term sustainability and scalability of this approach across diverse healthcare environments.

Data availability statement

Data are available upon reasonable request.