Interprofessional Collaboration and Patient/Family Engagement on Rounds in a Comprehensive Stroke Center: A Mixed-Methods Study

Abstract

Daily rounds provide an opportunity for interprofessional collaboration and patient/family engagement, which are critical to stroke care. As part of a quality improvement program, we conducted a baseline assessment to examine interprofessional collaboration and patient/family engagement during the current rounding process in a 12-bed comprehensive stroke center. Findings from the baseline assessment will be used to inform the development, implementation, and evaluation of a new rounding model. The baseline assessment used a mixed-methods approach with a convergent parallel design. Although observations of the current rounding process were conducted to quantitatively assess interprofessional collaboration and patient/family engagement on rounds, qualitative interviews were conducted with different stakeholders to identify strengths and weaknesses of the current rounding process, as well as suggestions for facilitating interprofessional collaboration and patient/family engagement. We observed 103 table rounds and 99 bedside rounds and conducted 30 interviews with patients, families, and clinicians. Although the current process was perceived to facilitate interprofessional collaboration, the participation of nurses and other health care professionals on rounds was inconsistent due to competing clinical duties. Good practices for engaging patients and families during bedside rounds were also performed inconsistently. These findings lead to recommendations for revising the rounding process with poststroke patients, utilizing a more interprofessional collaborative approach with focus on patient/family engagement.