Four Ways to Improve Multidisciplinary Rounds

Four Ways to Improve Multidisciplinary Rounds

As a nurse, you know that high-quality healthcare involves so much more than the “patient/physician” relationship. All members of a patient’s healthcare team need to work in collaboration to enhance patient experience and patient outcomes.

This kind of efficient and effective collaboration simply cannot happen without appropriate communication. In fact, interdisciplinary communication is so important that a growing number of hospitals and other healthcare settings now implement multidisciplinary rounds (sometimes referred to as MDR). Research shows that multidisciplinary rounds offer several benefits to both the patients and the clinical team. You’ll get a chance to learn about these benefits shortly.

Of course, even if you can readily see the benefits of multidisciplinary rounds for your patients, this awareness isn’t always enough to make sure rounds go smoothly. Nursing shifts get incredibly busy, and taking time away from your other duties to round with the team can be hectic and stressful.

How can healthcare facilities improve multidisciplinary rounds and make sure they remain an effective and time-efficient way to boost patient care? Time to round up what the research says.

What Are Multidisciplinary Patient Rounds?

Multidisciplinary patient rounds typically include a range of individuals who represent relevant disciplines involved in a patient’s care. While the rounding process can and does vary widely between facilities (and in some cases, even within facilities, depending on the care unit or floor), team members present at rounds may include:

  • The attending physician, hospitalist, resident, and other members of the primary medical team (e.g., surgeon)
  • A registered nurse and/or charge nurse
  • Social worker and case management
  • Pharmacist
  • Quality assurance
  • Nutritionist
  • Respiratory therapist
  • Physical therapist and/or physical therapy aide
  • Occupational therapist and/or occupational therapy aide
  • Speech therapist
  • Other support staff, including clergy, certified medical translators, patient advocates, and pet therapists

Depending on the setting and situation, clinical students (e.g., nursing students, physical therapy students) may also be invited to attend. Additionally, patients and their loved ones may be invited, as well, who can provide a tremendous amount of insight for coordinating and continuing care.

Frequency and duration of rounds are also highly variable. Teams may formally round on their patients a few times per week or even once a day, sometimes for up to an hour or more. The rounds themselves may be held at the patient’s bedside, on the unit, in a conference room, or anywhere that sensitive health information can be discussed privately.

Multidisciplinary rounds can be led by any team member, but are typically run by the attending physician, resident, or nurse. During these rounds, team members usually get a chance to update the rest of the team on how the patient is progressing within their related scope of care. Topics of discussion may include the results of recent or pending medical procedures (including imaging studies and lab work), plan of care priorities, discharge plans, barriers to discharge, and goals.

Are Multidisciplinary Rounds Effective? A Look at the Literature

Of course, getting the whole team together for formal communication certainly sounds like a good idea. But, are rounds actually effective?

Overall, yes! At least according to the available literature. By enhancing communication between clinical team members, virtually everyone involved stands to benefit.

Specifically, multidisciplinary rounds in hospital settings have been shown to:

  • Improve the Quality of Patient Care: A 2003 study published in the Archives of Internal Medicine found that the rate of preventable adverse drug events dropped by nearly 80% when pharmacists were involved in patient rounds!
  • Improve Patient Outcomes: Various studies show a reduced rate of everything from central line-associated bloodstream infections to falling events.
  • Improve the Satisfaction of Clinical Team Members: For example, by boosting autonomy, job enjoyment, and team interaction/communication.
  • Reduce Healthcare Costs
  • Reduce a Patient’s Length of Stay
  • Allow the Patients And/Or Their Family Members to Be Involved: Including family members in the decision-making process at the level they choose, can help them feel more involved, increase their education and knowledge about their care, and provide them with an opportunity to ask clarifying questions.These benefits have been specifically found to occur when the rounds are truly “multidisciplinary,” meaning that every team member has the opportunity to contribute. Ultimately, current research seems to indicate the need for facilities to make an important shift from the more traditional physician-centered model.

Four Ways to Make Multidisciplinary Rounds More Effective

So, there’s good evidence to show that multidisciplinary rounds improve patient outcomes. But as you may know, not all rounds were created equal. Some multidisciplinary rounds seem to run smoothly and seamlessly. Others can seem disorganized, repetitive, or inefficient.

How can rounds be improved while still optimizing patient care and respecting the team members’ time and productivity? These four tips can help:

1. Begin at a Set, Agreed-Upon Time and Location

While there’s truly no “one-size-fits-all” approach to rounding, having a scheduled and expected start time is generally considered best practice. This keeps things timely and ensures that all necessary team members are present since they’ll know when they will be needed.

2. Systemize Team Input

Establish an order for when each team member speaks or has the opportunity to speak, if necessary. This greatly streamlines rounds and reduces the risk of tangential conversation and lapses in communication. In the experience of this article’s author, for example, team members during intensive care unit rounds speak in the following order: attending physician, nurse, respiratory therapist, occupational or physical therapist, pharmacist, nutritionist, quality assurance, and case management. Remember that the chief perspective during rounds is relatively “big picture.” If a patient, family member, or another member of the team has specific questions that require a more in-depth conversation, these questions should be addressed after, not during, rounds.

3. Stay professional

Put those active listening skills to use—pay attention, don’t interrupt, ask clarifying questions as appropriate, mute your cell phone, and don’t have side conversations with other team members, especially while another person is talking. If the patient is present, make sure he or she is treated with dignity and can meaningfully participate to the best of their ability—mute the television, ensure they are properly clothed or covered with linens, talk to them rather than about them, and do whatever else is appropriate to make them feel comfortable and able to join in.

4. Keep the Goals in Mind

The ultimate questions that should be answered during rounds include: 1) Why is the patient here? 2) Why is the patient still here? 3) What needs to happen before the patient can be discharged? and 4) Where will the patient be going, and are there any barriers to getting them there? Every team member is responsible for understanding their unique role and expectations and should be prepared to provide the minimum effective amount of information to support the teams’ overall goals.


There’s no question that multidisciplinary patient rounds are an essential component of high-quality healthcare. As a nurse, your role is particularly valuable because you spend so much intimate time with the patient and his or her family members. Know that you are a key member of the interdisciplinary team and that your input can make a dramatic difference in a patient’s plan of care and overall outcomes.

Are you a regular part of patient care rounds at your facility? Share these pointers with your team so you, your fellow staff members, and your patients can get the most out of this cost-effective and value-based strategy.

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