Abstract 10813: Impact of Multidisciplinary Rounds in Cardiac Patients

Abstract

Introduction: A multidisciplinary care approach is the cornerstone of cardiac patient care. Multidisciplinary rounds (MDR) consisting of social workers, nutritionists, pharmacists, physical therapists, nursing and physicians systematically addressing the multifaceted components of hospital care of the cardiac patient have been implemented at many hospitals recently as an effort to increase collaboration throughout the care team and address care gaps. At this time there is little research into the impact of MDR on clinical outcomes. Hypothesis: Implementing MDR will decrease mortality, clinical complications, and length of stay (LOS) while also improving communication between ancillary staff and decreasing readmissions. Method: A single center case control study was conducted comparing Mortality Index, LOS, Clinical Complications (defined as adverse events documented during hospital stay), 30 day readmissions, and number of ancillary staff consults prior to implementation of MDR and after in patients admitted to the cardiology inpatient service at our major metropolitan academic medical center. Study duration was 34 months total with 2,695 unique hospital encounters studied. Results: Mortality Index after MDR implementation decreased from 1.179 to 0.648 and was statistically significant (p-value 0.06, CI -1.087,0.025). Average number of complications decreased by 27% (3.15 to 2.29) in response to MDR and average ancillary consults (Physical Therapy and Nutritional/Dietitian Consults) increased by 39.7% (19.75 to 27.6) and 182% (2.8 to 7.9) respectively. No significant change was observed in 30 day readmissions or LOS. Conclusion: MDR had statistically significant decrease on mortality index on cardiac patients admitted. MDR positively impacted resource utilization with appropriate consultations for ancillary services increasing. Continuation of MDR may impact LOS and readmissions over time.