Implementation of Daily Multidisciplinary Rounds on an Adult Inpatient Blood & Marrow Transplant Unit: Initial Observations and Future Plans

Abstract

Topic Significance & Study Purpose/Background/Rationale Background: Caring for patients undergoing allogeneic transplantation can require coordination from a dozen or more clinical specialties. The complex nature of this care presents important challenges for teams, especially during rounding, where lack of coordination leads to delays in service for patients. In 2018, following the successful launch of an autologous transplant program, our team recognized the need for a more coordinated care model, leading us to consider multidisciplinary rounding. Purpose To describe initial observations following multidisciplinary rounding intervention in an adult inpatient allogenic transplant unit. Methods, Intervention, & Analysis Every day, multidisciplinary rounding was divided into two parts. During the first part (staff debriefing), staff from nursing, pharmacy, transplant physicians, infectious disease, intensivists, primary care, social work, transfusion services, case management, advanced practice providers, and clinical nutrition are briefed on the patient. During part two (rounding), members of multidisciplinary team would round on the patient. Findings & Interpretation Initial observations suggest that multidisciplinary rounding has allowed for the majority of requests for clinical services to be inputted simultaneously, reducing overall time-to-service for patients and improving care coordination. In addition, by ensuring staff from all relevant disciplines are present during rounding, staff report enhanced communication, leading to development of more integrated care plans, improved provider-to-provider communication, and better outcomes. Discussion & Implications Initial findings suggest that multidisciplinary rounding may be an effective model for coordinating care delivery and enhancing provider-to-provider communication in outpatient allogenic transplant patients. Formal evaluation of these observations, including development of an instrument to measure multidisciplinary rounding outcomes, is underway now.