Implementation of a Multidisciplinary Rounding Tool in a Medical Intensive Care Unit and Its Association with Rounding Efficiency and Multidisciplinary Collaboration.
- 1Department of Pharmacy, Bronson Methodist Hospital, Kalamazoo, MI 49007, USA.
- 2Department of Pharmacy, Eskenazi Health, Indianapolis, IN 46202, USA.
- 3Department of Internal Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI 49008, USA.
Abstract
Background: Multidisciplinary rounds are essential for high-quality intensive care but are frequently hindered by inconsistent team participation and logistical inefficiencies. We evaluated the associated impact of implementing a standardized multidisciplinary rounding checklist and real-time paging system on multidisciplinary team attendance, rounding efficiency, and selected clinical outcomes in the ICU. Methods: A retrospective, observational pre- and post-intervention cohort study featuring a concurrent control group was conducted at a tertiary care hospital. The study included 331 adults admitted to the medical ICU (MICU) and neurovascular critical care unit (NCCU; control). The intervention combined a standardized rounding checklist incorporating the ICU Liberation (ABCDEF) bundle and FAST HUGS BID mnemonic with a real-time paging notification system to alert team members of round start times and locations. The primary outcome was change in multidisciplinary team participation at the start and end of rounds; secondary outcomes included rounding time per patient and exploratory care-process outcomes. Results: Multidisciplinary participation at the start and conclusion of rounds significantly improved for both the MICU advanced practice provider (APP) team (p = 0.003 and p = 0.002, respectively) and the resident team (p = 0.006 and p < 0.001, respectively), while attendance in the NCCU group remained unchanged. Median rounding time per patient decreased by 20.8% (13.0 to 10.3 min, p < 0.001). In a survivor-only sensitivity analysis, the streamlined workflow decreased the median time to physical and occupational therapy consultations from 4 to 2 days (p ≤ 0.002). Invasive device stewardship significantly improved; central venous catheter utilization decreased from 58.0% to 25.0% (p < 0.001), and arterial line utilization fell from 55.0% to 26.5% (p < 0.001), with median arterial catheter duration decreasing from 5 to 3 days (p = 0.001). Conclusions: Implementing low-cost, reliable workflow standardization tools was associated with significantly improved multidisciplinary participation and shorter rounding time per patient. Favorable changes in selected care-process measures were also observed, although patient-level clinical outcomes should be interpreted as exploratory and future studies are warranted.
Related
- Sustained neurosurgical decision support through remote multidisciplinary case conferencing: A six-year LMIC-HIC collaboration.
- Arthroplasty centers logistically separated from general orthopedic departments were associated with a more successful implementation of a standardized day-case setup : A Danish cohort study of 6718 procedures from a fast-track multi-center collaboration.
- 2026 ESC Guidelines for the management of cardiovascular disease and chronic kidney disease, in collaboration with the European Renal Association (ERA): Developed by the task force on the management of cardiovascular disease and chronic kidney disease of the European Society of Cardiology (ESC)
- Association of Iron Homeostasis With One‐Year All‐Cause Mortality Among Intensive Care Unit Patients with Atrial Fibrillation: A Retrospective Study
- Association of the Vasoactive-Inotropic Score with Postoperative Intensive Care Unit Stay Following Arterial Switch Operation
BibTeX
@article{washburn2026implementation,
title = {{Implementation of a Multidisciplinary Rounding Tool in a Medical Intensive Care Unit and Its Association with Rounding Efficiency and Multidisciplinary Collaboration.}},
author = {Natalie C Washburn and Todd A Walroth and Arghyadeep Ganguly and Thomas Blostica and Akram Alnounou and Chelsea Zambrano},
journal = {Journal of clinical medicine},
year = {2026},
month = sep,
doi = {10.3390/jcm15197437},
url = {https://europepmc.org/article/MED/42881898},
note = {CC BY},
}
RIS
TY - JOUR
TI - Implementation of a Multidisciplinary Rounding Tool in a Medical Intensive Care Unit and Its Association with Rounding Efficiency and Multidisciplinary Collaboration.
AU - Natalie C Washburn
AU - Todd A Walroth
AU - Arghyadeep Ganguly
AU - Thomas Blostica
AU - Akram Alnounou
AU - Chelsea Zambrano
PY - 2026
DA - 2026/09/24
JO - Journal of clinical medicine
DO - 10.3390/jcm15197437
UR - https://europepmc.org/article/MED/42881898
AB - Background: Multidisciplinary rounds are essential for high-quality intensive care but are frequently hindered by inconsistent team participation and logistical inefficiencies. We evaluated the associated impact of implementing a standardized multidisciplinary rounding checklist and real-time paging system on multidisciplinary team attendance, rounding efficiency, and selected clinical outcomes in the ICU. Methods: A retrospective, observational pre- and post-intervention cohort study featuring a concurrent control group was conducted at a tertiary care hospital. The study included 331 adults admitted to the medical ICU (MICU) and neurovascular critical care unit (NCCU; control). The intervention combined a standardized rounding checklist incorporating the ICU Liberation (ABCDEF) bundle and FAST HUGS BID mnemonic with a real-time paging notification system to alert team members of round start times and locations. The primary outcome was change in multidisciplinary team participation at the start and end of rounds; secondary outcomes included rounding time per patient and exploratory care-process outcomes. Results: Multidisciplinary participation at the start and conclusion of rounds significantly improved for both the MICU advanced practice provider (APP) team (p = 0.003 and p = 0.002, respectively) and the resident team (p = 0.006 and p < 0.001, respectively), while attendance in the NCCU group remained unchanged. Median rounding time per patient decreased by 20.8% (13.0 to 10.3 min, p < 0.001). In a survivor-only sensitivity analysis, the streamlined workflow decreased the median time to physical and occupational therapy consultations from 4 to 2 days (p ≤ 0.002). Invasive device stewardship significantly improved; central venous catheter utilization decreased from 58.0% to 25.0% (p < 0.001), and arterial line utilization fell from 55.0% to 26.5% (p < 0.001), with median arterial catheter duration decreasing from 5 to 3 days (p = 0.001). Conclusions: Implementing low-cost, reliable workflow standardization tools was associated with significantly improved multidisciplinary participation and shorter rounding time per patient. Favorable changes in selected care-process measures were also observed, although patient-level clinical outcomes should be interpreted as exploratory and future studies are warranted.
SN - 2077-0383
ER -