Nurse-Physician Communication During Interdisciplinary Team Rounding: An Observational Study in Internal Medicine

Dhwani Krishnan,1 Anna Dermenchyan,2 Wendy Simon,2 Caitlin Chen,1 Sitaram Vangala,3 Erin P Dowling2 1The Healthcare Improvement & Innovation in Quality (THINQ) Collaborative, Department of Medicine, UCLA Health, University of California, Los Angeles, CA, USA; 2Department of Medicine Quality, UCLA Health, Los Angeles, CA, USA; 3Department of Medicine Statistics Core, UCLA Health, Los Angeles, CA, USACorrespondence: Erin P Dowling, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Los Angeles, CA, 90095, USA, Tel +1 310-267-9643, Email [email protected]: Interdisciplinary team rounding improves communication in hospital settings by bringing together multiple disciplines to collaborate on a patient’s plan of care. While prior research has demonstrated the benefits, the relationship between time spent at the bedside and the delivery of key clinical content remains less understood. This study examined whether physician bedside rounding time and nurse-physician interaction time influenced discussions of care plan elements and engagement of care team members.Methods: We conducted an observational descriptive study at a quaternary academic medical center. Using a standardized observation tool, trained student observers recorded data from a sample of 1007 patient encounters during morning internal medicine rounds. Logistic regression was used to assess associations between bedside rounding time, nurse-physician interaction time, and discussions of the plan of the day, overall hospitalization goals, and anticipated discharge, as well as nurse and patient/family involvement.Results: Of the 1007 encounters, 64.7% (n=652) included a nurse-physician interaction, with a mean interaction time of 6.1 minutes (SD=4.8). Longer bedside rounding time increased the likelihood of discussions about hospitalization goals (OR=1.60, 95% CI: 1.09– 2.54) and anticipated discharge (OR=1.25, 95% CI: 1.02– 1.54). Longer nurse-physician interaction time significantly increased the likelihood of nurse involvement across all three discussion topics and was also associated with greater patient/family engagement.Conclusion: Longer bedside rounding and structured nurse-physician interaction both enhanced communication during rounds. Nurse-physician interaction time was the stronger predictor of inclusive discussions, underscoring the importance of structured approaches to engage nurses in interdisciplinary rounding.Keywords: interdisciplinary communication, patient care team, physician-nurse relations, teaching rounds