A systematic review of the literature on multidisciplinary rounds to design information technology
Technology Supporting Multidisciplinary Rounds (MDR)
Information tools utilized to assist with communications during MDR are key elements in coordination of care. MDR is a process of communication among the various health care disciplines charged with providing patient care. Many decisions are made during these MDR making the access of information important. Communication with those in other disciplines promotes better care coordination and management of responsibilities. A review of literature supports that information tools, especially computer based, have potential for enhancing the communication and collaborative support for the multidisciplinary treatment team.
There are many informational needs during MDR that need support such as clinical needs – test results; decision needs - up to date references for diagnostic and treatment purposes; and social and organizational needs - protocols and policies.
Information tools may assist with these many needs during rounds. Providing patient-centric information from medical records and monitoring devices. It was noted that the most wanted information from the medical record was related to medications, diagnostic test results and vital signs. Availability of such information when needed during rounds improved communication. Aiding the provider with check-off lists, a means to capture temporary notes through the use of process-oriented tools enabled the provider to manage his day-to-day activities. Use of decision-support tools showed an increase in the use of current evidence-based care information at the time care decisions were made. Various platforms including mobile wireless devices such as PDA and tablets were demonstrated to improve communications especially among the attendings and residents. Some useful tools include automatic current patient summary and status of work unit and the ability to support viewing by multiple users.
Some barriers to communication during MDR included noise and interruptions. The outcomes of MDR reviewed were clinical outcomes (mortality rate; los; prevention of complications; readmissions), efficiency, and satisfaction by both patient/family and the provider.
Computer based information tools provide current easily accessible information when and where it is needed. If designed well, information tools can be important means to achieve reliable consistent efficient communication and to support collaborative work in health care settings.