Facilitators and Barriers for Interprofessional Rounding

A Qualitative Study

Abstract

Purpose: 

The purpose of this qualitative study was to describe the barriers and facilitators for interprofessional patient-centered rounding across 4 acute care units in a large urban hospital.

Design: 

A qualitative descriptive method that included data gathered over an 18-month period was used.

Methods: 

Three data sources were included: participant observation of rounding activities, focused meetings related to interprofessional practice, and exit interviews with key informants representing multiple professions and roles. The data were analyzed, and the findings were developed through an extensive transcription, coding, and discussion process.

Results: 

The facilitators and barriers related to the team included high versus low turnover of team membership, structured versus unstructured rounding, valuing versus skepticism about interprofessional practice, and confidence versus hesitancy about skills. Facilitator/barrier pairs related to the environment included rounding aligned versus mismatched with hospital’s mission, time for rounding versus competing demands, geographically cohorted versus distributed teams, and readiness for change and innovation versus saturation.

Conclusion: 

Factors associated with the members of the interprofessional team were important in successful implementation of interprofessional rounding. The organizational context and structure were also important. Leaders who anticipate implementing interprofessional rounding may incorporate knowledge of these facilitators and barriers into their planning process.