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Improving Situation Awareness and Patient Outcomes Through Interdisciplinary Rounding and Structured Communication

Cornell, Paul PhD; Townsend-Gervis, Mary MSA, RN; Vardaman, James M. PhD; Yates, Lauren MSN, RN

Journal of Nursing Administration: March 2014 - Volume 44 - Issue 3 - p 164–169
doi: 10.1097/NNA.0000000000000045

OBJECTIVE: To measure the impact of interdisciplinary rounds (IDRs) and the situation-background-assessment-recommendation (SBAR) communication protocol on staff situation awareness and patient outcomes.

BACKGROUND: Communication frequency and consistency improve speed and clarity, especially between disciplines. Daily IDR using SBAR potentially facilitates the process.

METHODS: Four patient review conditions were observed across 3 medical-surgical units of an acute care hospital: baseline, mobile (IDR only), paper-SBAR, and electronic-SBAR (IDR and SBAR). Observations occurred over a 9-month span. Review time (seconds), tools used, location, and field notes were recorded for 960 patient reviews.

RESULTS: Patient review times were significantly shorter with IDR, decreasing from 102 to 69 seconds, but SBAR did not reduce times further. One patient satisfaction index did not change, whereas the other improved slightly. Length of stay did not change.

CONCLUSION: The structure, consistency, and familiarity afforded by SBAR and IDR resulted in improved situation awareness and provided process, staff, and patient benefits.

Author Affiliations: President (Dr Cornell), Healthcare Practice Transformation, Dallas, Texas; Chief Nursing Officer (Ms Townsend-Gervis) and Advanced Nurse Clinician (Ms Yates), Baptist Memorial Healthcare, DeSoto, Mississippi; Assistant Professor (Dr Vardaman), Mississippi State University.

The authors declare no conflicts of interest.

Correspondence: Dr Cornell, HPX LLC, 3412 Parr Rd, Grapevine, TX 76051 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins