Patients’ experiences of interdisciplinary bedside rounds in Swedish wards

Background: Interdisciplinary bedside rounds (IBRs) are an important part of everyday hospital routine. IBRs promote integrated and continuous care of patients as care and treatment are discussed by caregivers from different disciplines at the bedside and information is not distorted or lost during its transition. This study aimed to explore patients’ experiences of IBRs in the Swedish context.

 

 

Approach: Exploratory descriptive design was chosen. Data were collected through one-to-one semi-structured interviews performed with 16 patients (38-83 years) from the medical and surgical department of a medium-sized hospital in southern Sweden. The interviews were analyzed with reflexive thematic analysis located in critical realism, where reality is socially dependent and explored through people’s different perceptions and experiences.

 

Results: Patients experienced IBRs as a bridge between their experiences and knowledge and healthcare professionals, which is reflected in the main theme. They can meet each other and interact if the bridge functions well or there will be no meeting and no knowledge exchange if the bridge is absent. Factors which may hinder interaction between patients and health care professionals were as follows: patients were not invited into the dialogue; experienced treated non-professionally; were surrounded by several unknown people; were not reached by given

information; experienced barriers to asking questions as well as one-way communication; felt doubt if they were told everything; and if sensitive information was shared in public.

 

The factors that contributed to well-functioning interaction and positive patients’ experiences were: if they got space in the dialogue; got support from a nurse; felt a permissive atmosphere; got comprehensive and detailed information.

All together, these factors were included in two subthemes: Feeling of togetherness versus loneliness and Getting answers or being left in limbo.

Implications: IBRs contribute to equal access to care as patients and their families are involved in discussions with multidisciplinary teams, having opportunity and time to ask questions.

 

The European healthcare system is distinctive in its accessibility and universal care coverage and Sweden is a part of it. Moreover, Sweden has promoted patient involvement in their care in legislation. Nevertheless, there are still issues with patient involvement in IBRs. This research highlights that, notwithstanding measures in legislation to strengthen the patient position and promotion of person-centred care in Sweden, patients still experienced barriers to be involved in IBRs. Knowledge of patients’ experiences of IBRs gave a possibility to look after ways to better inform patients and support them in their involvement.

 

These results show that patient involvement depends not only on patients themselves but on healthcare professionals’ teamwork and how they encourage and support patients to participate in IBRs. Therefore, structural changes in IBRs and new strategies of healthcare teamwork are needed. IBR models that are built on patients’ experiences and healthcare professionals’ perspectives aiming to support sustainable teamwork and patient involvement are needed. Such a model is planned to be created and tested in developmental work in two hospitals in Sweden.