Interprofessional Grand Rounds: What goes around, comes around

Like many health-care organizations, Providence Healthcare has identified the importance of interprofessional education and practice as keys to the best possible patient and client care. Located in Toronto, Providence is one of Ontario’s largest rehabilitation and complex care facilities and brings together a wide spectrum of health-care professionals. Mounting evidence suggests that when health professionals work together sharing their knowledge and skills, the quality of patient care improves. Research shows that collaboration between different professionals learning from, with and about each other helps to decrease incidences of harm, improve patient flow and improves front-line staff job satisfaction. Acknowledging these positive outcomes, the interprofessional practice team at Providence embarked on a multi-year project to facilitate and encourage increased collaboration amongst care teams across the Hospital programs and services. One of the strategies initiated was the development of Interprofessional Grand Rounds.

“We launched the monthly Grand Rounds last winter the goals were to provide an opportunity for team-based interprofessional education; to improve the collaboration of care teams; and to encourage inter-unit/team education and collaboration,” explains Shawn Brady, Director, Interprofessional Practice. The ultimate aim during each session is to encourage cooperation, respect, and an understanding of the various health professions by providing the opportunity for knowledge sharing, and decision-making, which in turn helps develop the attitudes, knowledge, and skills required for interprofessional practice.

“To encourage attendance and participation we incorporate games, different forms of technology, team challenges, and icebreakers” says Shawn, “we try to create a relaxed, educational environment that’s conducive to team building.” Additionally, icebreakers and questions are used to encourage discussion and team problem solving. Occasionally lunches are offered with the support of sponsors. The Turning Point ™ clicker system is used to make the Rounds as interactive as possible for the large group size and for scoring the on-going team challenge. An award is given to the care team who has had the greatest participation and accumulated the most points throughout the year.

The feature of each Grand Rounds is a presentation from either a team or a content expert or patient. To encourage interprofessional and inter-unit education and collaboration, teams are invited to present case scenarios highlighting their successes and challenges. Content experts present on topics identified by staff as important to best practice. Recently, the staff have had the pleasure of hearing from a patient who shared his experience working with an interprofessional team at Providence.

Throughout the initiative, outcomes have been measured and feedback collected from participants. Providence’s conference centre has been packed with standing-room only for all twelve of the sessions offered to date; a significant improvement from past attempts of interprofessional sessions. There has been consistent representation from each of the clinical professions across all programs including speech language pathology; nursing; occupational therapy; physiotherapy; therapeutic recreation; registered dieticians; social work; medicine; chaplaincy; clinical ethics; and pharmacy.

When surveyed in June 2010, the top three reasons cited by staff for coming to Interprofessional Grand Rounds were: improving team work, learning something new, and having fun and competing. Seventy per cent say attendance at Grand Rounds positively influences their communication and collaboration in their teams. Satisfaction with the sessions is high with 80 per cent rating the rounds as ‘very good’ or ‘excellent’. Says Shelley Allen, Social Worker, “I love the opportunity to work together… in the Team Challenge. I’ve learned a lot about other professions through this teaching method as well.”

Participants have said they now better understand, recognize and appreciate the roles of others, respecting the contribution of each team member. All of these outcomes serve to foster an interprofessional care environment that in turn offers less fragmentation in service delivery, and a more seamless, integrated and holistic approach to care.

Implications from the findings are informing the next steps of the project, including the importance of measuring the impact of education on practice and the potential for integrating the success factors of the Grand Rounds into future education initiatives across the organization.

The concept and success of Providence Healthcare’s Interprofessional Grand Rounds has been highlighted at the annual Interprofessional Education Ontario Conference and the 2011 GTA Rehab Network Best Practices Day.