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Objective:
To evaluate surgical multidisciplinary rounds (SMDR) as a means to improve surgical care.
Design:
SMDR was instituted in 2009. It includes members from surgery, health information systems, quality, pharmacy, nursing, and others and meets twice weekly. The group reviews patient management, clinical documentation, adherence to core measures, and other initiatives. A retrospective analysis of quality data was collected from the hospital’s databases.
Setting:
302 bed academic community hospital.
Patients:
All patients admitted to the surgery service from January 2008 to December 2011.
Interventions:
Real time changes to clinical care, documentation and programs.
Main Outcome Measures:
AHRQ patient safety data, Core measures, length of stay, complications, HCAHPS communication data.
Results:

Results

Measure	Year	2008	2009	2010	2011
SCIP All or none %		95.6	95.8	95.4	98.7	p<0.0001*
AHRQ-PO Resp failure		15.5	10.6	9.0	6.8	p=0.051*
AHRQ-PO DVT/PE		2.8	6.0	4.1	2.3	p=0.485*
Surgery ALOS (days)		6.1	6.1	5.5	5.1	p=0.007**
HCAHPS Physician Communication		76.1	82.5	80	84.2
Complication Codes/1000 admits
Respiratory Complications		11.3	6.9	4.9	3.6	p=0.003*
Urinary Complications		5.2	5.4	3.8	1.6	p=0.038*
Cardiac Complications		7.0	10.3	0.5	1.6	p=0.007*

*Two-sample percent defective t-test comparing 2008 to 2011
** Two sample t-test comparing 2008 to 2011
Conclusions:Twice weekly SMDR is an effective tool to impact quality measures and outcomes of surgical inpatients. SMDR has changed culture, improved coordination of care, and facilitated rapid and sustained process improvement. Using SMDR as part of a comprehensive quality improvement program improved core measures, reduced length of stay and complications, and improved surgical inpatients’ perception of physician communication.