Structured Interdisciplinary Bedside Rounds (SIBR)

Great hospital teams are possible — you just need the right formula

SIBR is a team-based, patient-centered teamwork model which brings the bedside nurse, physician, and any available allied health professionals to the bedside to synthesize mutually supported plans of care and discharge in an efficient, patient-centered experience.

SIBR creates the time, space, and structure for team members to concentrate on what they do best.

At its core, SIBR is a 6-step communication protocol to create a shared mental model of who says what, when, and in what sequence. This structure ensures role clarity, consistency, efficiency, and “sense-making.”

Create accountability with checklists

Cross-check data with patient, family, and staff

Identify closely held misinformation

Synthesize a mutually supported plan of care

Develop teamwork skills & communication

100% Nursing Job Satisfaction

is achievable with Structured Interdisciplinary Bedside Rounds (SIBR) led daily by unit-based physicians…

because it’s the ideal work environment for med-surg nurses.

Tools and training to hardwire great hospital teams. (Yes, we can get your docs on board.)

Safer Nursing

“SIBR makes everything safer, it’s made me a better nurse. And when doctors see what we can do, they trust us.”
-Cassie, Bedside Nurse

Support New Grads

“It’s made the new grad nurses a lot more confident… I just can’t imagine anybody doing it any other way.”
-Jennifer, Nurse Manager

Patient-Centered

“It just works really well. Everybody who was negative — they’re all on board. Patients think it’s amazing.” 
-Kathleen, Nurse Manager

Achieve certified excellence on 3 units in 3 months with SIBR

Nursing Job Satisfaction Source: Gausvik et al., 2015. Journal of Multidisciplinary Healthcare.

Explore Real Examples and Case Studies

 

No other interdisciplinary care model has been as thoroughly studied and validated.

1Unit SIBR rounds doctor and care team with patient

Voices from the Frontline

Hear from nurses, doctors, and allied health about what it’s like working on a 1Unit-implemented SIBR unit.

“Our metrics improved on every category”

– Jon, MD

“Highlight of my career”

– Nancy, Pharmacist

“What is the why for SIBR? The patient is the why!”

– Cassie, RN

Select your role to see the benefits

1Unit SIBR Rounds Patient benefits emphasis

Patients

Benefits Reported:

-Loving SIBR rounds
-Happier patients
-More engaged patients
-Opportunities to participate in decision making
-Getting questions answered
-Goal for the day discussed everyday
-Better informed, less uncertainty
-Increased family attendance at rounds with set time
-Discharge planning discussed daily

1Unit SIBR Rounds Doctor benefits emphasis

Physicians

Benefits Reported:

-Better communication with nurses and allied health
-Quicker resolution of issues
-Fewer calls, pages, and shoulder taps
-Remaining interruptions are efficient and short
-Less hectic shifts, less frustration
-Greater sense of control
-Shift usually ends on time
-Carrying less burden
-More efficient discharge coordination
-Less time calling family
-A more efficient clinical day

Nurses

Benefits Reported:

- Know when the doctor will come to see patients
- Efficient information exchange between team members
- Plan of care shared between team members
- No more guessing, no more uncertainty
- Better access and rapport with doctors
- Resolve issues and concerns efficiently
- Care team work and communicate like an actual team
- Higher job satisfaction

1Unit SIBR Rounds Allied benefits emphasis

Allied Health

Benefits Reported:

-Better integration into planning
-Better communication with physician and nurses
-Quicker identification of barriers to discharge
-Better able to support continuing care needs
-Higher work satisfaction

1Unit SIBR rounds allied health nurses advanced hospital teams

Leaders

Benefits Reported:

-More control on processes & operations
-Happier unit staff
-Happier patients and families
-Improved clinical, cost, and patient outcomes
-Decreased turnover
-More time for interpersonal relationships
-Less time on administrative duties
-Streamlines other Performance Improvement projects
-Quieter units

Watch the SIBR webinar (40 minutes, on-demand)

1Unit SIBR rounds nurse physician patient

Frequently Asked Questions

What is SIBR?

Structured Interdisciplinary Bedside Rounds (or SIBR, pronounced “cyber”) is a team-based, patient-centered teamwork model. SIBR brings the bedside nurse, physician, and any available allied health & therapy professionals to the bedside. It creates the time, space, and scaffolding for team members to:

  1. Exchange updates and collaboratively cross check information with the patient, family, and one another
  2. Re-examine assumptions and identify closely held misinformation
  3. Hold each other accountable to a quality-safety checklist
  4. Synthesize a mutually supported plan of care; and
  5. Create the common ground needed to complete interdependent tasks efficiently the rest of the day

SIBR uses a 6-step communication protocol which outlines who says what, when, and in what sequence. It is designed this way for efficiency, but also for “sense-making.” Sense-making, of course, refers to how much easier it is to make sense of a myriad of data points when listeners know and can trust they will hear the same thing in the same order every time.

For SIBR to be operationally effective, staff must learn to arrive to SIBR prepared, respect punctual start times, and adhere to the 6-step communication protocol. Because they make sense but are also not obvious, these operational norms are taught and emphasized initially through online and onsite training, then reinforced through practice until they become routine.

What is clinically effective SIBR?

Clinically effective SIBR must be high-performance SIBR. The path to high-performance SIBR starts with online and onsite training to learn individual SIBR skills and team SIBR skills. Individual SIBR skills are verified through real-time, electronic assessment and feedback of individual performance. Verification is data-driven: when an individual demonstrates 9 of 10 discrete SIBR high-performance behaviors for 3 different SIBRs, “SIBR Certification” is earned and tracked through a data and analytics software platform.

Team SIBR skills are learned through practicing “orchestration,” a unique concept taught and emphasized initially through online and onsite training, then reinforced through deliberate SIBR practice. The hallmark sign of a SIBR team practicing great orchestration is when participants routinely notice the effectiveness of each step of SIBR and interact dynamically as self-aware team members to optimize it.

High-performance SIBR requires training and self-awareness, but it drives all the gains, from throughput and cost outcomes to clinical outcomes and, patient and staff satisfaction. Just showing up to go through the motions of interdisciplinary rounds is not enough. As with any other clinical competence, expertise matters – each SIBR participant should have individual skills and teams skills.

High-performance SIBR can be tracked across key criteria and reported to unit leaders, service line directors and hospital executives using the 1Unit Software Platform.

How is Nurses First™ connected to Structured Interdisciplinary Bedside Rounds (SIBR)?

Units that have already implemented Nurses First will have their nurses optimally set up to participate in SIBR rounds. The Nurses First Bedside Handover includes the quality-safety checklist items that the nurses will be sharing during SIBR.

Nurses should leave nursing bedside handover with >90% of the information they need for each of their patients for SIBR. Our handover process thus enables bedside nurses to continue with their other key tasks during the busy morning period, yet are always ready to present or advocate for their patients during the shift.

By aligning nursing handover with the nurse’s portion of SIBR, we reduce communication errors and elevate the preparedness and presentation skills of all bedside nurses, so that nurses can be fully recognized as being the experts on their patient.

We have numerous reports of new grad nurses handing over to specialist consultants or Rapid-Response Teams/Medical Emergency Teams with confidence, composure, and clarity.

SIBR Training Process

STEP ONE
Learning

 

Brief online videos and quizzes followed up by efficient classroom training for all SIBR participants.

STEP TWO
Skills Assessments

 

Charge nurses and clinical educators use our web-app to conduct quick electronic skills assessments — providing private, objective feedback on actual bedside skills. When SIBR participants can demonstrate high-performance behaviors at the bedside, they earn their SIBR Certification.

STEP THREE
Data-driven Insights

 

Regular activity reports and performance analytics to track progress of each individual and unit, so leaders can quickly gauge progress and take action.

Accountable Care Units (ACUs)

Organizing care teams by unit creates predictability, cohesiveness, and better communication.

At its core, the ACU is about bringing people together to work together and care together.


 

An Accountable Care Unit (ACU) is a hospital unit specifically organized for operational and clinical effectiveness.

An ACU starts with Nurses First, but then goes beyond to add SIBR and a nurse-physician dyad as a co-leadership and co-management layer.

A fully developed ACU has four features:

  1. Unit-oriented physician teams: physicians able to dedicate themselves to the relationships and routines of a single unit throughout a day or week.
  2. Unit-based teamwork: nurses support each other through Nurses First and integrate with physicians through high-performance Structured Interdisciplinary Bedside Rounds (SIBR).
  3. Unit co-leaders: the nurse manager and a specified physician partner are paired in formal co-leadership roles to support staff, set high expectations, and to drive key performance indicators. This dyad receives special attention from hospital leadership, but also accepts responsibility for managing the unit’s outcomes to specific targets.
  4. Unit performance reports: the unit co-leaders have the training, performance and clinical outcomes data to share with staff and the autonomy and accountability to actively manage outcomes.

When these 4 elements are present, remarkable results are possible. See the Evidence Base section for a variety of results reported by ACUs.