Great hospital teams are possible - you just need the right formula
SIBR creates the time, space, and structure for team members to concentrate on what they do best.
SIBR is designed for consistency & efficiency by structuring who says what, when, and in what sequence. SIBR has a multi-step communication protocol designed for consistency, with the same data elements in the same sequence every time.
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
What can SIBR do for your role?
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
Doctors
Benefits Reported:
-Better communication with nurses and allied health
-Quicker resolution of issues
-Fewer interruptions and pages
-Less hectic shifts
-Greater sense of control
-SIBR saves time
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
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
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
-Quieter units
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:
- Exchange updates and collaboratively cross check information with the patient, family, and one another
- Re-examine assumptions and identify closely held misinformation
- Hold each other accountable to a quality-safety checklist
- Synthesize a mutually supported plan of care; and
- 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 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.
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
Online Learning
Streamline core concept learning with brief “what to do and why” videos and quizzes. Our online learning is concise, high quality, on-demand and fully trackable.
STEP TWO
Skills Verification
Provides units with the ability to do electronic skills verification. Any user can conduct a real-time, impartial, skills assessment with a web-app and provide private, objective feedback on high-performance behaviors to verify SIBR certification.
STEP THREE
Tracking & Reporting
Gives units and executives the ability to track SIBR data every day and provides regular activity reports and performance analytics to track progress toward, and to sustain, Nurses First and SIBR. Charts and reports are provided to track performance of each individual and unit, so leaders can quickly gauge progress and take action.
Explore Real Life Examples and Case Studies
Our procedures and programs, which have been embraced by hundreds of unit-based teams around the world, provide better care more efficiently and with a more human touch.
Accountable Care Units (ACUs)
Organizing care teams by unit creates predictability, cohesiveness, and better communication.
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Client Comments and Testimonials
“Two and a half months ago that [we] implemented [our] first Accountable Care Unit… So far this system has had a very positive impact on patient care. On average patients on this unit are heading home two and a half days earlier.‘
– President and CEO
“The ACU difference is dramatic. It’s like we have twice the number of hands on deck, but we haven’t hired anyone new. We’ve just trained everyone to coordinate with each other and with greater purpose. You can see this remarkable belief here now. We know we’re delivering the care we’d want for our family members or ourselves.”
– Unit Medical Leader
“We’ve been teaching the same way for 50 years, but with this care model we now teach delivery of care. This is exactly where healthcare is heading. Staff and trainees today need to understand that prescribing a therapy is the easy part. The hard part is getting a huge, complicated system to deliver that therapy to the right patient at the right time, while being alert enough to recognize-and-respond when therapy fails or patients drift off course. Traditional hospital care does none of that. But this care model does. This is the future. This is the ‘new way’ and the ‘old way’ just looks crude and unacceptable by comparison.”
– Unit Medical Leader
“I was suspicious. It sounded too good to be true… When I started working on the ACU I felt how different it was. My days used to be filled with running from floor to floor, getting paged by worried nurses to come urgently to see a patient, flipping through patient charts trying to find that important piece of nursing information that would be key to understanding. Now I’m part of a team. And with that team I go and see the patients and listen to them and find out what are their key priorities that need to be addressed… I love my job again.”
– Unit Medical Leader
“This is more than just a Unit, this is a culture change. The other floors want to look like the [ACU]… This is the way to do it.”
– CMO
“I’m not worried about going to work anymore.”
– Nurse
“Less time in hospital, the freeing up of beds. The care is better. The communication is better.”
– Chair Regional Health Authority
“We are already seeing how physically locating these physicians in one place and the subsequent regular interactions through standardized rounding, is improving teamwork and communication among our care provider partners.”
– CMO
“To have the entire team together on the same page, if the nurse or the patient raises an issue we have the computer right there to change orders in real time.”
– Physician
“I don’t know how … we haven’t done this yet. It just makes sense. It makes sense for patient safety, and for patient advocacy. Just to have the physician there and support me as nurse, and know that he or she has my back and I can communicate face-to-face with that physician. That’s very important to patient safety.”
– Nurse
“It’s totally patient-centred… We can tell you exactly what time the doctor is going to come every day… We’re not spending all day trying to get a hold of doctors.”
– Nurse
“Strangely, the chaos in traditional hospitals is still considered normal. Leaders seem genuinely surprised by complications and delays. So many resources and hours are wasted recovering from what could’ve been prevented in the first place. Our ACU reverses all that and the difference is profound. Every hospital unit should work this way.”
– Unit Medical Leader
“Accountable care gets rid of the chaos and fosters teamwork with all people providing care and with a much improved relationship with the patient and their families. It’s so obvious to me that this is what we’re supposed to be doing.”
– Unit Medical Leader
“This is the best model for coordinating care that I’ve ever seen. Patients spend less time in the hospital, get better quicker, and don’t bounce back. Our Accountable Care Unit helped us establish a culture of safety. Now we have a unit where patients don’t die and don’t even fall.”