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.

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.

There are many obvious benefits of SIBR rounds for physicians:

1. optimizing shared time with the rest of the care team,
2. dedicated time to discuss questions about the care plan each day, so fewer interruptions outside of rounds
3. ensuring the team, patient and family are on the same page, working towards the shared plan for the day and for discharge
4. easier to delegate tasks to team members
5. fewer follow-up questions from patients & family

We also see several less-obvious benefits of SIBR rounds for physicians:

1. Improved interprofessional collaboration, relationships and engagement
2. Reductions in harm events
3. Improved patient satisfaction, resulting in less patient frustration
4. Reductions in cost of care

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.