Date of Award


Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chair

Mark Reynolds


Communication in medicine, Nurse-physician joint practice, Outcome assessment (Medical care)


Interprofessional communication supports collaboration, discussion, and timely interventions to reduce occurrences of adverse patient events, such as dissatisfaction with care or increased facility readmission rates. Elevated facility readmissions above the national benchmark and reduced patient satisfaction as seen on the Centers for Medicare and Medicaid’s (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey increase risk of CMS reimbursement loss, potentially impacting the institution’s financial bottom line. Implementation of a nurse leader-physician bedside rounding protocol was initiated on a 34-bed medical-surgical unit at an academic-medical center in the Southeastern United States. Five internal medicine teams participated in bedside rounds with a nurse leader each day on new admissions utilizing the structured PATIENT rounding tool for 30 days. Calculation of rounding adherence, unit-specific readmission rates, and unit-specific HCAHPS scores in nursing communication and physician communication was completed. During the 30-day implementation period, nurses and physicians completed combined bedside rounds on 104 out of 118 eligible patients, demonstrating an adherence rate of 88.14% to the protocol. The 30-day all-cause unit-specific readmission rate during the implementation period was 18.62%, 1.72% above the three-month baseline average (p=0.668). The unit-specific HCAHPS score in nursing communication was 76.75% during implementation, a 1.95% increase in satisfaction when compared to the three-month baseline (p=0.9158). The unit-specific HCAHPS score in physician communication was 78.15%, a 1.52% increase in satisfaction when compared to the three-month baseline (p=0.9290). Incorporation of a nurse leader-physician bedside rounding protocol improves interprofessional collaboration and communication that has the potential to positively impact patient outcomes. Despite improvement in patient satisfaction on HCAHPS with nursing and physician communication and an increase in unit-specific readmissions during the implementation period, neither were statistically significant. A longer implementation and evaluation period and inclusion of all medical specialties in the protocol should demonstrate greater improvement and statistical significance.



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