A systematic review on content, structure and process characteristics of interprofessional case discussions (InCaD) involving nurses in adult acute hospital care.

Abstract

This systematic review examines the content, structure, and process characteristics of interprofessional case discussions (InCaD) involving nurses in adult acute hospital care. Given the complexity of patient care and the need for enhanced interprofessional collaboration. Drawing on the structuration model of interprofessional collaboration framework, a comprehensive search was conducted in PubMed, CINAHL, Cochrane Library and PsycINFO (last search: December 2024). Studies with any type of multiprofessional case discussion were included if they described nurse´s tasks and roles. It was conducted a Level of Evidence statement. In total 42 out of 4541 studies were included. Eight types of InCaD were identified, including interprofessional bedside rounds (I(B)Rs), interdisciplinary rounds (IDRs), structured interdisciplinary bedside rounds (SIBR), and multidisciplinary team meetings (MDTM). Central contents of InCaD encompass collaborative decision-making, coordination of care, ethical reflection, and the integration of patient and family perspectives. Nurses play a pivotal role in InCaD, fulfilling tasks related to information exchange, ethical reflection, and coordination of care. However, nurses rarely assume leadership roles within InCaD. Our results reveal considerable heterogeneity in InCaD formats, theoretical foundations, and methodological approaches, no meta-analysis was feasible. While InCaD are seen as a valuable tool to improve care outcomes, further research to establish standardized frameworks and best practices is needed. These findings underscore the need for clear guidelines, nurse-led initiatives, and structured implementation strategies to optimize InCaD in clinical practice. The broad definition used may limit coherence and generalizability, and robust evidence on effectiveness remains scarce. This review provides insights for healthcare leaders, nurse educators by highlighting how the heterogeneity of InCaD formats can be harnessed as a flexible toolkit to develop context-sensitive implementation strategies, strengthen interprofessional collaboration, and ensure patient-centered, team-based care across diverse clinical settings.