Introducing the bowel huddle: An interprofessional approach to enhancing management of neurogenic bowel dysfunction.

Abstract

Context/objective: Neurogenic bowel dysfunction (NBD) is common after spinal cord injury (SCI) and contributes to prolonged hospitalization, reduced quality of life, and secondary complications. Interprofessional huddles may improve outcomes, safety, and staff autonomy. This study evaluated a weekly bowel huddle in an inpatient rehabilitation facility (IRF) from the perspective of frontline staff.

Design: Quality improvement initiative using a cross-sectional survey design.

Setting: Acute 29-bed IRF at a large Midwest academic medical center, with 15.7% of total patients with SCI from 2024 requiring NBD management.

Participants: Frontline staff including registered nurses and licensed occupational therapists (N = 26) caring for patients with NBD due to SCI.

Interventions: Weekly interprofessional bowel huddle for NBD management.

Outcome measures: Staff perceptions were collected using an 8-item Likert-type survey and 3 open-ended questions. Data analyses included descriptive statistics, independent-sample t-tests by timing of hire, and a framework qualitative analysis. Internal consistency reliability was evaluated using Cronbach's alpha.

Results: Internal consistency was high (α = .85) with no differences by timing of hire. Staff agreed huddles improved communication and autonomy, though post-huddle communication needed improvement. Comments highlighted better coordination, team communication, and confidence with bowel protocols.

Conclusion: An interprofessional Bowel Huddle for NBD management in patients with SCI may improve team communication, staff autonomy, and care coordination, and facilitate earlier patient and caregiver education, enhancing discharge readiness within an IRF setting.