Institutions that focus on patient–family centered care have seen improvements in their patient and staff satisfaction. Bedside rounding with the patient/family involved is a tool that hospitalists can use to deliver care that centers on patient and family whilst improving their efficiency.
To evaluate the effectiveness of physician led team rounds at the bedside in a hospitalist practice.
Over a 2–week period one hospitalist conducted daily bedside team rounds on two different medical floors. Family members were invited to attend by staff at the time of the patient’s admission to the unit, and a rounding time window was set 24 hours in advance. The window was between 60 and 90 minutes. The rounds included the physician, patient and family, primary or charge nurse and particular ancillary staff were invited based on needs of the patient. The rounds included clinical exam, review of the past 24 hours, goals of care, discharge planning, electronic order entry and medication reconciliation. During rounds any patient and/or family concerns were addressed by the care team. Results: The pilot included 36 different patients, with a total of 36 bedside rounds conducted. There were between 1 and 10 patients daily between the two designated units. The average rounding time was 7.3 minutes. The rounds on patients who had a family member present were 8.3 minutes and 6.2 minutes for those without. Family members were present in 42% of the rounds. There was a total of seven pages to the physician during the pilot on these patients. These pages came on four of the 14 days. This represents 71% of the days without any pages related to patients in the pilot. A total of 15 nurses participated in the pilot. 93% responded to a post survey. 87% (60% top box (TB) in a 4–point scale) felt using bedside rounds improved communication with the doctor. 87% (60% TB) felt that the bedside rounds improved their understanding of the patient’s plan of care. 73% (33% (TB) score) felt their other patients are covered when they were in rounds. 87% agreed that this rounding process improved their job satisfaction.14 of the 36 patients responded to a mailed post hospital survey for a 39% response rate. 86% (50% TB) stated that they felt like a partner in their care during bedside rounds. 79% (65% TB) felt bedside rounds helped the care team work in the same direction. 86% (65% TB) patients felt that bedside rounds created an atmosphere which included them more in the discussion. 86% (65% TB) of patients stated that they were able to ask questions and get additional information about their plan of care.
Bedside rounding with patients and family was found to be efficient and improved communication with patients and staff. This rounding method should be explored by hospitalists who seek to improve communication, patient and staff satisfaction.