Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.

<h4>Objective</h4>Existing observational data describing rounds in teaching hospitals are 15 years old, predate duty-hour regulations, are limited to one institution, and do not include pediatrics. We sought to evaluate the effect of medical specialty, institution, patient-census, and te...

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Autores principales:	James R Priest, Sylvia Bereknyei, Kambria Hooper, Clarence H Braddock
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/aed9e42f66cc422c8692f46e66d30307
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spelling	oai:doaj.org-article:aed9e42f66cc422c8692f46e66d303072021-12-02T20:20:38ZRelationships of the location and content of rounds to specialty, institution, patient-census, and team size.1932-620310.1371/journal.pone.0011246https://doaj.org/article/aed9e42f66cc422c8692f46e66d303072010-06-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20574534/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Existing observational data describing rounds in teaching hospitals are 15 years old, predate duty-hour regulations, are limited to one institution, and do not include pediatrics. We sought to evaluate the effect of medical specialty, institution, patient-census, and team participants upon time at the bedside and education occurring on rounds.<h4>Methods and participants</h4>Between December of 2007 and October of 2008 we performed 51 observations at Lucile Packard Children's Hospital, Seattle Children's Hospital, Stanford University Hospital, and the University of Washington Medical Center of 35 attending physicians. We recorded minutes spent on rounds in three location and seven activity categories, members of the care team, and patient-census.<h4>Results</h4>Results presented are means. Pediatric rounds had more participants (8.2 vs. 4.1 physicians, p<.001; 11.9 vs. 2.4 non-physicians, p<.001) who spent more minutes in hallways (96.9 min vs. 35.2 min, p<.001), fewer minutes at the bedside (14.6 vs. 38.2 min, p = .01) than internal medicine rounds. Multivariate regression modeling revealed that minutes at the bedside per patient was negatively associated with pediatrics (-2.77 adjusted bedside minutes; 95% CI -4.61 to -0.93; p<.001) but positively associated with the number of non-physician participants (0.12 adjusted bedside minutes per non physician participant; 95% CI 0.07 to 0.17; p = <.001). Education minutes on rounds was positively associated with the presence of an attending physician (2.70 adjusted education minutes; 95% CI 1.27 to 4.12; p<.001) and with one institution (1.39 adjusted education minutes; 95% CI 0.26 to 2.53; p = .02).<h4>Conclusions</h4>Pediatricians spent less time at the bedside on rounds than internal medicine physicians due to reasons other than patient-census or the number of participants in rounds. Compared to historical data, internal medicine rounds were spent more at the bedside engaged in patient care and communication, and less upon educational activities.James R PriestSylvia BereknyeiKambria HooperClarence H BraddockPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 5, Iss 6, p e11246 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q James R Priest Sylvia Bereknyei Kambria Hooper Clarence H Braddock Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.
description	<h4>Objective</h4>Existing observational data describing rounds in teaching hospitals are 15 years old, predate duty-hour regulations, are limited to one institution, and do not include pediatrics. We sought to evaluate the effect of medical specialty, institution, patient-census, and team participants upon time at the bedside and education occurring on rounds.<h4>Methods and participants</h4>Between December of 2007 and October of 2008 we performed 51 observations at Lucile Packard Children's Hospital, Seattle Children's Hospital, Stanford University Hospital, and the University of Washington Medical Center of 35 attending physicians. We recorded minutes spent on rounds in three location and seven activity categories, members of the care team, and patient-census.<h4>Results</h4>Results presented are means. Pediatric rounds had more participants (8.2 vs. 4.1 physicians, p<.001; 11.9 vs. 2.4 non-physicians, p<.001) who spent more minutes in hallways (96.9 min vs. 35.2 min, p<.001), fewer minutes at the bedside (14.6 vs. 38.2 min, p = .01) than internal medicine rounds. Multivariate regression modeling revealed that minutes at the bedside per patient was negatively associated with pediatrics (-2.77 adjusted bedside minutes; 95% CI -4.61 to -0.93; p<.001) but positively associated with the number of non-physician participants (0.12 adjusted bedside minutes per non physician participant; 95% CI 0.07 to 0.17; p = <.001). Education minutes on rounds was positively associated with the presence of an attending physician (2.70 adjusted education minutes; 95% CI 1.27 to 4.12; p<.001) and with one institution (1.39 adjusted education minutes; 95% CI 0.26 to 2.53; p = .02).<h4>Conclusions</h4>Pediatricians spent less time at the bedside on rounds than internal medicine physicians due to reasons other than patient-census or the number of participants in rounds. Compared to historical data, internal medicine rounds were spent more at the bedside engaged in patient care and communication, and less upon educational activities.
format	article
author	James R Priest Sylvia Bereknyei Kambria Hooper Clarence H Braddock
author_facet	James R Priest Sylvia Bereknyei Kambria Hooper Clarence H Braddock
author_sort	James R Priest
title	Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.
title_short	Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.
title_full	Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.
title_fullStr	Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.
title_full_unstemmed	Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.
title_sort	relationships of the location and content of rounds to specialty, institution, patient-census, and team size.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/aed9e42f66cc422c8692f46e66d30307
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Relationships of the location and content of rounds to specialty, institution, patient-census, and team size.

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