Bedside Rounding Appreciated but Not Preferred

1Yale University School of Medicine, VA CT
2 Health Care System, West Haven, CT

Meeting: Hospital Medicine 2014, March 24-27, Las Vegas, Nev.

Abstract number: 21

Background:

Bedside rounding (BR) on inpatients has decreased over time. BR has many potential benefits that include increased shared medical decision making and a better understanding of the patient’s medical problems as well as plan of care. Additionally, BR can contribute to the patient’s sense of autonomy, inclusion in care and improved patient satisfaction. We sought to determine medical residents’ attitudes regarding BR.

Methods:

An electronic and anonymous questionnaire using Qualtrics Survey Tool was emailed to all Internal Medicine house staff (HS). Response to each question was based on the Likert scale. For reporting, the positive and negative responses were grouped together. Z Test was used to determine statistical differences between responses with a p<0.05 considered significant.

Results:

66 of the 122 residents responded to the survey (54% response rate). Overall, HS feel positively about BR and are more likely to agree than disagree with the following statements (p<0.05): BR allows incorporation of patient preferences (62% vs.14%), improves patient‐friendly communication (67% vs.12%), improves oral presentation and physical examination skills (50% vs.25%), empowers patients (70% vs. 14%), allows patients to appreciate the process of medical decision making (76% vs. 14%), improves patient satisfaction (52% vs. 11%) and improves overall patient care (47% vs. 17%). The HS were more likely to disagree than agree with the following statements (p<0.05): BR compromises patient privacy (56% vs. 26%) and BR makes HS concerned about being corrected by patients (56% vs. 26%). HS were not conclusively positive about the educational value of BR (33% agree vs. 35% disagree). Similarly, no significant difference was noted about feelings of insecurity about their knowledge when being taught by attendings during BR (45% agree vs. 32% disagree). Most of the HS agreed that impediments to BR include the following (p<0.05): concern that BR takes longer time (73%) and that team communication during BR can be confusing or alarming to patients (76%). HS reported that patients prefer BR (41% vs. 20%, p<0.05) and that HS would like to see more BR (41% vs. 29%, not significant). However, when asked about their preferred site of rounding, only 20% chose the bedside, while the rest preferred a conference room (39%), hallway (27%) or a combination (14%).

Conclusions:

HS express many positive perceptions about BR, although concerns about the length of rounds and the fear of confusing or alarming the patients persist. Despite the many attributes and advantages of BR expressed in this project, more HS prefer either conference or hallway rounds over BR and are not sure about the overall educational value of bedside rounding.

To cite this abstract:

Merchant N, Federman D. Bedside Rounding Appreciated but Not Preferred. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 21. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/bedside-rounding-appreciated-but-not-preferred/. Accessed May 26, 2019.

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