Initial studies demonstrate that locating the majority of a physician’s patients on a designated unit (geographic rounding) can enhance physician efficiency and facilitate physician nurse communication. Further benefits can include better patient satisfaction, improved patient outcomes and streamlined hospital throughput. Literature also supports the use of multi‐disciplinary rounds to improve coordination of care and teamwork. We sought to evaluate the effects of geographic rounding for hospitalists’ patients and multi‐disciplinary rounds on coordination of care and discharge times at our academic medical center.
At our institution, we implemented geographic rounding for two non‐teaching hospitalist teams (PHS) on a designated unit of the main hospital. We determined that 80% of all PHS patients should be located on this unit. We initiated multi‐disciplinary rounds to include hospitalists, nurses, case managers, physical and occupational therapists with a goal of increasing patient discharges prior to 3pm. On a monthly basis, we tracked every aspect of the discharge process from the time orders were written to the time patients left the hospital. These discharge times were compared to those prior to project initiation. Physicians and nurses assigned to the designated unit completed a validated survey to assess their perceptions of care decisions before and 5 months after geographic rounding began.
Initial and repeat survey response of physicians and nurses were similar – 98% and 93% respectively. Of respondents, 83% were female, 55% were nurses and the majority was between ages 29‐46. 50% had community based practice experience. Matched analysis was performed on survey data finding improvements in 5 of 6 domains (p<0.05). Respondents agreed that there was better communication and coordination between physicians and nurses about patient care decisions and plans. The percentage of patient discharges prior to 3pm increased from 15% to 54%.
The initiation of geographic rounding and multi‐disciplinary rounds increased communication and coordination of patient care between physicians and nurses. With the implementation of both initiatives, we increased the percentage of patients discharged prior to 3pm.
To cite this abstract:Wise K, Kyle T, Curnell‐Pean K, Iverson P, Caton C. Impact of Geographic Rounding and Multi‐Disciplinary Rounds on Coordination of Care and Discharge Times. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 103. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/impact-of-geographic-rounding-and-multidisciplinary-rounds-on-coordination-of-care-and-discharge-times/. Accessed April 5, 2020.