At the University of New Mexico Hospital inpatients with cystic fibrosis were previously admitted to the on‐call general medicine ward team. The team would round on these patients on their own, often with the attending physician and intern rounding separately, and await recommendations from the pulmonary/cystic fibrosis team later in the day. Because the care plan was protocol driven and primarily directed by specialists, medicine teams often felt that they did not participate in clinical decision making, received little educational value and that patients often felt they were superfluous.
Our goal was to create a new rounding and patient care system for inpatients with cystic fibrosis as part of creation of a new medical team at UNMH in order to improve patient care, education and ease of practice in caring for these patients.
In June 2013, we created a new medical team as part of a re‐design of our ward system. This team is made up of 2 interns and an attending physician. Their responsibilities include ER triage, providing medical consultations, and being the primary service for inpatients with cystic fibrosis. Since all inpatients with cystic fibrosis were now on a single team, we devised a system to have simultaneous rounding with the pulmonary/cystic fibrosis team. The intern presents the patients to the pulmonary and primary teams, the plan of care is discussed, and the patient is seen by both services concurrently. We sought to evaluate provider perceptions of patient care, education and ease of practice by administering a survey asking them to compare this model to our previous system. Hospitalist faculty (n=9) who had rotated on this service were asked to rate various aspects of care on a 1 to 5 scale, 1 representing significantly worse, 3 representing no change, and 5 representing significantly better compared to the old system. All categories were rated to be an improvement on the previous system with the exception of convenience in rounding:
|Overall patient care||3.89||0.74|
|Perceived patient satisfaction||3.75||0.66|
|Amount of teaching on rounds||3.86||0.93|
|Quality of teaching on rounds||3.86||0.93|
|Confidence in caring for CF patients||4||0.94|
|Satisfaction in caring for CF patients||3.89||1.29|
|Ease of practice||4||1.05|
|Convenience of rounding system||2.78||1.03|
|Frequency of delays in treatment or miscommunication||3.67||0.94|
|Quality of communication between services||3.80||1.20|
|Attendance on multidisciplinary rounds||4||1.05|
Simultaneous rounding with the pulmonary/CF team improved provider perceptions of patient care, education, patient satisfaction and ease of practice with a trade‐off of a slightly less convenient rounding system for the medicine team. This model may be applicable to other highly specialized patient populations such as cancer patients or patients with HIV/AIDS. Future directions include evaluation of patient care measures (i.e. glycemic control, length of stay, etc.) and a direct evaluation of patient’s perceptions of this rounding system.
To cite this abstract:Montanaro M, Rendon P. Simultaneous Rounding with Subspecialist Team Improves Perceived Patient Care, Education and Provider Satisfaction for Inpatients with Cystic Fibrosis. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 196. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/simultaneous-rounding-with-subspecialist-team-improves-perceived-patient-care-education-and-provider-satisfaction-for-inpatients-with-cystic-fibrosis/. Accessed April 1, 2020.