The Ecology Of The Hospitalist-Led Round: Examining The Effects Of Dual Vs. Individual Rounding Type On Patient Outcomes And Communication Processes
While considerable research has been done on Multi-Disciplinary Rounds, this research has not focused on Dual Rounds conducted by the Hospitalist and RN, specifically. This study explored the effects of Dual Rounding versus Hospitalist-led Individual Rounding on patient outcomes and communication processes between healthcare team members. An organizational ecological approach was used to further understand the relationships and interdependencies between rounding type, patient outcome and communication processes; as well as the physical layout, available information and technologies, and organizational culture. Four data collection methods were used: patient outcome measures for overall length and cost of stay, complications in care, and patient satisfaction scores; observation of communication patterns for interaction type, duration, location, and person with whom they are interacting; and informal interviews to supplement and illustrate key themes found during the observation period. Patient outcome data was not adequately reliable for analysis. Observation data showed that Dual Rounds were associated with slight, but meaningful differences in communication patterns when compared to Hospitalist-led Individual Rounds. Additionally, discussions surrounding Dual Rounding activities served as a means for explicit and implicit relationship building between healthcare team members. During daily activities, Hospitalists and RNs spent the most time interacting with no one, pursuing charting, documentation, and computer-based activities. Of all interactions with other healthcare team members; Hospitalists spent the most time interacting with other Hospitalists and MDs, and RNS with other RNs. This finding suggests that the physical design of the unit should promote informal, opportunistic communication via visual accessibility and neutral zones for computer-based work.
patient rounding; rounding; multidisciplinary rounding; hospitalist; communication; MD RN interactions
Becker, Franklin David
Sonnenstuhl, William James
Master of Science
dissertation or thesis
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