Randomized Study of Bedside vs Hallway Rounding

Abstract

Over the last century, attending rounds have shifted away from the bedside. Despite evidence for greater patient satisfaction rates and improved nursing perception of teamwork with bedside presentations, residents and attending physicians are apprehensive of the bedside approach. There is lack of data to guide rounding practices within neurology, and therefore optimal rounding methods remain unclear. The objective of this study was to compare bedside rounding with hallway rounding on an academic neurology inpatient service and assess efficiency, trainee education, and satisfaction among patients and staff.We conducted a single-center prospective randomized study of bedside versus hallway rounding on new inpatient neurology admissions over one-week blocks. The bedside team presented patients at the bedside, while the hallway team presented patients outside of the patient’s room. We evaluated the two approaches with time-motion analysis, which investigated the rounding style’s effect on composition and timing of rounds (primary outcome), and surveys of patients, nurses, residents, and attending physicians on both teams (secondary outcomes).The mean rounding time per newly admitted patient in the bedside group (n = 38 patients) and hallway group (n = 41 patients) was 23 minutes and 23.2 minutes, respectively (p = 0.93). The bedside group spent on average 56.4% of patient rounding time in the patient’s room, while the hallway group spent 39.5% of rounding time in the patient’s room (p = 0.036). Residents perceived hallway rounding to be more efficient and associated it with a superior educational experience and more effective data review. Nurses had improved perception of their participation in bedside rounds. Though patients’ views of bedside and hallway rounds were similar, patients who had experienced bedside rounds preferred it.In conclusion, bedside rounding was perceived less favorably by most residents but was as efficient as hallway rounding. Although bedside rounding limited the use of technology for data review, it promoted nursing participation and resulted in more time spent with the patient.

Review on Comfort Nursing Interventions for Patients Undergoing Neurosurgery and General Surgery

“…It is common that elderly patients in neurology, due to the influence of illness or age, will suffer from different degrees of hemiplegia, aphasia, confusion, etc. It is clinically necessary to develop neurological care in a precise and comfortable manner to help patients recover and improve their quality of life [ 2 ]. General surgery is the largest specialty within the surgical system, and it is a clinical discipline with surgery as its primary modality of treatment.…”

Optimizing the Educational Value of Bedside Rounds by Exploring Perceptions of Internal Medicine Residents

“…2,13 Patients, however, seem to prefer bedside case presentations. 14,15 Our findings suggest that interns perceive bedside presentations as beneficial depending on how the attending structures rounds. Interns emphasized that attendings should establish explicit expectations for the content and structure of bedside presentations, encourage interns to use patient-friendly language, and avoid interrupting or correcting the presenter.…”

Education During Ward Rounds: Systematic Review

“…The themes pertaining to education in ward rounds were identified (Table 3). [22], 2018 ✓ Goodrich et al [23], 2020 ✓ Levine et al [24], 2020 ✓ Spence et al [25], 2020 ✓ Gray et al [26], 2020 ✓ Armendariz et al [27], 2021 ✓ ✓ ✓ Khan et al [28], 2021 ✓ ✓ ✓ ✓ Modak and Gray [29], 2020 ✓ Solomon et al [30], 2021 a ✓: indicates the studies incorporated the relevant theme(s) mentioned in the header.…”

“…A total of 4 studies addressed different interventions that were attempted to optimize residents’ educational experiences during ward rounds [ 15 , 23 , 26 , 30 ]. Of these, 2 studies attempted to use frameworks that involved the following four stages: planning, implementing a teaching strategy (this can involve asking questions, prompting reasoning, identifying themes, encouraging evidence-based learning, and observing), observing, and ending sessions by reinforcing learning points and participants’ understanding.…”

“…Furthermore, 2 of the 4 studies investigated the impact of changing the setting of ward rounds on residents' educational experiences [23,30]. Solomon et al [30] compared rounds conducted at patients' bedsides with hallway rounds; they found that hallway rounds were perceived to be superior in terms of efficacy and the education rendered. Moreover, Goodrich et al [23] compared hallway rounds to a novel "conference room rounding style."…”