Explicit approach to rounds in an ICU improves communication and satisfaction of providers

Abstract

Objective: To evaluate an explicit approach to responsibilities and reporting during bedside rounds in the intensive care unit (ICU).

Design and setting: Before-after comparison in the 15-bed medical-surgical ICU in a tertiary teaching hospital.

Patients: All patients in the ICU during two 1-month periods: 2 months before and 16 months after the intervention.

Interventions: Explicit approach to clinical and educational responsibilities and to reporting assessments and plans during bedside rounds.

Measurements and results: Surveys of all ICU staff (attending physicians, residents, nurses, respiratory therapists, pharmacists, and medical students) were conducted during rounds on each patient. After the intervention, more respondents agreed that there was a long-term plan for each patient (74% vs. 53% before), that the long-term plan was clear (76% vs. 54% before), that there was structured teaching around each patient (46% vs. 30% before), that discussions other than structured teaching around each patient were useful (79% vs. 65% before), and that they were satisfied with the process and outcome of rounds (95% vs. 86% before). In contrast, slightly fewer respondents were aware of a problem list for the patients (96% vs. 99% before), and fewer residents and medical students had examined their patients before rounds (76% vs. 88% before).

Conclusions: An explicit approach to bedside rounds in an ICU improves communication and satisfaction of health care providers.