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. 2022 Aug 4;22(1):600.
doi: 10.1186/s12909-022-03599-x.

NET Rounding: a novel approach to efficient and effective rounds for the modern clinical learning environment

Shirley J Chan  1 , Hannah L Archibald  1 , Stephanie M Conner  2
Affiliations

NET Rounding: a novel approach to efficient and effective rounds for the modern clinical learning environment

Shirley J Chan et al. BMC Med Educ. .

Abstract

Background: Rounds are a foundational practice in patient care and education in the inpatient healthcare environment, but increased demands on inpatient teams have led to dissatisfaction with inefficient, ineffective rounds. In this study, we describe the design, implementation, and evaluation of a novel rounding framework ("NET Rounding") that provides behaviorally-based strategies to inpatient teams to achieve efficient rounds while preserving patient safety and education.

Methods: NET Rounding consists of nine recommendations divided into three categories: Novel rounding strategies, shared Expectations, and Time management. This framework was introduced as a bundled intervention at a single-site, quaternary-care, academic hospital from March-May 2021. Eighty-three residents and 64 attendings rotated on the inpatient teaching service during the intervention period. Participants were surveyed before, during, and after their rotation about rounding's contribution to educational value, patient safety, resident duty hour violations and rotation experience. Additionally, rounding duration was recorded daily by team attendings.

Results: Thirty-two residents (38.5%) and 45 attendings (70%) completed post-intervention surveys. Rounding duration was recorded on 529/626 rounding days (80.6%) and resulted in achieving efficient rounds on 412/529 days (77.9%). Residents reported improvement in perceived patient safety (54 to 84%, p = 0.0131) and educational value of rounds (38 to 69%, p = 0.0213) due to NET Rounding; no change was observed amongst attendings in these areas (79 to 84% and 70 to 80%, p = 0.7083 and 0.4237, respectively). Overall, 29/32 residents (91%) and 33/45 attendings (73%) reported a positive impact on rotation experience.

Conclusions: NET Rounding enabled inpatient teaching teams to complete rounds more efficiently while preserving patient safety and education.

Keywords: Clinical education; Efficiency; Patient safety; Resident work hours; Rounding.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Percent achievement of daily rounding time goal by team and month
See this image and copyright information in PMC

References

    1. Linfors EW, Neelon FA. Sounding boards: the case of bedside rounds. N Engl J Med. 1980;303(21):1230–1233. doi: 10.1056/NEJM198011203032110. - DOI - PubMed
    1. Clay-Williams R, Plumb J, Luscombe GM, et al. Improving teamwork and patient outcomes with daily structured interdisciplinary bedside rounds: a multimethod evaluation. J Hosp Med. 2018;13(5):311–317. doi: 10.12788/jhm.2850. - DOI - PubMed
    1. Rabinowitz R, Farnan J, Hulland O, et al. Rounds Today: A Qualitative Study of Internal Medicine and Pediatrics Resident Perceptions. J Grad Med Educ. 2016;8(4):523–531. doi: 10.4300/JGME-D-15-00106.1. - DOI - PMC - PubMed
    1. Stickrath C, Noble M, Prochazka A, et al. Attending rounds in the current era: what is and is not happening. JAMA Intern Med. 2013;173(12):1084–1089. doi: 10.1001/jamainternmed.2013.6041. - DOI - PubMed
    1. Miller M, Johnson B, Greene HL, Baier M, Nowlin S. An observational study of attending rounds. J Gen Intern Med. 1992;7(6):646–648. doi: 10.1007/BF02599208. - DOI - PubMed