Patient Centered Rounds
Over the past 70 years, teaching rounds in training hospitals have moved progressively from the bedside to rounding rooms.
Recent data suggests the average PGY-1 resident spends about 8 minutes per day in a room with each patient. In many instances, teaching rounds are used for aggregating and delivering data to the attending physician, with time for little else. Duty hour changes have exacerbated this problem by compressing work into tighter and tighter spaces.
As a result, traditional rounding often leaves patients and learners feeling rushed and unfulfilled, and provides role modeling at odds with the ideals of Medicine.
In 2010 we launched an initiative called Project RENEW (Revitalizing the patieNT Experience on the Wards).
The most important result of Project RENEW was the creation of our inter-professional bedside rounding teams. These teams are dynamic, fluid, and patient-centered.
Almost all of our work is done at the beside and we include the patient at the center of the experience.
In addition to making the correct medical decisions, you will learn how to fit these decisions in the context of your patient’s life.
And most importantly, you will learn how to assess and improve a patient’s sense of self efficacy. Does the patient know what is going on with his/her medical care? Do they have the knowledge and skills to care for themselves when they go home?
We don’t round the same way on every patient – the key is flexibility around a core set of principles:
1. Rounds should meet the needs of the patient AND be efficient for the medical team
2. Rounds should include an interprofessional group
3. Patients should be able to articulate what is happening to them
4. Teams should ensure the patient can safely care for him/herself at home (or if not, arrange proper caregivers)
5. Teams should ensure high quality care (maximizing the positive) and highly safe care (minimizing the negative).
Click on the links below to view a series of brief videos showing examples of our bedside rounds in action (or search UCINTMED in YouTube).
Patient Centered Rounds Overview
Providing A Safe Environment for Intern Presentations
Providing the Right Amount of Data at the Bedside
Involving Friends and Family During Bedside Rounds
Inpatient Resident Assessment: The Case for Bedside Rounds
Starting a Bedside Rounding Encounter
Presenting the Patient History at the Bedside
Performing the Physical Exam on Rounds
Presenting Labs at the Bedside
Reviewing the Assessment and Plan at the Bedside
Teachback at the Bedside
Minimizing Unfamiliar Terms at the Bedside
The Value of Interprofessional Rounds
Organizing Work after Interprofessional Rounds
University of Cincinnati Internal Medicine Project RENEW Part 1
University of Cincinnati Internal Medicine Project RENEW Part 2
University of Cincinnati Internal Medicine Project RENEW part 3