Do you spend less time on patients at the end of your ward rounds?
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Do you spend less time on patients at the end of your ward rounds?
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A preliminary study has found that clinicial staff spend significantly less time with ICU patients at the end of their rounds, compared with the beginning of the rounds. The study showed that the time
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Do you spend less time on patients at the end of your ward rounds?
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Do you spend less time on patients at the end of your ward rounds?
posted at 16/2/2012 4:34 PM GMT
on bmj.com
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*Moderator*
Posts: 1436
First: 7/4/2011 Last: 17/5/2013 |
A preliminary study has found that clinicial staff spend significantly less time with ICU patients at the end of their rounds, compared with the beginning of the rounds. The study showed that the time decreased by a minute per patient in a 12 bed cardiothoracic ICU. Jones and colleagues found that rounds "did not adhere to a particular format, schedule, or structure. The order of patient visits varied substantially during the 20 days of observation, following a certain bed order on some days (clockwise or counterclockwise) and reflecting staff or attending-physician preferences on others." http://www.medpagetoday.com/MeetingCoverage/SCCM/31096 What order do you undertake a round? What order are the patients positioned in? Do you think this have any effect on their outcomes? |
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Re: Do you spend less time on patients at the end of your ward rounds?
posted at 16/2/2012 5:26 PM GMT
on bmj.com
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Posts: 26
First: 9/2/2012 Last: 12/1/2013 |
Due to some complex cases here and there, this will inevitably occur from time to time, specially with time constrains of the medical workload. Making a habit of it shows poor time keeping, poor patient management and may impact on the treatment of patients. |
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Re: Do you spend less time on patients at the end of your ward rounds?
posted at 16/2/2012 7:33 PM GMT
on bmj.com
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Posts: 1177
First: 19/4/2010 Last: 16/5/2013 |
Interesting discussion. It always seems that the patient at the end of the receiving round is the sickest person admitted that day, but perhaps that's because we always do the side rooms last? I try to start at a different point on the ward round each day, so sometimes I start in bay 1 and move around in the 'standard' way. Other times I start in the side rooms, and work backwards. Otherwise patients in bay 4 get to wait a long time to see the doctors..... Whether waiting extra time leads to a worse outcome, I don't think we can say. It smells like a registrar project to me! |
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Re: Do you spend less time on patients at the end of your ward rounds?
posted at 17/2/2012 10:33 AM GMT
on bmj.com
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Posts: 8
First: 18/2/2011 Last: 7/2/2013 |
The sister on the chest ward I worked on used to insist on switching starting points each day - you'd get in serious trouble if bay 4 was left till last again... As to whether that meant bay 4 got better or worse care - now that's seperate question ;-)
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Re: Do you spend less time on patients at the end of your ward rounds?
posted at 17/2/2012 3:55 PM GMT
on bmj.com
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Posts: 1
First: 17/2/2012 Last: 17/2/2012 |
sometimes, depends on the day of the week, number of patients, other commttments after the round(meetings, clinic...); the way to go through this is to start the round from a different direction every day.... |
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Re: Do you spend less time on patients at the end of your ward rounds?
posted at 18/2/2012 10:55 AM GMT
on bmj.com
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Posts: 59
First: 9/3/2009 Last: 9/11/2012 |
I don't know about ICU, but in a mathematical modelling exercise we did on a course recently it was clear that the only parameter that influenced bed satate and waiting times for admission was discharging patients. It was commented that the best thing for the hospital as a whole would be for clinicians always to start with those who had been in longest rather than those just admitted (and therefore sicker) - counter to what most docotrs would like to do! |
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