relationships of the location and content of rounds to specialty, institution, patient-census, and team size轮的位置和内容的关系专业,机构,但是病人,团队规模.pdfVIP

Relationships of the Location and Content of Rounds to Specialty, Institution, Patient-Census, and Team Size 1,2 3 3 3 James R. Priest *, Sylvia Bereknyei , Kambria Hooper , Clarence H. Braddock III 1 Seattle Children’s Hospital, Seattle, Washington, United States of America, 2 Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, United States of America, 3 Department of General Internal Medicine, Stanford University School of Medicine, Stanford, California, United States of America Abstract Objective: Existing observational data describing rounds in teaching hospitals are 15 years old, predate duty-hour regulations, are limited to one institution, and do not include pediatrics. We sought to evaluate the effect of medical specialty, institution, patient-census, and team participants upon time at the bedside and education occurring on rounds. Methods and Participants: Between December of 2007 and October of 2008 we performed 51 observations at Lucile Packard Children’s Hospital, Seattle Children’s Hospital, Stanford University Hospital, and the University of Washington Medical Center of 35 attending physicians. We recorded minutes spent on rounds in three location and seven activity categories, members of the care team, and patient-census. Results: Results presented are means. Pediatric rounds had more participants (8.2 vs. 4.1 physicians, p ,.001; 11.9 vs. 2.4 non-physicians, p ,.001) who spent more minutes in hallways (96.9 min vs. 35.2 min, p ,.001), fewer minutes at the bedside (14.6 vs. 38.2 min, p = .01) than internal medicine rounds. Multivariate regression modeling revealed that minutes at the bedsi