Explicit approach to rounds in an ICU improves communication and satisfaction of providers.
OBJECTIVE
To evaluate an explicit approach to responsibilities and reporting during bedside rounds in the intensive care unit (ICU).


METHODS
Before-after comparison in the 15-bed medical-surgical ICU in a tertiary teaching hospital.


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


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


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.
Dodek
Peter M
PM
Program in Critical Care Medicine, St. Paul's Hospital and University of British Columbia, 1081 Burrard Street, Vancouver, B.C., V6Z 1Y6, Canada. pedodek@interchange.ubc.ca
Raboud
Janet
J
D001955:British Columbia; D019538:Health Care Surveys; D006801:Humans; D007325:Institutional Practice / Q000458:organization & administration*; D007362:Intensive Care Units / Q000458:organization & administration*; D007396:Internship and Residency / Q000458:organization & administration; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008505:Medical Staff, Hospital / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000458:organization & administration; D015279:Organizational Culture; D012139:Respiratory Therapy Department, Hospital / Q000458:organization & administration