Dissecting multidisciplinary cardiac surgery rounds.
BACKGROUND
Multidisciplinary rounds in the critical care environment have demonstrated increased communication, a reduction in medical errors, a shorter hospital stay, and consequently, economic savings. We attempt to assess the cost of this intervention, and to review the time utilization of professionals participating in the process.


METHODS
We analyzed video-recorded weekly multidisciplinary teaching rounds on cardiac patients in a pediatric intensive care unit (n = 22). Rounding time was categorized as presentation or discussion and was measured in minutes. The cost of a round was calculated by multiplying the hourly salary of all healthcare professionals present by the time spent rounding and measured in US dollars.


RESULTS
Median rounding time per patient was 15 minutes (range, 5 to 29). Patient presentation took between 2 and 8 minutes (median 4), or 26% of the rounding time. Time needed for discussion, including teaching and planning, varied between 2 and 25 minutes (median 10.5). Median number of participants was 13.5 (range, 11 and 16). Mean cost in salaries per patient rounded was $140.87 (95% confidence interval: $106.80 to $174.90).


CONCLUSIONS
Multidisciplinary rounds are a low-cost medical intervention with proven benefits. Available tools and rounding cultural changes should be adopted to shorten data retrieval and presentation time to the benefit of discussion and teaching. Current billing requirements for rounding multidisciplinary teams do not reflect the realities of their time use.
Cardarelli
Marcelo
M
Department of Surgery, Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore 21201, Maryland, USA. mcard001@umaryland.edu
Vaidya
Vinay
V
Conway
Dyana
D
Jarin
Jennifer
J
Xiao
Yan
Y
D000046:Academic Medical Centers; D015142:Baltimore; D002648:Child; D003362:Cost-Benefit Analysis; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000191:economics*; D033183:Interdisciplinary Communication; D007396:Internship and Residency; D007902:Length of Stay / Q000191:economics; D019300:Medical Errors / Q000191:economics / Q000517:prevention & control; D010348:Patient Care Team / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics*; D019616:Thoracic Surgical Procedures / Q000191:economics*; D013996:Time and Motion Studies