title: Attending rounds in the current era: what is and is not happening.
abstract: OBJECTIVE
  General medicine rounds by attending physicians provide the foundation for patient care and education in teaching hospitals. However, the detailed activities of these rounds in the current era are not well characterized.
  
  
  OBJECTIVE
  To describe the characteristics of attending rounds for internal medicine inpatients in a large teaching hospital system.
  
  
  METHODS
  A cross-sectional observational study of attending rounds in internal medicine. Rounds were observed directly by research assistants.
  
  
  METHODS
  Four teaching hospitals associated with a large public medical school.
  
  
  METHODS
  Fifty-six attending physicians and 279 trainees treating 807 general medicine inpatients.
  
  
  METHODS
  Duration and location of rounds, composition of teams, and frequency of 19 potential activities during rounds.
  
  
  RESULTS
  We observed 90 days of rounds. A typical rounding day consisted of 1 attending with 3 trainees visiting a median of 9 (range, 2-18 [SD, 2.9]) patients for a median of 2.0 hours (range, 25-241 [SD, 2.7] minutes). On rounds, teams most frequently discussed the patient care plan (96.7% of patients), reviewed diagnostic studies (90.7%), communicated with patients (73.4%), and discussed the medication list (68.8%). Teams infrequently discussed invasive lines or tubes (9.3%) or nursing notes (6.2%) and rarely communicated with nurses (12.0%) or taught physical examination skills (14.6%), evidence-based medicine topics (7.2%), or learner-identified topics (3.2%). Many commonly performed activities occurred infrequently at the bedside.
  
  
  CONCLUSIONS
  Most activities on attending rounds do not take place at the bedside. The teams discuss patient care plans and test results most of the time but fail to include many items that may be of significant value, including specific aspects of patient care, interprofessional communication, and learner-centered education. Future studies are needed to further assess the implications of these observations.
authors: Department of Medicine, University of Colorado Denver School of Medicine, Denver, CO 80220, USA. Chad.stickrath@va.gov
authors: Chad
authors: C
authors: Stickrath
authors: Melissa
authors: M
authors: Noble
authors: Allan
authors: A
authors: Prochazka
authors: Mel
authors: M
authors: Anderson
authors: Megan
authors: M
authors: Griffiths
authors: Jonathan
authors: J
authors: Manheim
authors: Stefan
authors: S
authors: Sillau
authors: Eva
authors: E
authors: Aagaard
mesh_terms: D003120:Colorado; D003430:Cross-Sectional Studies; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients; D007388:Internal Medicine / Q000193:education*; D008505:Medical Staff, Hospital / Q000193:education*; D010348:Patient Care Team / Q000592:standards*; D019555:Physician-Nurse Relations; D011787:Quality of Health Care; D056164:Teaching Rounds / Q000592:standards* / Q000639:trends