title: A time-motion study of inpatient rounds using a family-centered rounds model.
abstract: OBJECTIVE
  Family-centered rounds (FCR) have become increasingly prevalent in pediatric hospital settings. The objective of our study was to describe time use and discrete events during pediatric inpatient rounds by using a FCR model.
  
  
  METHODS
  We conducted a prospective observational study at Children's National Medical Center between September 2010 and February 2011. Investigators directly observed rounds on hospitalist and neurology services. Events were timed, and key features were recorded by using a Microsoft Access-based program. Associations with increased time spent during rounds were determined by using regression analyses.
  
  
  RESULTS
  One hundred fifty-nine rounding encounters were observed. Rounds lasted 7.9 minutes on average per patient. An average of 1.3 minutes was spent between patients during rounds. Eighty-six (54%) encounters occurred outside the patient's room, 3% of the time because of the family's request. Infectious isolation was associated with rounds occurring outside the room (P<.0001). Participation of the parent, location of rounds inside or outside the patient's room, most teaching behaviors, and interruptions were not significantly associated with increased time spent during rounds. Teaching physical examination techniques by allowing multiple trainees to examine the patient was associated with increased rounding time (P= .02).
  
  
  CONCLUSIONS
  The majority of rounds occurred outside the patient's room, yet rarely at the parent's request. Patients on infectious isolation were more likely to have rounds occur outside the patient's room. Neither parental participation nor most teaching behaviors were associated with increased time spent on rounds. These findings will enrich the evidence base needed to establish FCR best practices.
authors: The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA. pbhansal@childrensnational.org
authors: Priti
authors: P
authors: Bhansali
authors: Sarah
authors: S
authors: Birch
authors: Joyce K
authors: JK
authors: Campbell
authors: Dewesh
authors: D
authors: Agrawal
authors: Wendy
authors: W
authors: Hoffner
authors: Paul
authors: P
authors: Manicone
authors: Kyle
authors: K
authors: Shah
authors: Evelina
authors: E
authors: Krieger
authors: Mary
authors: M
authors: Ottolini
mesh_terms: D006776:Hospitals, Pediatric; D006801:Humans; D010290:Parents; D010356:Patient Isolation; D010358:Patient Participation; D010362:Patients' Rooms; D011368:Professional-Family Relations; D011446:Prospective Studies; D056164:Teaching Rounds / Q000379:methods*; D013997:Time Factors