title: A Survey of Rounding Practices in Canadian Adult Intensive Care Units.
abstract: OBJECTIVE
  To describe rounding practices in Canadian adult Intensive Care Units (ICU) and identify opportunities for improvement.
  
  
  METHODS
  Mixed methods design. Cross sectional survey of Canadian Adult ICUs (n = 180) with purposefully sampled follow-up interviews (n = 7).
  
  
  RESULTS
  Medical directors representing 111 ICUs (62%) participated in the survey. Rounding practices varied across ICUs with the majority reporting the use of interprofessional rounds (81%) that employed an open (94%) and collaborative (86%) approach, occurred at the patient's bedside (82%), and started at a standard time (79%) and standard location (56%). Most participants reported that patients (83%) and family members (67%) were welcome to attend rounds. Approximately half of ICUs (48%) used tools to facilitate rounds. Interruptions during rounds were reported to be common (i.e., ≥ 1 interruption for ≥ 50% of patients) in 46% of ICUs. Four themes were identified from qualitative analysis of participant responses to open-ended survey questions and interviews: multidisciplinarity, patient and family involvement, factors influencing productivity, and teaching and learning.
  
  
  CONCLUSIONS
  There is considerable variation in current rounding practices in Canadian medical/surgical ICUs. Opportunities exist to improve ICU rounds including ensuring the engagement of essential participants, clearly defining participant roles, establishing a standardized approach to the rounding process, minimizing interruptions, modifying the role of teaching, utilizing a structured rounding tool, and developing a metric for measuring rounding quality.
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jessalyn K
authors.initials: JK
authors.lastname: Holodinsky
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Marilynne A
authors.initials: MA
authors.lastname: Hebert
authors.affiliation: Division of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Zygun
authors.affiliation: Centre De Recherche, l'Université de Montréal, Montréal, Québec, Canada.
authors.forename: Romain
authors.initials: R
authors.lastname: Rigal
authors.affiliation: Département de Médecine d'Urgence, CHU de Québec, Québec City, Québec, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Berthelot
authors.affiliation: Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Cook
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.|Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
mesh_terms: D000328:Adult; D002170:Canada; D003430:Cross-Sectional Studies; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D010348:Patient Care Team; D056164:Teaching Rounds / Q000379:methods*