title: Standardized Attending Rounds to Improve the Patient Experience: A Pragmatic Cluster Randomized Controlled Trial.
abstract: At academic medical centers, attending rounds (AR) serve to coordinate patient care and educate trainees, yet variably involve patients.
  
  
  
  To determine the impact of standardized bedside AR on patient satisfaction with rounds.
  
  
  
  Cluster randomized controlled trial.
  
  
  
  500-bed urban, quaternary care hospital.
  
  
  
  1200 patients admitted to the medicine service.
  
  
  
  Teams in the intervention arm received training to adhere to 5 AR practices: 1) pre-rounds huddle; 2) bedside rounds; 3) nurse integration; 4) real-time order entry; 5) whiteboard updates. Control arm teams continued usual rounding practices.
  
  
  
  Trained observers audited rounds to assess adherence to recommended AR practices and surveyed patients following AR. The primary outcome was patient satisfaction with AR. Secondary outcomes were perceived and actual AR duration, and attending and trainee satisfaction.
  
  
  
  We observed 241 (70.1%) and 264 (76.7%) AR in the intervention and control arms, respectively, which included 1855 and 1903 patient rounding encounters. Using a 5-point Likert scale, patients in the intervention arm reported increased satisfaction with AR (4.49 vs 4.25; P = 0.01) and felt more cared for by their medicine team (4.54 vs 4.36; P = 0.03). Although the intervention shortened the duration of AR by 8 minutes on average (143 vs 151 minutes; P = 0.052), trainees perceived intervention AR as lasting longer and reported lower satisfaction with intervention AR.
  
  
  
  Medicine teams can adopt a standardized, patient-centered, time-saving rounding model that leads to increased patient satisfaction with AR and the perception that patients are more cared for by their medicine team. Journal of Hospital Medicine 2017;12:143-149.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Monash
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Nader
authors.initials: N
authors.lastname: Najafi
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Mourad
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Alvin
authors.initials: A
authors.lastname: Rajkomar
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Sumant R
authors.initials: SR
authors.lastname: Ranji
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Fang
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Glass
authors.affiliation: Kaiser Permanente Medical Center, Oakland, CA, USA.
authors.forename: Dimiter
authors.initials: D
authors.lastname: Milev
authors.affiliation: California Pacific Medical Center, San Francisco, CA, USA.
authors.forename: Yile
authors.initials: Y
authors.lastname: Ding
authors.affiliation: University of California, Berkeley, Berkeley, CA, USA.
authors.forename: Andy
authors.initials: A
authors.lastname: Shen
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Sharpe
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Harrison
mesh_terms: D000046:Academic Medical Centers / Q000379:methods / Q000592:standards*; D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000592:standards*; D017060:Patient Satisfaction; D056164:Teaching Rounds / Q000379:methods / Q000592:standards*