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Original article

Vol. 152 No. 0304 (2022)

Perception of physicians and nursing staff members regarding outside versus bedside ward rounds: ancillary analysis of the randomised BEDSIDE-OUTSIDE trial

  • Sebastian Gross
  • Katharina Beck
  • Christoph Becker
  • Martina Gamp
  • Jonas Mueller
  • Nina Loretz
  • Simon A. Amacher
  • Chantal Bohren
  • Jens Gaab
  • Philipp Schuetz
  • Beat Mueller
  • Christoph A. Fux
  • Jörg D. Leuppi
  • Rainer Schaefert
  • Wolf Langewitz
  • Marten Trendelenburg
  • Tobias Breidthardt
  • Jens Eckstein
  • Michael Osthoff
  • Stefano Bassetti
  • Sabina Hunziker
DOI
https://doi.org/10.4414/SMW.2022.w30112
Cite this as:
Swiss Med Wkly. 2022;152:w30112
Published
19.01.2022

Abstract

BACKGROUND: We recently compared the effects of bedside and outside the room ward rounds on patients’ knowledge about their medical care. Here, we report preferences of medical and nursing staff members regarding outside versus bedside ward rounds. 

METHODS: Within this ancillary project of a large multicentre randomised controlled trial, we prospectively conducted a survey of medical and nursing staff members participating in the weekly consultant ward rounds in the internal medicine division of three Swiss teaching hospitals between July 2017 and October 2019. Participants were asked about their preferences on outside versus bedside ward rounds. The primary endpoint was satisfaction of healthcare workers with the ward round measured with a visual analogue scale from 0 to 100. 

RESULTS: Between July 2017 and October 2019, 919 patients were included in the trial, and we received 891 survey responses (nurses 15.6%, residents 26.8%, attending physicians 29.6%, consultants 7.8% and chief physicians 20.2%. In the overall analysis, mean (± standard deviation) satisfaction of healthcare workers was higher with outside the room than bedside ward rounds (78.03 ± 16.96 versus 68.25 ± 21.10 respectively; age-, gender- and centre-adjusted difference of –10.46, 95% confidence interval [CI] –12.73 to –8.19; p <0.001). Healthcare workers reported better time management, more discussion of sensitive topics and less discomfort when case presentations were conducted outside the room. A stratified subgroup analysis considering the profession, however, showed strong differences, with nurses being more satisfied with bedside rounds (69.20 ± 20.32 versus 65.32 ± 20.92, respectively; adjusted difference 4.35, 95% CI –1.79 to 10.51; p <0.001), whereas attending physicians showed higher satisfaction with outside the room rounds (82.63 ± 13.87 versus 66.59 ± 21.82; adjusted difference –16.51, 95% CI –20.29 to –12.72; p = 0.002).

CONCLUSIONS: While bedside ward rounds are considered more patient centred and are preferred by the nursing staff, physicians prefer outside the room presentation of patients during ward rounds because of the perceived better discussion of sensitive topics, better time management and less staff discomfort. Continuous training including medical communication techniques may help to increase satisfaction of physicians with bedside ward rounds.

Trial registration: https://clinicaltrials.gov/ct2/show/NCT03210987

References

  1. Ward Rounds in Medicine: Principles for Best Practice: a Joint Publication of the Royal College of Physicians and the Royal College of Nursing, October 2012. 2012.
  2. O’Mahony S, Mazur E, Charney P, Wang Y, Fine J. Use of multidisciplinary rounds to simultaneously improve quality outcomes, enhance resident education, and shorten length of stay. J Gen Intern Med. 2007 Aug;22(8):1073–9. https://doi.org/10.1007/s11606-007-0225-1
  3. Pucher PH, Aggarwal R, Darzi A. Surgical ward round quality and impact on variable patient outcomes. Ann Surg. 2014 Feb;259(2):222–6. https://doi.org/10.1097/SLA.0000000000000376
  4. Zwarentein M, Goldman J, Reeves S. Interprofessional collaboration : effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Db Syst Rev. 2009(3).
  5. Gamp M, Becker C, Tondorf T, Hochstrasser S, Metzger K, Meinlschmidt G, et al. Effect of Bedside vs. Non-bedside Patient Case Presentation During Ward Rounds: a Systematic Review and Meta-analysis. J Gen Intern Med. 2019 Mar;34(3):447–57. https://doi.org/10.1007/s11606-018-4714-1
  6. Becker C, Gamp M, Schuetz P, Beck K, Vincent A, Hochstrasser S, et al.; BEDSIDE-OUTSIDE Study Group. Effect of Bedside Compared With Outside the Room Patient Case Presentation on Patients’ Knowledge About Their Medical Care : A Randomized, Controlled, Multicenter Trial. Ann Intern Med. 2021 Sep;174(9):1282–92. https://doi.org/10.7326/M21-0909
  7. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009 Nov;374(9702):1714–21. https://doi.org/10.1016/S0140-6736(09)61424-0
  8. Wang-Cheng RM, Barnas GP, Sigmann P, Riendl PA, Young MJ. Bedside case presentations: why patients like them but learners don’t. J Gen Intern Med. 1989 Jul-Aug;4(4):284–7. https://doi.org/10.1007/BF02597397
  9. Seo M, Tamura K, Morioka E, Shijo H. Impact of medical round on patients’ and residents’ perceptions at a university hospital in Japan. Med Educ. 2000 May;34(5):409–11. https://doi.org/10.1046/j.1365-2923.2000.00516.x
  10. Chauke HL, Pattinson RC. Ward rounds — bedside or conference room? S Afr Med J. 2006 May;96(5):398–400.
  11. Gonzalo JD, Masters PA, Simons RJ, Chuang CH. Attending rounds and bedside case presentations: medical student and medicine resident experiences and attitudes. Teach Learn Med. 2009 Apr-Jun;21(2):105–10. https://doi.org/10.1080/10401330902791156
  12. Weber H, Stöckli M, Nübling M, Langewitz WA. Communication during ward rounds in internal medicine. An analysis of patient-nurse-physician interactions using RIAS. Patient Educ Couns. 2007 Aug;67(3):343–8. https://doi.org/10.1016/j.pec.2007.04.011
  13. Roter D, Larson S. The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns. 2002 Apr;46(4):243–51. https://doi.org/10.1016/S0738-3991(02)00012-5
  14. Stickrath C, Noble M, Prochazka A, Anderson M, Griffiths M, Manheim J, et al. Attending rounds in the current era: what is and is not happening. JAMA Intern Med. 2013 Jun;173(12):1084–9. https://doi.org/10.1001/jamainternmed.2013.6041

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