The computerized rounding report: implementation of a model system to support transitions of care. J Surg Res 2012 Jan;172(1):11-7
Date
07/23/2011Pubmed ID
21777923DOI
10.1016/j.jss.2011.04.015Scopus ID
2-s2.0-82955162798 (requires institutional sign-in at Scopus site) 27 CitationsAbstract
OBJECTIVES: In response to ACGME work-hour restrictions, residency programs that require continuous inpatient clinical care for educational objectives will be forced to increase the proportion of junior resident experience involved in shift work. Maintaining the balance of education over service at these levels will be a challenge, where a considerable amount of time must be spent gathering data for morning rounds and signing out patients at shift change. Patient safety is an issue with this new paradigm. We hypothesized that computerized sign-out would improve resident efficiency.
MATERIALS AND METHODS: A multidisciplinary clinical team collaborated to design a computerized rounding and sign-out (CSO) program to automate collection of clinical information in addition to a brief narrative describing ongoing care issues. Residents returned a self-administered questionnaire before (n = 168) and after implementation (n = 83) examining: pre-rounding time, missed patients, handoff quality, and duty hours.
RESULTS: Residents reported spending 11 fewer min/d pre-rounding (P = 0.006). After implementation, residents missed fewer patients on rounds (P = 0.01). A majority (70%) of responders stated that the new program helped them with duty hours.
CONCLUSION: The current study demonstrates the reproducibility of the University of Washington model system for rounding and sign-out at an independent site, using basic infrastructure and leadership common to all residency programs. Developing a CSO was associated with a modest reduction in pre-rounding time and fewer patients missed on rounds. Although automating resident tasks may improve workflow in an increasingly complex hospital environment, structured handoff education and other institutional changes are necessary.
Author List
Wohlauer MV, Rove KO, Pshak TJ, Raeburn CD, Moore EE, Chenoweth C, Srivastava A, Pell J, Meacham RB, Nehler MRMESH terms used to index this publication - Major topics in bold
Computer SimulationContinuity of Patient Care
Efficiency
Humans
Internship and Residency
Patient Care Management
Patient Care Team
Reproducibility of Results
Safety
Software
Surveys and Questionnaires
Workload