The Rounds Efficiency Index: A Novel Physics-Based Construct for Patient- and Family-Centered Rounds. Hosp Pediatr 2024 Jul 01;14(7):584-591
Date
06/06/2024Pubmed ID
38841773DOI
10.1542/hpeds.2022-006971Scopus ID
2-s2.0-85198042444 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND AND OBJECTIVES: Efficiently conducting patient- and family-centered rounds (PFCR) is challenging, particularly without a measure of efficiency. In physics, efficiency is the ratio of work output to work input. We sought to evaluate PFCR efficiency via a novel construct rooted in physics. Our objectives were to (1) Establish baseline work output for clinical work (CW), educational effectiveness (EE), and family experience (FE); (2) establish baseline work input for rounds length (RL); and (3) begin preliminary construction of a rounds efficiency index (REI) as a measure of PFCR efficiency.
METHODS: Four components of rounds efficiency were collected on 5 inpatient acute care teams during a baseline period. CW consisted of the percentage of daily orders placed on rounds. EE was assessed via survey for trainees and FE by families. RL was recorded in minutes per patient. During an 8-week intensive period, the REI (reported as %) was calculated as a ratio of work output/work input using aggregate mean/median ratings for CW, EE, FE, and RL.
RESULTS: Baseline data included 809 orders, 28 EE ratings, 21 FE ratings, and RL mean of 11.4 minutes per patient. During the intensive period, the median team-specific weekly REI for the end versus beginning of the academic year was 58% and 52.5% (P = .17), respectively. The median REI during the start and end of the block was 49% and 57% (P = .15), respectively.
CONCLUSIONS: The study assessed 4 components of efficiency (CW, EE, FE, RL) and calculated REI allowing for a preliminary tool to measure rounding efficiency. With this, targeted interventions can improve PFCR efficiency.
Author List
Tuomela K, Agbeh A, Anibaba F, Toth H, Rogers A, Porada K, Lynch K, Hadjiev J, Weisgerber MC, Bauer SCAuthors
Sarah Bauer MD Associate Professor in the Pediatrics department at Medical College of WisconsinAmanda Rogers MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Heather Toth MD Professor in the Medicine department at Medical College of Wisconsin
Jennifer M. Watson MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michael C. Weisgerber MD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Efficiency, OrganizationalHumans
Patient Care Team
Patient-Centered Care
Teaching Rounds
