Abstract Details

Title NEUrology ROundiNg Study (NEURONS): A Randomized Study of Bedside versus Hallway Rounding

Topic Research Methodology, Education, and History

Presentation(s) Research Methodology and Education Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 013

Background

Attending rounds have shifted away from the bedside. Medical residents and attending physicians are apprehensive of the bedside approach, with barriers including perceived workflow inefficiency and excessive patient involvement. There is a lack of data to guide rounding practices within neurology and optimal rounding methods remain unclear.

Objective To compare bedside rounding with hallway rounding on an academic neurology inpatient service and assess efficiency, educational, and patient care outcomes.

Design/Methods We conducted a single-center, crossover, randomized prospective study of bedside versus hallway rounding on new inpatient neurology admissions over one-week blocks. The bedside team presented patients at the bedside, while the hallway team presented patients outside of the patient’s room and then examined the patient in the room. We evaluated the two approaches with time-motion analysis, which investigated the rounding style’s effect on composition and timing of rounds (primary outcome), and surveys of patients, nurses, residents, and attending physicians on both teams.

Results The mean rounding time per newly admitted patient in the bedside group (n=40 patients) and hallway group (n=41 patients) was 23 minutes and 23.2 minutes, respectively (difference not significant). The bedside group spent on average 56.4% of patient rounding time in the patient’s room, while the hallway group spent 39.5% of rounding time in the patient’s room (p = 0.036). Residents perceived hallway rounding to be more efficient and associated it with a superior educational experience and more effective data review. Nurses had improved perception of their participation in bedside rounds. Though patients’ views of bedside and hallway rounds were similar, patients who had experienced bedside rounds preferred it.

Conclusions Bedside rounding was perceived less favorably by most residents but was likely as efficient as hallway rounding. Although bedside rounding limited the use of technology for data review, it promoted nursing participation and resulted in more time spent with the patient.

Authors/Disclosures
Jacqueline Solomon, MD (St. Michael's Hospital, University of Toronto) PRESENTER	Dr. Schulman has nothing to disclose.
Shamik Bhattacharyya, MD, FAAN (Brigham and Women's Hospital)	Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Merck. The institution of Dr. Bhattacharyya has received research support from Alexion Pharmaceuticals. The institution of Dr. Bhattacharyya has received research support from National Institute of Health. The institution of Dr. Bhattacharyya has received research support from UCB. The institution of Dr. Bhattacharyya has received research support from Genentech. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care.
Ahya S. Ali, MD (Westchester Medical Center)	Dr. Ali has nothing to disclose.
Liam M. Cleary	Mr. Cleary has nothing to disclose.
	No disclosure on file
	No disclosure on file
Tracey A. Milligan, MD, FAAN	Dr. Milligan has nothing to disclose.