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ABSTRACT: Objective
To describe rounding practices in Canadian adult Intensive Care Units (ICU) and identify opportunities for improvement.Design
Mixed methods design. Cross sectional survey of Canadian Adult ICUs (n = 180) with purposefully sampled follow-up interviews (n = 7).Measurements and main results
Medical directors representing 111 ICUs (62%) participated in the survey. Rounding practices varied across ICUs with the majority reporting the use of interprofessional rounds (81%) that employed an open (94%) and collaborative (86%) approach, occurred at the patient's bedside (82%), and started at a standard time (79%) and standard location (56%). Most participants reported that patients (83%) and family members (67%) were welcome to attend rounds. Approximately half of ICUs (48%) used tools to facilitate rounds. Interruptions during rounds were reported to be common (i.e., ? 1 interruption for ? 50% of patients) in 46% of ICUs. Four themes were identified from qualitative analysis of participant responses to open-ended survey questions and interviews: multidisciplinarity, patient and family involvement, factors influencing productivity, and teaching and learning.Conclusions
There is considerable variation in current rounding practices in Canadian medical/surgical ICUs. Opportunities exist to improve ICU rounds including ensuring the engagement of essential participants, clearly defining participant roles, establishing a standardized approach to the rounding process, minimizing interruptions, modifying the role of teaching, utilizing a structured rounding tool, and developing a metric for measuring rounding quality.
SUBMITTER: Holodinsky JK
PROVIDER: S-EPMC4689549 | biostudies-literature | 2015
REPOSITORIES: biostudies-literature
Holodinsky Jessalyn K JK Hebert Marilynne A MA Zygun David A DA Rigal Romain R Berthelot Simon S Cook Deborah J DJ Stelfox Henry T HT
PloS one 20151223 12
<h4>Objective</h4>To describe rounding practices in Canadian adult Intensive Care Units (ICU) and identify opportunities for improvement.<h4>Design</h4>Mixed methods design. Cross sectional survey of Canadian Adult ICUs (n = 180) with purposefully sampled follow-up interviews (n = 7).<h4>Measurements and main results</h4>Medical directors representing 111 ICUs (62%) participated in the survey. Rounding practices varied across ICUs with the majority reporting the use of interprofessional rounds ( ...[more]