Revitalizing Rounds

Most healthcare institutions and work settings require attendance at multi-disciplinary rounds. In past years, rounds were attended daily and there somehow seemed to be ample time for dialogue and opportunities for inter-educational teaching across disciplines. In today's world, clinicians are stretched across units and often find themselves working within hospital continuums-perhaps at several sites within one week. Attendance at rounds is difficult and at times can seem hurried and mundane. Although it is a clinician's best intention to provide ultimate care and compassion for each and every patient, attendance at rounds can be hard to work in, and may impact the amount of time we can actually allocate to spend with our patients, offering direct care.

One way to maximize patient care and enhance staff collaborations is to structure rounds with a presentation forum focusing on a specific discipline once a month. This might take the form of an 'experiential', where a staff member shows a particular technique from an actual session (such as a breathing technique, or music meditation). Another type of presentation could be a case study, where a difficult case is decided prior and a rep from each discipline answers similar questions regarding the toughest areas and how and why to proceed in an identified way. Another interesting forum for rounds is to have a patient come to discuss an integral area of treatment, such as pain or a procedure, for example. This needs to be decided carefully, and every institution has its own regulations regarding patient inclusion and sharing of information. However, it can be quite empowering for patients to come speak to staff about what was helpful and/or unhelpful. Providing this kind of feedback mechanism at rounds reminds us all why we are clinicians and takes quality of care to the center stage.