Go to any hospital medicine meeting and rounding is usually one of the topics being discussed. Though many options exist for rounding well, debate rages about which method is best. A survey published in February in the Journal of Hospital Medicine found most attendings believe bedside or hallway rounds are better than conference room rounds for teaching patient care and systems-based practice…yet conference room rounds are still used for more than a third of established patients. Our cover story delves into several types of rounding—their advantages and challenges, how to set them up effectively, and how to ensure they are working well for your team and patients.
A good rounding model keeps patients' best interests in mind, and the same goes for communication with colleagues during the workday. Ideally, hospital clinicians have frequent, open and honest discussions about patients, including about when things go wrong. However, a 2012 Agency for Healthcare Research and Quality survey found more than half of hospital staffers aren't comfortable questioning the actions of coworkers with more authority, and about half also felt there were negative repercussions for reporting mistakes. Our feature looks at things hospitals and hospitalists can do to encourage a blame-free culture of openness when it comes to discussing errors in patient care.
In clinical coverage, our inside feature on pneumonia looks at growing concerns that the condition is being overdiagnosed by physicians and what hospitalists can do in their practice to curb this tendency. Meanwhile, physicians from Tulane University School of Medicine share lessons learned from their patients in The Brief Case column. Our bonanza of conference coverage starts with a recap from the National Readmission Summit last December, then continues with summaries of sessions from the Society of Critical Care Medicine's Annual Congress in January.
We would love to hear how your hospital approaches rounds or encourages discussion about patient errors. Write to us anytime.
Editor-in-Chief, ACP Hospitalist