Transforming Ward Rounds Through Rounding-in-Flow.

Area of Science:

• Healthcare Management
• Clinical Operations
• Lean Healthcare

Background:

• Traditional bedside clinical care rounds (
• batched
• rounding) can delay patient care and decrease resident efficiency.
• Inefficiencies in current rounding models necessitate innovative solutions.

Purpose of the Study:

• To evaluate the impact of a novel
• Rounding-in-Flow
• approach on clinical care efficiency.
• To assess changes in timely patient discharge and resident duty hours using Lean principles.

Main Methods:

• A retrospective cohort study was conducted with 17,376 inpatients.
• The study compared traditional
• batched
• rounding with the new
• Rounding-in-Flow
• method.
• Outcome measures included timely discharge orders and resident duty hours.

Main Results:

• Timely discharge orders (by 9:00 am) significantly increased from 8.6% to 26.6%.
• Resident duty hour violations decreased from 2.96 to 0.98 per intern per rotation.
• Average daily intern work hours saw a slight decrease from 12.3 to 11.9 hours.

Conclusions:

• Lean Rounding-in-Flow, utilizing
• 1-piece flow
• principles, improved discharge order timeliness and reduced duty hour rule violations.
• The approach demonstrated enhanced efficiency in clinical workflows.
• Minimal impact was observed on total intern work hours and actual patient discharge times.