The Rounds Efficiency Index: A Novel Physics-Based Construct for Patient- and Family-Centered Rounds.

Area of Science:

• Healthcare Management
• Medical Education
• Patient Experience

Background:

• Conducting efficient patient- and family-centered rounds (PFCR) is crucial but lacks standardized efficiency metrics.
• Existing challenges in PFCR efficiency necessitate novel measurement approaches.
• Leveraging physics principles offers a unique framework for evaluating healthcare process efficiency.

Purpose of the Study:

• To establish baseline metrics for clinical work (CW), educational effectiveness (EE), and family experience (FE) as work output.
• To establish baseline metrics for rounds length (RL) as work input.
• To develop a preliminary rounds efficiency index (REI) to quantify PFCR efficiency.

Main Methods:

• Collected data on CW, EE, FE, and RL across 5 inpatient acute care teams.
• Calculated the REI as a ratio of aggregated work output (CW, EE, FE) to work input (RL).
• Evaluated REI during an 8-week intensive period to assess its preliminary utility.

Main Results:

• Baseline data included 809 orders, 28 EE ratings, 21 FE ratings, and a mean RL of 11.4 minutes per patient.
• The median team-specific weekly REI showed variations, with 58% at the end vs. 52.5% at the beginning of the academic year (P = .17).
• Median REI during the intensive period was 49% at the start and 57% at the end (P = .15).

Conclusions:

• The study successfully assessed four key components of rounding efficiency (CW, EE, FE, RL).
• A preliminary rounds efficiency index (REI) was constructed, providing a novel tool for measuring PFCR efficiency.
• The REI can inform targeted interventions to enhance PFCR efficiency and improve healthcare delivery.