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Geographic Rounding on Young Adults With Childhood-Onset Chronic Conditions: A Mixed Methods Retrospective
Samantha H Collins1,2, Alyssa Platt3, Jesse Rhodes1
1Departments of Internal Medicine and Pediatrics, Duke University School of Medicine, Durham, USA.
Cureus
|July 17, 2026
Summary
Geographic rounding did not improve efficiency for young adults with childhood-onset chronic conditions (COCC). This approach led to longer hospital stays and significant nursing burnout, suggesting it may not suit complex patient groups.
Area of Science:
- Healthcare Management
- Patient Care Models
- Nursing Workforce Studies
Background:
- Geographic rounding is linked to better inpatient care efficiency.
- Young adults with childhood-onset chronic conditions (COCC) face challenges like extended hospital stays and frequent readmissions.
- This study examined geographic rounding's impact on COCC patients.
Purpose of the Study:
- To assess if geographic rounding improves outcomes for hospitalized young adults with COCC.
- To evaluate the effect on length of stay (LOS) and 30-day readmission rates.
- To analyze nursing workload and staff experiences.
Main Methods:
- Retrospective observational cohort study comparing pre- and post-geographic rounding periods.
- Analysis of length of stay (LOS) and 30-day readmission rates.
- Evaluation of nursing workload data and a nursing survey.
Main Results:
- Length of stay (LOS) was significantly longer during the geographic rounding period (event time ratio=1.29).
- No significant difference was found in 30-day readmission rates (risk ratio: 1.45).
- Nurses reported burnout and inadequate resources despite similar measured workloads.
Conclusions:
- Geographic rounding was associated with decreased efficiency and increased workforce challenges in this COCC population.
- Findings suggest geographic rounding may not be universally effective for medically and socially complex patients.
- Implementing geographic models for specialty cohorts requires nursing partnership, training, and resources.
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