@Article{info:doi/10.2196/humanfactors.6642,
author="Abraham, Joanna
and Kannampallil, Thomas G
and Patel, Vimla L
and Patel, Bela
and Almoosa, Khalid F",
title="Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study",
journal="JMIR Hum Factors",
year="2016",
month="Dec",
day="09",
volume="3",
number="2",
pages="e29",
keywords="teaching rounds; communication; intensive care units",
abstract="Background: Recent research has shown evidence of disproportionate time allocation for patient communication during multidisciplinary rounds (MDRs). Studies have shown that patients discussed later during rounds receive lesser time. Objective: The aim of our study was to investigate whether disproportionate time allocation effects persist with the use of structured rounding tools. Methods: Using audio recordings of rounds (N=82 patients), we compared time allocation and communication breakdowns between a problem-based Subjective, Objective, Assessment, and Plan (SOAP) and a system-based Handoff Intervention Tool (HAND-IT) rounding tools. Results: We found no significant linear dependence of the order of patient presentation on the time spent or on communication breakdowns for both structured tools. However, for the problem-based tool, there was a significant linear relationship between the time spent on discussing a patient and the number of communication breakdowns (P<.05)----with an average of 1.04 additional breakdowns with every 120 seconds in discussion. Conclusions: The use of structured rounding tools potentially mitigates disproportionate time allocation and communication breakdowns during rounds, with the more structured HAND-IT, almost completely eliminating such effects. These results have potential implications for planning, prioritization, and training for time management during MDRs. ",
issn="2292-9495",
doi="10.2196/humanfactors.6642",
url="http://humanfactors.jmir.org/2016/2/e29/",
url="https://doi.org/10.2196/humanfactors.6642",
url="http://www.ncbi.nlm.nih.gov/pubmed/27940423"
}