Impact of Structured Rounding Tools on Time Allocation During Multidisciplinary Rounds: An Observational Study

JMIR Hum Factors. 2016 Dec 9;3(2):e29. doi: 10.2196/humanfactors.6642.


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.

Keywords: communication; intensive care units; teaching rounds.