Make Sure The Patient Is Part Of Teaching Rounds

Rounds: This description of highly-structured inpatient internal medicine “chiefs’ service” rounds, as compared with usual teaching service rounds, is a useful reminder of the importance of bedside rounds including the patient, as opposed to hallway or conference room rounds.  Both the chiefs’ service and usual teaching rounds were highly regarded by residents, and the minor differences in quantitative evaluations favoring the chiefs’ service may have simply been a “halo effect” created by the new program and more-invested attendings.  More interesting to this reviewer were resident comments on some of the more unique aspects of the rounding structure: presentation in front of each patient every day; extensive day-of-discharge rounding in front of the patient to ensure adequate understanding and follow-up; and having a care coordinator call all discharged patients and give the team feedback about the patient’s post-discharge course.  These elements sensitized the residents to patients’ difficulties understanding their medical care and navigating the system outside of the hospital. — Laura Willett, MD

Bennett, Nadia L. MD; Flesch, Judd D. MD; Cronholm, Peter MD, MSCE; Reilly, James B. MD, MS; Ende, Jack MD, Bringing Rounds Back to the Patient: A One-Year Evaluation of the Chiefs’ Service Model for Inpatient Teaching. Academic Medicine, December 2016

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