Last patients on ICU rounds get least time

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Doctors spent significantly less time with intensive care unit patients at the end of rounds as compared with the beginning.

The time decreased by about a minute per patient as clinical staff members made rounds in a 12-bed cardiothoracic intensive care unit (ICU).

Comparison of the first four and last four patients seen on rounds produced a statistically significant difference in the time spent with physicians and other participants in rounds, said Laura Jones, PhD, at the Society of Critical Care Medicine meeting.

To study time distribution during clinical rounds, Jones and colleagues accompanied clinical staff on 20 nonconsecutive weekdays during rounds in a cardiothoracic ICU. All patients had undergone coronary bypass surgery. On any given day, participants in rounds included one or more physicians, nurses, medical students, a pharmacist, a dietitian, and other healthcare providers. At the very least, an intensivist and one other physician participated in each session. The number of patient visits during the study period averaged 6.4, and rounds duration averaged 117.9 minutes. Interruptions accounted for about 10 minutes per rounds session and social interruptions for another 11.5 minutes.

Overall, the time spent with each patient during rounds decreased by 54 seconds per patient. Using a nine-patient session as an example, Jones said the clinical staff spent about eight minutes less with the last patient seen compared with the first. The difference between the first four and last four patients seen was statistically significant (P<0.05).