* I apologize in advance for the number of times I use the word “hate” in this post, but it’s gone beyond dreading into the realm of hating. Let me explain:
have a background in Health Promotion and I always try to find ways to
incorporate patient understanding and literacy in to my interactions. I
realized early in medical school that I dread and now hate rounding.
Absolutely hate it. As I have often seen it, it is Team-Centered with
the patient/ family on the periphery. It is not health promoting. The
literacy level is directed to professionals. All big no nos.
a week on the Wards, I realized yet again that I hate “Family Centered
Rounding” for pediatric patients due to the following reasons:
- way too much information is being spewed at parents who have probably just woken up
way too much detailed information is being reported; if medical
students and Interns have trouble keeping up how do we expect families
- there are way too many people in the room who have only minimal involvement with the care of a particular patient
it is unprofessional and unappealing when folks with minimal
involvement are only half-present (ex. the other Interns working
feverishly to complete notes and orders on other patients)
my biggest concern is are we hurting patient care when we list detailed
and often scary differential diagnoses and mention lab tests that we
probably will not perform?
could go on and on but I won’t. I think Family-Centered Rounds has the
potential to be a wonderful educational tool for families, a way to
increase engagement in the medical decision making process. At least as I
have seen it (at a large urban tertiary care center and at a medium
size community hospital), it falls short. Rather than complaining
without taking action, I am very interested in helping make these rounds
better at my hospital, for our patients. I am motivated, selfishly, to
at least work toward making the process less dread and hate-inducing for
myself so that I don’t completely omit becoming a Hospitalist from my
list of possible future careers.
1. How do Family-Centered or Patient-Centered Rounds work (or fail to) at your institution?
2. If you could change this process and make it better given time constraints, what would you do?
I think I see a Quality Improvement project simmering . . . .