Later physician rounding improves satisfaction of postpartum women

1. Postpartum women who were rounded on by the physician team from 8-10 am instead of 5-7 am reported improved perception of their hospital experience and physician communication.

2. Early rounding did not change timing of maternal or neonatal hospital discharge.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Patient satisfaction is a key measure of the quality of medical care received, but as more systems adopt pay-for-performance models, it becomes an even more important metric. In fact, Medicare reimbursements are now linked to patient satisfaction. In the hospital, physicians see and assess the status of inpatients during what is known as “rounding”. Traditionally, rounding occurs very early—before 7 am—so that physicians can get to their other daily duties, like clinic and surgery. However, early morning rounding may disrupt patient sleep and compromise patients’ understanding of the medical plan. Pregnancy accounts for one-quarter of all hospitalizations in the United States, therefore pregnant women are an ideal population to study patient satisfaction. In this controlled quality improvement study, researchers randomized postpartum women to rounding between 5 and 7 am or between 8 and 10 am to assess patient satisfaction with delayed rounding.

Women who were in the delayed rounding group reported an improved hospital experience, better physician communication, and a higher overall hospital rating than women in the early rounding group. There was no difference found in timing either maternal or neonatal hospital discharge between the two groups. Strengths of this study include a novel study question–this is one of the first studies to compare the effects of rounding time on patient satisfaction in postpartum women. Limitations of this study are that it was conducted in a university-based tertiary care hospital, so findings may not be generalizable to other practice settings. In future studies, it would be interesting to include a component of physician satisfaction as well.

Click to read the study in Obstetrics & Gynecology

Relevant Reading: The relationship between physician humility, physician-patient communication, and patient health

In-Depth [randomized controlled trial]: Women at one academic hospital were randomized to early (5-7 am) (n = 76) or late (8-10 am) (n = 76) rounding by the medical team. At discharge women were asked to fill out a satisfaction survey. The primary outcome was rating of the hospital, while secondary outcomes included assessment of patient-physician communication, various hospital experiences, and timing of discharge.

The median hospital rating was higher in the delayed rounding group compared with the early rounding group (9.0 vs. 7.0, p < 0.01). Physician communication scores (8.0 vs. 6.0, p < 0.001) and perception of hospital experience (17.0 vs. 15.0, p < 0.01) were also higher in the delayed group. There were no differences found in the timing of maternal or neonatal discharge.

Image: PD

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