Rounding is a formalized and scheduled process used in hospital settings for healthcare professionals to assess patients, discuss progress, and coordinate the daily treatment plan. This practice is a structured way to ensure that multiple caregivers are aligned on the patient’s condition and future steps for care. The primary purpose of this activity is to promote continuity of care and improve communication among the various people responsible for the patient’s well-being. This daily meeting is designed to be patient-centered, focusing the team’s efforts on achieving the best possible outcome for the person receiving care.
Defining Clinical Rounding
Clinical rounding today is a structured review that occurs daily for most hospitalized patients, serving as the central mechanism for care coordination. During the round, the team methodically reviews new laboratory results, imaging scans, and changes in the patient’s physical examination findings. This comprehensive review allows the team to update the patient’s working diagnosis and overall treatment strategy. A primary goal is to establish specific, actionable goals for the next 24 hours, such as discontinuing a certain medication or planning a new physical therapy session.
The process of rounding has evolved significantly from its historical roots, shifting from what was often called “teaching rounds” to modern, patient-centered models. Traditional teaching rounds frequently occurred in a conference room, referred to as “table rounds,” where the medical team discussed the patient’s case without the patient present. However, it often left the patient feeling excluded from the conversation about their own health.
Modern practice increasingly favors “bedside rounds,” a multidisciplinary approach where the team gathers in the patient’s room. This allows for direct patient engagement, which has been shown to improve patient satisfaction and communication. While educational discussions still occur, the focus at the bedside is streamlined and directed toward ensuring the patient understands the plan of care.
The Multidisciplinary Team
A typical rounding team involves several specialists who contribute their unique expertise to the patient’s care plan. The attending physician, often a hospitalist or the primary specialist, acts as the leader, making the final decisions and overseeing the overall trajectory of care. They are responsible for guiding the discussion and ensuring all medical issues are addressed. Beneath the attending physician, a hierarchy of trainee physicians, such as residents and fellows, may be present, especially in academic medical centers.
The resident is a physician who has finished medical school and is undergoing specialized training; this person often presents the patient’s case to the attending physician, summarizing the most important details of the last 24 hours. Medical students, if present, are the most junior members of the team, observing the process and sometimes presenting a brief portion of the patient’s history. The primary nurse who is caring for the patient is an important participant, offering the most current information about the patient’s immediate comfort, response to treatment, and any nursing concerns.
Beyond the core medical and nursing staff, modern rounding teams frequently include allied health professionals to provide a holistic view of the patient’s needs. A pharmacist may join to review the patient’s current medications, checking for potential drug interactions or suggesting dosage adjustments. Social workers or case managers are often involved to address non-medical needs, such as coordinating post-discharge care, arranging for necessary equipment, or addressing insurance issues.
Patient Participation and Expectations
Clinical rounds typically occur during the morning hours, often starting between 8:00 a.m. and 11:00 a.m., though the exact time can vary depending on the hospital and the specialty. The entire process is designed to be efficient, with most patient discussions lasting between five and ten minutes. Because of the quick pace, patients can prepare by noting down any questions or concerns they have beforehand to make the most of the limited time.
Patients should understand that the team may use medical terminology during the discussion, or they may step outside the room briefly to discuss sensitive or complex information. This practice is often necessary to maintain the flow of the discussion or to comply with privacy regulations. If the team uses language that is unclear, the patient should feel comfortable asking for an explanation in plain language.
The patient’s role is to be an active collaborator in their own care, providing direct feedback on their symptoms and understanding of the care plan. Patients should ensure the team is aware of their personal goals for their hospital stay and any concerns they have about returning home.