So excited for this @OHSUIMRes #ChiefResident #GrandRounds! “What is the purpose of rounds?”
This has been a fascinating discussion to participate in via #medtwitter over the last year or so
@AdamRodmanMD @medpedshosp @ETSshow @PaulNWilliamz @cjchiu @tony_breu @michellebr00ks
Fascinating @JHospMedicine article which was the subject of a #JHMchat gets an early discussion @FutureDocs @WrayCharles
(I think this is also the chat I really “met” a lot of my #medtwitter peeps)
@OHSUIMRes alumnus @AdamRodmanMD gets a shout out!! What was the origin of “rounds”??
Rounds—BEDSIDE rounds—with, at, for the patient
But also—clinical care & bedside care used to be synonymous, with medical records physically at the bedside
Early 20th century and 21st century rounds are not the same
Gone are the days when house staff literally lived in the hospital & did tons of clerical tasks incl phlebotomy
The info stream as it relates to the purpose of “pre-rounding” v teaching rounds is also dramatically different
—changes in duty hours
—rise of EHR
To amplify the line from the last photo—the rest of the team had access to the information the intern is presenting, often accessible to the attending at home first thing in the AM (where was the #medtwitter convo about “do attendings look at the chart before rounds”???)
A glimpse into the the time compressed morning...
THIS is the money slide! Capturing so many changes (not just duty hours), in many ways boiling down to work load compression
Dr. @CLachowiez now doing a deep dive into the pros and cons of the EHR compared to paper charts
Talk about “click fatigue”! 28 potential clicks for an acetaminophen order?
How could the EHR revamp the purpose and structure of rounds?
Recent article on models for how the EHR (boxes outlined in red) could be used to bring versatility of rounds... journals.plos.org/plosone/articl…
How can we revamp rounds to focus on patients and learners?
Do we ask for data points as attendings because we don’t know them, or because we’re emphasizing data interpretation and clinical reasoning—not “what’s the WBC” but “why is it relevant?”
Ok, another money slide! So many incredible points so artfully shared by the #ChiefResidents
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