Geographical rounding or unit based rounding for hospitalists

What are the Pros and Cons of unit-based rounding?

Unit based rounding is basically making each doctor or a hospitalist work on one floor only with the intention to give patients better care.

Pros:

1. Saves time: It saves time by the fact that if a patient is out of the floor, you can move on to the next patient. There is no time wasted for moving from one floor to another, finding a computer to sign in, talk to someone you met on the way etc.

2. Quick Service to the patient: If a patient is deteriorating, you can see the patient immediately.

3. Easy to talk to specialists as you are readily available right there

4. Better HCAHPS scores due to the above advantages

5. I am not sure about length of stay and final outcomes. I am hoping that they are better

Cons:

1. I think the most important disadvantage is probably too many hands off. Changing of doctors for any given patients will be high if you want to strictly follow unit-based rounding. This happens because when you admit a lot of patients in the evening in the ER, some patients may end up in floors not being covered by the admitting hospitalist. You can request for a bed in your floor but availability is not guaranteed.

2. Sometimes, there can be too much of disturbance to your thought process by too much interaction with various people

3. Unequal work distribution: Sometimes, the workload among various hospitalists on a particular day can be very unequal. The work load in pure Telemetry floor can be tremendous on certain days. The workload in pure med-surgical floors can be very low. An ideal situation could be that all floors have Telemetry and Non-telemetry beds.

4. Sometimes, it can be very uncomfortable to sit at one place most of the time in a day. Some floor designs (especially the place we sit) may not be ideal to spend hours and hours every day for a week.

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