Can Patient Satisfaction Scores be Increased by Interdisciplinary Bedside Rounding: An Integrative Research Review

Focus on the patient experience is becoming an issue world-wide. Patient satisfaction metrics have a financial impact on how hospitals are reimbursed and resultantly, healthcare leaders need to know what variables are positively associated with patient and their family satisfaction. Evidence suggests bedside rounding is a known patient satisfier; yet despite recommendations to perform bedside rounding as an effective teaching strategy for new physicians, this practice has decreased in use and the reasons for this decline have not been fully reported. Various barriers interfering with effective bedside rounding by the interdisciplinary team are reviewed in the following research, as well as the potential beneficial outcomes from incorporating bedside rounding into daily practice in the hospital setting. The research question set out to be answered is, “Does a physician’s performing a bedside round and presentation in the presence of the patient and their family have an impact on how they perceive the quality of their care, as compared to when the physician teams conduct their presentations outside of the patient room with an abbreviated follow-up round afterwards?”. Since pediatric research is more abundant in terms of parent satisfaction with their child care, this integrative review will focus solely on the adult population.

The integrated review of the literature was conducted using the methodology described by Whittemore and Knafl (2005) and Brown (2018). To conduct this study, the author utilized the terms “bedside round” and “satisfaction” in the following databases: Cochrane, CINAHL, PubMed, MEDLINE Complete, Health Source: Nursing/Academic Edition, and Psychology and Behavioral Sciences Collection. The original search identified 73 articles, of which 17 were immediately removed for being duplicates. Exclusion criteria included relevant studies covering the pediatric population, studies dating back prior to 2013, and studies that were not relevant to this review. This integrative research review included 11 studies through the initial search, as well as an additional 3 articles from bibliographic mining, for a total of 14 studies.

The majority of the studies included in the review conclude that a bedside round tends to lead to a more positive perception from the patients and/or their families because they are included in the discussion, perceive that more time is spent on the patient, and stated a better understanding regarding the plan of care. Several studies with outcomes that were statistical significant found registered nurses preferred physicians who performed bedside rounding, and that this practice improved relationships between physicians and nurses. Further, a number of studies with significant findings reported, residents and other new physicians preferred bedside rounds as an improved teaching tool as it allowed for more teaching opportunities and encouraged better teamwork with the nursing staff. Common barriers to rounding included frustration from patients listening to medical jargon, potential HIPPA violations, and a negative perception from physicians believing that bedside rounds generally take more time to complete. In comparison, some studies were unable to identify a significant difference in satisfaction levels of care and the type of rounding, however, these studies often had other positive associations such as an increased perception in compassion of hospital staff and trust in the health care providers. Overall findings from the literature synthesis support standardized bedside rounding as a strategy to improve patient satisfaction. While some studies were unable to demonstrate statistical significance, data did suggest patient preference for bedside rounding from an interdisciplinary team. Scheduling a time for the healthcare professionals and families to meet together appears to be an ineffective strategy. Rather, a structured approach including the interdisciplinary team, such as the registered nurse and physician team, allowed for consistency that could be predicted by staff, patients, and their families. This structure of bedside rounding allowed several teams to realize quicker and more efficient patient rounding practices. It is important to note that no negatives are associated with patient rounding. Additional information is needed to empirically support patient rounding and replication and expansion of research is needed on this topic to generate more robust evidence to support the use of bedside rounding as a tool to increase patient satisfaction.