Anybody have experience with flow rounds?

[Laradd]

Interviewing at a couple places that have implemented flow rounds and curious to what people’s thoughts are? I’ve always experienced the traditional rounds.

For those who don’t know what it is it’s basically the senior, attending and one of the interns go see the highest acuity patient and then that intern goes and writes the note while the senior and attending take the other intern and go see their highest acuity patient and this repeats for the rest of the day.

I fell like this results in better patient care but overall makes the day much much longer for the senior resident

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[lulu09]

Interviewing at a couple places that have implemented flow rounds and curious to what people’s thoughts are? I’ve always experienced the traditional rounds.

For those who don’t know what it is it’s basically the senior, attending and one of the interns go see the highest acuity patient and then that intern goes and writes the note while the senior and attending take the other intern and go see their highest acuity patient and this repeats for the rest of the day.

I fell like this results in better patient care but overall makes the day much much longer for the senior resident

I mean I often did this unofficially as a senior resident leading the team because some attendings were very long-winded and if we rounded traditionally where everyone sat down to discuss every single patient or everyone saw every patient together things will simply not get done (consults won't be called until past noon, and then consultants will refuse to see the pts).

The traditional argument against this is that the intern who is working is missing half of the learning that is going on, but I think it totally depends on the quality of teaching that is actually occurring (e.g. if the attending is just going to ramble and chat with every patient then the intern who isn't taking the patient should honestly just go work and call consults). I did find this model of rounding to be more efficient overall for the team as a senior but I had to do more coordination during the rounds. The interns liked it because they were able to finish work faster and most of the time they were too tired to learn anyway.

 

[Laradd]

That’s an interesting perspective. Thanks! To me it seems like it makes the day go longer but I would assume that by the time your on your last patient the day is done since all your other notes and consults are finished so I guess it’s better in that sense. I would also assume that patient care is better since the patient is getting the full attention at that time and immediately afterward their plan is being put into effect. I’m just not sure how I feel mentally about the day taking so long

 

[Psai]

I would just call consults and put in orders while the other intern presented. When I had ten patients, I couldn't care less about what the other person was doing.

 

[GoldenFish]

We tried that a couple of times and it was okay.

I like just staying outside the room and doing orders and consults while the other intern was presenting on traditional rounds.

Plus it helped to know the definitive plan on my patients earlier - being second means I had to wait longer to really be done.

 

[shemer77]

We tried that a couple of times and it was okay.

I like just staying outside the room and doing orders and consults while the other intern was presenting on traditional rounds.

Plus it helped to know the definitive plan on my patients earlier - being second means I had to wait longer to really be done.

Which one did you prefer?

 

[end stage fibro]

At my residency, the whole team would chart round in our call room and go over salient teaching points, pearls, and usually a 5-minute presentation on a topic or follow up from previous day. The attending, senior, and intern 1 would then go see pts in whatever order was deemed logical for the day, leaving intern 2 to do their work. This still seems the best route for me in order to promote efficiency and learning while minimizing the existential dread as I pondered the deep mysteries of the universe while the other intern was talking about their patient during traditional rounds.

... but overall makes the day much much longer for the senior resident

I'm not too sure about this. Sure there is there some time lost from a little bit of extra walking. On the other hand, the senior can leave intern 2 with a list of things to ensure happen while rounding with intern 1 and vice versa. The checklists can then be run over en masse during the natural break points in the day.

 

[shemer77]

Yea I'm not necessarily sure its going to make the day longer either. Maybe a little bit but your much more productive during that time.