To compare bedside rounding with hallway and conference room rounding on the neurology inpatient ward service at Brigham and Women’s Hospital and identify best practices associated with educational and patient care outcomes.

Despite increasing focus on patient-centered care and evidence showing higher patient satisfaction with bedside presentations, trainees and attending physicians express concerns for bedside rounding and often prefer hallway rounding. The use of the common styles of rounding has not been assessed within neurology and best practices are unclear.

The inpatient neurology service at Brigham and Women’s Hospital consists of two teams. During a two-week attending rotation, one of the teams will be designated the “bedside rounding team” and the other team the “hallway and conference room rounding team”, serving as the control group. The bedside rounding team will present patients at the bedside, with nursing involvement in each patient's room. The hallway rounding team will present patients outside of the patient’s room, with nurse participation in the hallway. Our planned study period is an 8 week period, with anticipated sample size of 150-200 patients.

To evaluate the two  approaches, we will survey patients (or their families if the patient is unable), residents, attending physicians, and nurses on both teams. For collection of data, a research assistant will accompany the neurology teams during morning rounds and record data about the composition and timing of rounds. The primary outcome measures will be resident educational experience and patient satisfaction with rounds. Secondary outcome measures will be the proportion of rounding time spent at the patient’s bedside and total duration of rounds.

The proposed educational trial provides a pragmatic approach to evaluating effects of different rounding styles on patient satisfaction and resident educational experience.

This will be the first randomized trial of different rounding structures within neurology.