Care Rounds

As you may have read this week in a Detroit News article, my leadership team and I have recently incorporated care rounding with patients at Henry Ford Hospital into our weekly activities.

You might ask, “What’s new about a physician and an administrative team rounding on patients in a hospital?”

My response? “Quite a bit.”

At Henry Ford Hospital, care rounds concentrate specifically on the general care and services a patient receives.

Although not fully divorced from clinical issues, these rounds bring out issues related to environment, food, communication, ease of use, and general comfort. Quite simply, it is the service aspect of our profession and business.

At the hospital, all of us go about our activities with a specific purpose. As a physician caring for patients, my concentration and intention is primarily on the diagnosis and treatment of the patient. Patients’ needs are generally first viewed from the perspective of their clinical care.

Much is discovered when the lens is focused intently.

I was struck by the application of purposeful activities when studying LEAN-inspired management methods, where so called “waste rounds” had managers stepping out of their usual role (which includes waste reduction in processes) to concentrate fully on eliminating unnecessary steps or use of supplies.

On care rounds, after asking if I can come into the room and talk, I introduce myself and acknowledge the patient formally before asking one simple question: “How has your care been at the hospital?”

Because I often wear my white coat, patients frequently will begin to provide their medical history. After a bit of talk, we get back on the topic of the general care and services they are receiving. We fix problems as we identify them and track the problems to address common issues to correct.

What do I hear from patients?

• Connect with me
• Respect me as a person
• Keep me informed
• Comfort me
• Smile at me
• Address my concerns and problems, even when you think they are less important than the clinical problems you are addressing.

Many of us in health care, especially in academic centers, live in a culture where professional expertise is the coin of the realm. In busy hospital environments, clinicians and other employees feel pressed with the significant time demands of modern care.

Given the expert culture, I am not infrequently asked, “Which do you want us to do, provide high quality clinical care or high quality service?”

My response is emphatically both. Neither is optional.

Being a patient in a hospital is an experience steeped in the feeling of isolation, anxiety and powerlessness. Concerns raised on care rounds highlight these issues, and our service needs to address them.

That is what separates a hospital experience from a hotel experience.

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