Communication on Rounds: The Role of Rounds Culture and Communication in Patient Care and Teaching.

Abstract

Background: The daily visit by the treating doctor or medical team at the bedside of the hospitalized patient («rounds») is essential for patient-centered care and interprofessional exchange.

Methods: This narrative review is based on pertinent publications (up to December 2024) that were retrieved by a selective search in the PubMed/Medline database.

Results: Bedside rounds are used to fulfill multiple tasks: medical, communicative, and educational. Complex social interactions, in particular, require precise and empathetic communication. 71% of patients say they primarily expect clear information about their medical situation. Information exchange can nonetheless be difficult, particularly with older and frail patients. So-called teach-back techniques improve patients' understanding of medications and behavioral instructions (OR 1.84 [1.09; 3.12] and 1.83 [1.07; 3.13], respectively). Although many patients would like to take active part in discussions on rounds, the physicians explicitly encouraged them to do so in only 54% of cases. If the team discusses the patient outside the room before entering, the patient's understanding of their condition is no different, but they are less likely to be confused by medical technology (21.3 versus 13.7); team satisfaction is higher (78.0 versus 68.3), and there is more opportunity to discuss sensitive topics (84.3 versus 59.3, each on a visual analog scale VAS 1-100).

Conclusion: Interprofessional discussion of the patient and suitable communication on rounds can improve patient care and are essential for undergraduate, postgraduate, and continuing medical education.