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First Time Rounding Experiences for Nonclinicians: The Cleveland Clinic Experience Laura R. Greenwald, Amy S. Nowacki and James K. Stoller American Journal of Medical Quality published online 11 February 2014 DOI: 10.1177/1062860614521657 The online version of this article can be found at: http://ajm.sagepub.com/content/early/2014/02/11/1062860614521657
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On behalf of: American College of Medical Quality
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>> OnlineFirst Version of Record - Feb 11, 2014 What is This?
Downloaded from ajm.sagepub.com at University of Huddersfield on October 6, 2014
521657 research-article2014
AJMXXX10.1177/1062860614521657American Journal of Medical QualityGreenwald et al
Article
First Time Rounding Experiences for Nonclinicians: The Cleveland Clinic Experience
American Journal of Medical Quality 1–5 © 2014 by the American College of Medical Quality Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1062860614521657 ajmq.sagepub.com
Laura R. Greenwald, MBA,1 Amy S. Nowacki, PhD,1 and James K. Stoller, MD, MS1
Abstract Clinical rounds serve several key objectives in academic medical centers: providing a forum for patient communication, clinical decision making, and teaching. Nonclinical colleagues ordinarily do not have the opportunity to round, and the idea of implementing a rounding program that includes nonclinical colleagues has received little attention to date. Reasoning that a rounding program with nonclinicians could enhance (1) understanding of the organization’s clinical mission, (2) appreciation of caregivers’ roles, and (3) engagement, the authors created such a program. From 2010 to 2013, 51 nonclinicians within the Cleveland Clinic Education Institute participated; 14 submitted written reflections, and 27 responded to a survey about their experience. Overall, 12 themes emerged that suggest an enhanced familiarity with the institution and increased engagement and alignment with its mission. Notably, the results align with a long-standing focus on organizational engagement and an observed increase in mean engagement scores since the program was implemented. Keywords clinical rounding, nonclinician rounding, employee engagement
Clinical rounds are one of the time-honored cornerstones of inpatient practice in academic medical centers because they provide an important forum for direct communication with patients and among caregivers, for clinical decision making at the bedside, and for teaching. Although rounding may be familiar to clinicians, this activity may be unfamiliar to the many nonclinician colleagues (eg, administrators, nonphysician scientists, graphic artists)1 with whom clinicians work in an academic medical center. Indeed, such individuals may never have experienced rounds or may have experienced rounds only in the unfortunate scenario of a personal or family member’s hospitalization. Yet the work of such nonclinician colleagues is critical to the mission of academic medical centers, and enhancing mutual appreciation of all caregivers’ roles, clinical and nonclinical, in an academic medical center is highly desirable. Reasoning that inviting nonclinician colleagues on rounds could strengthen their understanding of the clinical mission of the institution and increase engagement, the authors designed and offered a rounding program in the Education Institute of Cleveland Clinic. Specifically, in this program, called Rounds with Jamie (the senior author’s nickname), nonclinician colleagues were invited to both join clinicians on rounds and to submit a short
written piece reflecting on their experience. Later, participants were asked to respond to a short, structured online questionnaire that explored their experience and the impact of rounding. This report summarizes feedback from participants in Rounds with Jamie from the program’s inception (December 2010) through May 2013.
Methods Because the program was launched as an administrative activity, the study was approved by the Cleveland Clinic Institutional Review Board as being exempt from the need for informed consent. Invitations were sent electronically to members of the Cleveland Clinic Education Institute (approximately 200 individuals, only a small minority [
First Time Rounding Experiences for Nonclinicians: The Cleveland Clinic Experience Laura R. Greenwald, Amy S. Nowacki and James K. Stoller American Journal of Medical Quality published online 11 February 2014 DOI: 10.1177/1062860614521657 The online version of this article can be found at: http://ajm.sagepub.com/content/early/2014/02/11/1062860614521657
Published by: http://www.sagepublications.com
On behalf of: American College of Medical Quality
Additional services and information for American Journal of Medical Quality can be found at: Email Alerts: http://ajm.sagepub.com/cgi/alerts Subscriptions: http://ajm.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav
>> OnlineFirst Version of Record - Feb 11, 2014 What is This?
Downloaded from ajm.sagepub.com at University of Huddersfield on October 6, 2014
521657 research-article2014
AJMXXX10.1177/1062860614521657American Journal of Medical QualityGreenwald et al
Article
First Time Rounding Experiences for Nonclinicians: The Cleveland Clinic Experience
American Journal of Medical Quality 1–5 © 2014 by the American College of Medical Quality Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1062860614521657 ajmq.sagepub.com
Laura R. Greenwald, MBA,1 Amy S. Nowacki, PhD,1 and James K. Stoller, MD, MS1
Abstract Clinical rounds serve several key objectives in academic medical centers: providing a forum for patient communication, clinical decision making, and teaching. Nonclinical colleagues ordinarily do not have the opportunity to round, and the idea of implementing a rounding program that includes nonclinical colleagues has received little attention to date. Reasoning that a rounding program with nonclinicians could enhance (1) understanding of the organization’s clinical mission, (2) appreciation of caregivers’ roles, and (3) engagement, the authors created such a program. From 2010 to 2013, 51 nonclinicians within the Cleveland Clinic Education Institute participated; 14 submitted written reflections, and 27 responded to a survey about their experience. Overall, 12 themes emerged that suggest an enhanced familiarity with the institution and increased engagement and alignment with its mission. Notably, the results align with a long-standing focus on organizational engagement and an observed increase in mean engagement scores since the program was implemented. Keywords clinical rounding, nonclinician rounding, employee engagement
Clinical rounds are one of the time-honored cornerstones of inpatient practice in academic medical centers because they provide an important forum for direct communication with patients and among caregivers, for clinical decision making at the bedside, and for teaching. Although rounding may be familiar to clinicians, this activity may be unfamiliar to the many nonclinician colleagues (eg, administrators, nonphysician scientists, graphic artists)1 with whom clinicians work in an academic medical center. Indeed, such individuals may never have experienced rounds or may have experienced rounds only in the unfortunate scenario of a personal or family member’s hospitalization. Yet the work of such nonclinician colleagues is critical to the mission of academic medical centers, and enhancing mutual appreciation of all caregivers’ roles, clinical and nonclinical, in an academic medical center is highly desirable. Reasoning that inviting nonclinician colleagues on rounds could strengthen their understanding of the clinical mission of the institution and increase engagement, the authors designed and offered a rounding program in the Education Institute of Cleveland Clinic. Specifically, in this program, called Rounds with Jamie (the senior author’s nickname), nonclinician colleagues were invited to both join clinicians on rounds and to submit a short
written piece reflecting on their experience. Later, participants were asked to respond to a short, structured online questionnaire that explored their experience and the impact of rounding. This report summarizes feedback from participants in Rounds with Jamie from the program’s inception (December 2010) through May 2013.
Methods Because the program was launched as an administrative activity, the study was approved by the Cleveland Clinic Institutional Review Board as being exempt from the need for informed consent. Invitations were sent electronically to members of the Cleveland Clinic Education Institute (approximately 200 individuals, only a small minority [
