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This Article Full Text Full Text (PDF) Online Discussion (Pediatric) Online Discussion (Adult) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Marcelo Cardarelli Permission Requests Google Scholar Articles by Cardarelli, M. Articles by Xiao, Y. PubMed Articles by Cardarelli, M. Articles by Xiao, Y. Related Collections Education Professional affairs

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Original Articles: Adult Cardiac

Dissecting Multidisciplinary Cardiac Surgery Rounds

^a Department of Surgery, Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland
^b Department of Pediatrics, Division of Critical Care, University of Maryland Medical Center, Baltimore, Maryland
^c Department of Anesthesia, University of Maryland Medical Center, Baltimore, Maryland
^d School of Nursing, University of Maryland Medical Center, Baltimore, Maryland

Accepted for publication May 4, 2009.

^_* Address correspondence to Dr Cardarelli, University of Maryland Medical System, 22 S Greene St, Baltimore, MD 21201 (Email: mcard001{at}umaryland.edu).

Background: Multidisciplinary rounds in the critical care environment have demonstrated increased communication, a reduction in medical errors, a shorter hospital stay, and consequently, economic savings. We attempt to assess the cost of this intervention, and to review the time utilization of professionals participating in the process.

Methods: We analyzed video-recorded weekly multidisciplinary teaching rounds on cardiac patients in a pediatric intensive care unit (n = 22). Rounding time was categorized as presentation or discussion and was measured in minutes. The cost of a round was calculated by multiplying the hourly salary of all healthcare professionals present by the time spent rounding and measured in US dollars.

Results: Median rounding time per patient was 15 minutes (range, 5 to 29). Patient presentation took between 2 and 8 minutes (median 4), or 26% of the rounding time. Time needed for discussion, including teaching and planning, varied between 2 and 25 minutes (median 10.5). Median number of participants was 13.5 (range, 11 and 16). Mean cost in salaries per patient rounded was $140.87 (95% confidence interval: $106.80 to $174.90).

Conclusions: Multidisciplinary rounds are a low-cost medical intervention with proven benefits. Available tools and rounding cultural changes should be adopted to shorten data retrieval and presentation time to the benefit of discussion and teaching. Current billing requirements for rounding multidisciplinary teams do not reflect the realities of their time use.