Effects of Bedside Compared to Outside the Room Case Presentation

University Hospital Basel

Status: Completed

Conditions: Bedside Patient Case Presentation; Outside-the-room Patient Case Presentation

Treatments: Procedure: patient case presentation Outside-the-room; Procedure: patient case presentation bedside

Study type: Interventional

Funder types: Other

Identifiers

NCT03210987

Visitenstudie (2017-00991)

Details and patient eligibility

About

Patient case presentations during ward rounds can take place at the bedside or outside the room. The best approach to patient case presentation is yet unclear. Thus, the overall aim of this multicenter, randomized-controlled study is to test the hypothesis that outside the room patient case presentation compared to bedside patient case presentation results in better outcomes across different dimensions including patient understanding and perception of quality of care as well as patient outcomes, physicians' preferences, perception of quality and effectiveness, and timing of the ward rounds, respectively.

Full description

Patient-centered care may be defined as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions". Involving patients in all steps of the healthcare process is thus important. Yet, best presentation of patients' cases during ward rounds remains unknown. During outside the room patient case presentation, the medical team discusses difficult patient or medical issues in the team, and later presents a "patient-friendly" synthesis to the patient. Bedside patient case presentation, on the other hand, allows a patient to be part of the whole team discussion. Yet, there is concern that patients may be unable to cope with the magnitude of medical information and misunderstandings may occur. Currently, there is equipoise regarding both possibilities of patient case presentation with an important lack of trial data. We thus aim to compare the effect of bedside patient case presentation with outside the room patient case presentation during ward rounds ("Chefarztvisite") on different patient- and physician-related endpoints.

Therefore, this randomized controlled trial aims to test the hypothesis that outside the room patient case presentation compared to bedside patient case presentation results in better outcomes across different dimensions including patient understanding and perception of quality of care as well as patient outcomes, physicians' preferences, perception of quality and effectiveness, and timing of the ward rounds, respectively.

Enrollment: 1,092 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Consecutive adult (>18 years) medical inpatients during their first ward round independently of their underlying disease and reason for hospital stay.

Exclusion criteria

1. Patients with cognitive impairment, such as dementia/delirium
2. Patients with paracusia.
3. Patients who do not understand local language(s).
4. Patients already included in this study

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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1,092 participants in 2 patient groups

patient case presentation Bedside

Active Comparator group

Description:

In the bedside presentation group, patient case presentation and discussions will be at bedside with direct involvement of the patient as needed.

Treatment:

Procedure: patient case presentation bedside

patient case presentation Outside-the-room

Active Comparator group

Description:

In the outside the room condition, case presentation and discussions will take place outside without the patient being present. After the case presentation and discussions the team will enter the room and give the patient a short summary of the medical situation, complete the medical information and examine the patient, as needed, and discuss the next steps.

Treatment:

Procedure: patient case presentation Outside-the-room