Virtual Team Rounding

A Cross-Specialty Inpatient Care Staffing Program to Manage Covid-19 Surges

Bibliographic Data

ID21614778
AuthorsNora V Becker (0000-0001-5232-8663, University of Michigan, corresponding author), Salina Bakshi (S. Bakshiis instructor, Harvard Medical School, and primary care physician and associate medical director for primary care, Brigham and Women’s Hospital, Boston, Massachusetts.), Kate Martin (0000-0001-5230-221X, Brigham and Women's Hospital), Kate L Martin (K.L. Martinis senior physician assistant, Department of Radiation Oncology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts; ORCID:.), Amina Bougrine (A. Bougrineis a fellow, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.), Jonathan Andrade (0000-0002-0064-7686, J. Andradeis physician assistant, Department of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.), Paul R Massey (0000-0001-5114-2613, P.R. Masseyis a fellow, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.), Jesse P Hirner (J.P. Hirneris dermatologist, Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.), Jesse Hirner (Brigham and Women's Hospital), Julie Eccleston (J. Ecclestonis physician assistant, Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.), Niteesh K Choudhry (0000-0001-7719-2248, N.K. Choudhryis professor, Harvard Medical School, and executive director, Center for Healthcare Delivery Sciences, Brigham and Women’s Hospital, Boston, Massachusetts; ORCID:.), Kathryn A Britton (K.A. Brittonis instructor in medicine, Harvard Medical School, and associate chief medical officer and vice president of medical affairs, Brigham and Women’s Hospital, Boston, Massachusetts.), Adam B Landman (A.B. Landmanis associate physician, Department of Emergency Medicine, Brigham and Women’s Hospital, and associate professor of emergency medicine, Harvard Medical School, Boston, Massachusetts; ORCID:.), Adam Landman (0000-0002-2166-0521, Brigham and Women's Hospital), Adam M Licurse (Harvard Medical School), Adam Licurse (Harvard University), Narath Carlile (0000-0002-6601-6035, N. Carlileis technology, education and clinical health informatics lead, Brigham Educational Institute, director of innovation, Internal Medicine Residency, Brigham and Women’s Hospital, and instructor, Harvard Medical School, Boston, Massachusetts; ORCID:.), Mallika L Mendu (0000-0002-9345-4516, M.L. Menduis assistant professor, Renal Division, Department of Medicine, and executive medical director of clinical operations, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.)
Year2021
Volume96
Issue12
Pages1717-1721
Publication date2021-12-01
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000004208
PMID34133344
OpenAlexW3167667219
LanguageEN
Citations received1
References cited8

PROBLEM: The SARS-CoV-2 (COVID-19) pandemic presented numerous challenges to inpatient care, including overtaxed inpatient medicine services, surges in patient censuses, disrupted patient care and educational activities for trainees, underused providers in certain specialties, and personal protective equipment shortages and new requirements for physical distancing. In March 2020, as the COVID-19 surge began, an interdisciplinary group of administrators, providers, and trainees at Brigham and Women's Hospital created an inpatient virtual staffing model called the Virtual Team Rounding Program (VTRP). APPROACH: The conceptual framework guiding VTRP development was rapid-cycle innovation. The VTRP was designed iteratively using feedback from residents, physician assistants, attendings, and administrators from March to June 2020. The VTRP trained and deployed a diverse set of providers across specialties as "virtual rounders" to support inpatient teams by joining and participating in rounds via videoconference and completing documentation tasks during and after rounds. The program was rapidly scaled up from March to June 2020. OUTCOMES: In a survey of inpatient providers at the end of the pilot phase, 10/10 (100%) respondents reported they were getting either "a lot" or "a little" benefit from the VTRP and did not find the addition of the virtual rounder burdensome. During the scaling phase, the program grew to support 24 teams. In a survey at the end of the contraction phase, 117/187 (62.6%) inpatient providers who worked with a virtual rounder felt the rounder saved them time. VTRP leadership collaboratively and iteratively developed best practices for challenges encountered during implementation. NEXT STEPS: Virtual rounding provides a valuable extension of inpatient teams to manage COVID-19 surges. Future work will quantitatively and qualitatively assess the impact of the VTRP on inpatient provider satisfaction and well-being, virtual rounders' experiences, and patient care outcomes

Best practice · Documentation · Family medicine · Health care · Inpatient care · Medical education · MEDLINE · Patient safety · Specialty · Staffing · Workforce · Computer Science · Interprofessional Education and Collaboration · Medicine · Nursing · Psychology · Simulation-Based Education in Healthcare · Telemedicine and Telehealth Implementation

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