Effects of Bedside Compared to Outside the Room Case Presentation

NCT ID: NCT03210987

Last Updated: 2020-01-23

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 1092 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-07-11
• Study Completion Date: 2019-10-20

Brief Summary

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.

Detailed 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.

Conditions

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

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: SINGLE

Study Groups

patient case presentation Bedside

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

Group Type: ACTIVE_COMPARATOR

patient case presentation bedside

Intervention Type: PROCEDURE

Patient case presentation in absence or presence of Patient at bedside.

patient case presentation Outside-the-room

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.

Group Type: ACTIVE_COMPARATOR

patient case presentation Outside-the-room

Intervention Type: PROCEDURE

Patient case presentation Outside-the-room.

Interventions

patient case presentation bedside

Patient case presentation in absence or presence of Patient at bedside.

Intervention Type: PROCEDURE

patient case presentation Outside-the-room

Patient case presentation Outside-the-room.

Intervention Type: PROCEDURE

Other Intervention Names

teaching round; bedside round; ward round

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Kantonsspital Aarau

OTHER

Sponsor Role: collaborator

Kantonsspital Liestal

OTHER

Sponsor Role: collaborator

University Hospital, Basel, Switzerland

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Sabina Hunziker, Prof.

Role: PRINCIPAL_INVESTIGATOR

Medical Communication, Department of Psychosomatic Medicine, University Hospital Basel, and University of Basel, Switzerland

Locations

University Hospital Basel

Basel, , Switzerland

Countries

Switzerland

References

Lehmann LS, Brancati FL, Chen MC, Roter D, Dobs AS. The effect of bedside case presentations on patients' perceptions of their medical care. N Engl J Med. 1997 Apr 17;336(16):1150-5. doi: 10.1056/NEJM199704173361606.

Reference Type: BACKGROUND

PMID: 9099660 (View on PubMed)

Chauke HL, Pattinson RC. Ward rounds -- bedside or conference room? S Afr Med J. 2006 May;96(5):398-400. No abstract available.

Reference Type: BACKGROUND

PMID: 16751910 (View on PubMed)

O'Leary KJ, Killarney A, Hansen LO, Jones S, Malladi M, Marks K, M Shah H. Effect of patient-centred bedside rounds on hospitalised patients' decision control, activation and satisfaction with care. BMJ Qual Saf. 2016 Dec;25(12):921-928. doi: 10.1136/bmjqs-2015-004561. Epub 2015 Dec 1.

Reference Type: BACKGROUND

PMID: 26628552 (View on PubMed)

Ramirez J, Singh J, Williams AA. Patient Satisfaction with Bedside Teaching Rounds Compared with Nonbedside Rounds. South Med J. 2016 Feb;109(2):112-5. doi: 10.14423/SMJ.0000000000000419.

Reference Type: BACKGROUND

PMID: 26840968 (View on PubMed)

Seo M, Tamura K, Morioka E, Shijo H. Impact of medical round on patients' and residents' perceptions at a university hospital in Japan. Med Educ. 2000 May;34(5):409-11. doi: 10.1046/j.1365-2923.2000.00516.x. No abstract available.

Reference Type: BACKGROUND

PMID: 10760128 (View on PubMed)

Gross S, Becker C, Beck K, Memma V, Gaab J, Schutz P, Leuppi JD, Schaefert R, Langewitz W, Trendelenburg M, Breidthardt T, Eckstein J, Osthoff M, Bassetti S, Hunziker S. Occurrence of sensitive topics during ward round: an ancillary analysis of the BEDSIDE-OUTSIDE trial. BMJ Open. 2023 Sep 21;13(9):e073584. doi: 10.1136/bmjopen-2023-073584.

Reference Type: DERIVED

PMID: 37734895 (View on PubMed)

Becker C, Gross S, Gamp M, Beck K, Amacher SA, Mueller J, Bohren C, Blatter R, Schaefert R, Schuetz P, Leuppi J, Bassetti S, Hunziker S. Patients' Preference for Participation in Medical Decision-Making: Secondary Analysis of the BEDSIDE-OUTSIDE Trial. J Gen Intern Med. 2023 Apr;38(5):1180-1189. doi: 10.1007/s11606-022-07775-z. Epub 2022 Sep 9.

Reference Type: DERIVED

PMID: 36085211 (View on PubMed)

Gross S, Beck K, Becker C, Gamp M, Mueller J, Loretz N, Amacher SA, Bohren C, Gaab J, Schuetz P, Mueller B, Fux CA, Leuppi JD, Schaefert R, Langewitz W, Trendelenburg M, Breidthardt T, Eckstein J, Osthoff M, Bassetti S, Hunziker S. Perception of physicians and nursing staff members regarding outside versus bedside ward rounds: ancillary analysis of the randomised BEDSIDE-OUTSIDE trial. Swiss Med Wkly. 2022 Jan 19;152:w30112. doi: 10.4414/smw.2022.w30112. eCollection 2022 Jan 17.

Reference Type: DERIVED

PMID: 35072414 (View on PubMed)

Becker C, Gamp M, Schuetz P, Beck K, Vincent A, Hochstrasser S, Metzger K, Widmer M, Thommen E, Mueller B, Fux CA, Leuppi JD, Schaefert R, Langewitz W, Trendelenburg M, Breidthardt T, Eckstein J, Osthoff M, Bassetti S, Hunziker S; BEDSIDE-OUTSIDE Study Group. Effect of Bedside Compared With Outside the Room Patient Case Presentation on Patients' Knowledge About Their Medical Care : A Randomized, Controlled, Multicenter Trial. Ann Intern Med. 2021 Sep;174(9):1282-1292. doi: 10.7326/M21-0909. Epub 2021 Jun 29.

Reference Type: DERIVED

PMID: 34181449 (View on PubMed)

Other Identifiers

Visitenstudie (2017-00991)

Identifier Type: -

Identifier Source: org_study_id