Effects of Bedside Compared to Outside the Room Case Presentation

NCT03210987 | Completed

• 1 other identifier: Visitenstudie (2017-00991)
• Study Type: interventional
• Target: 1,092
• Locations: 1 country
• Sites: 1

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.

Conditions

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

Keywords

ward round; patient case presentation; communication; patient-centered care

Outcome Measures

Primary Outcomes (1)

• Subjective understanding of disease and management

  average of the visual analog scale (VAS) score across the following three dimensions rated by the patient (0 "I have no knowledge at all about the situation" to 100 "I have best possible knowledge about the situation": I. Patients' subjective understanding of the disease II. Patients' subjective understanding of the therapeutic concept III. Patients' subjective understanding of the next steps

  post ward round up to 36 h

Secondary Outcomes (14)

• Improvement understanding

  post ward round up to 36 h

• Objective understanding of disease and management

  post ward round up to 36 h

• Overall quality of care

  post ward round up to 36 h

• Follow up health status

  30 days follow up after study inclusion

• Follow up understanding

  30 days follow up after study inclusion

Study Arms (2)

patient case presentation Bedside

ACTIVE COMPARATOR

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

Procedure: patient case presentation bedside

patient case presentation Outside-the-room

ACTIVE COMPARATOR

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.

Procedure: patient case presentation Outside-the-room

Interventions

patient case presentation bedside PROCEDURE

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

Also known as: teaching round, bedside round, ward round

patient case presentation Bedside

patient case presentation Outside-the-room PROCEDURE

Patient case presentation Outside-the-room.

patient case presentation Outside-the-room

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

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

Sponsors & Collaborators

• University Hospital, Basel, Switzerland: lead
• Kantonsspital Aarau: collaborator
• Kantonsspital Liestal: collaborator

Study Sites (1)

University Hospital Basel

Basel, 4056, Switzerland

Location

Related Publications (9)

• 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.

  PMID: 9099660 BACKGROUND

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

  PMID: 16751910 BACKGROUND

• 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.

  PMID: 26628552 BACKGROUND

• 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.

  PMID: 26840968 BACKGROUND

• 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.

  PMID: 10760128 BACKGROUND

• 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.

  PMID: 37734895 DERIVED

• 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.

  PMID: 36085211 DERIVED

• 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.

  PMID: 35072414 DERIVED

• 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.

  PMID: 34181449 DERIVED

MeSH Terms

Conditions

Communication

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Sabina Hunziker, Prof.

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

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: On the day before the ward round, patients will be randomized 1:1 into one of both study arms. In one study arm, patient case presentation will be performed at bedside. In the other study arm, patient case presentation will be performed outside the room.

Study Record Dates

• First Submitted: June 27, 2017
• First Posted: July 7, 2017
• Study Start: July 11, 2017
• Primary Completion: September 21, 2019
• Study Completion: October 20, 2019
• Last Updated: January 23, 2020

Record last verified: 2020-01

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)