Table 3.
Fellow survey responses: structure and perceptions of hospital nephrology rounds
| Parameter | All, n=621a | Domain/Subdomain | |
|---|---|---|---|
| Average patient census (per fellow)b | Domain: structure subdomain: workload | ||
| 0–4 patients | 6 (0.97%) | ||
| 5–10 patients | 24 (4%) | ||
| 11–15 patients | 118 (19%) | ||
| 16–20 patients | 224 (36%) | ||
| ≥21 patients | 237 (38%) | ||
| Missing | 12 (2%) | ||
| Hospital arrival time for a day shiftb | Domain: structure subdomain: workflow | ||
| Before 6:00 am | 75 (12%) | ||
| 6:01 am–6:30 am | 128 (21%) | ||
| 6:31 am–7:00 am | 163 (26%) | ||
| 7:01 am–7:30 am | 144 (23%) | ||
| 7:31 am–8:00 am | 84 (14%) | ||
| After 8:01 am | 13 (2%) | ||
| Missing | 14 (2%) | ||
| Time of progress note completionb | Domain: structure subdomain: workflow | ||
| Before 10:00 am | 8 (1%) | ||
| 10:01 am–12:00 pm | 36 (6%) | ||
| 12:01 pm–5:00 pm | 279 (45%) | ||
| 5:01 pm–8:00 pm | 263 (42%) | ||
| After 8:01 pm | 22 (4%) | ||
| Missing | 13 (2%) | ||
| Frequency of patient data (vital signs, laboratory results) collection without interviewing and examining patients before rounding with the attendingb | Domain: structure subdomain: workflow | ||
| Never | 130 (21%) | ||
| Rarely | 153 (25%) | ||
| Sometimes | 142 (23%) | ||
| Most of the time | 99 (16%) | ||
| Always | 83 (13%) | ||
| Missing | 14 (2%) | ||
| Proportion of patients examined together with the attendingb | Domain: structure subdomain: workflow | ||
| None | 31 (5%) | ||
| Less than half | 137 (22%) | ||
| Approximately half | 69 (11%) | ||
| More than half but not all | 185 (30%) | ||
| All | 185 (30%) | ||
| Missing | 14 (2%) | ||
| Type of technologyc | Domain: structure subdomain: workflow | ||
| Electronic tablets to view patient data | 189 (30%) | ||
| Mobile phone applications to view patient data | 332 (53%) | ||
| Mobile laptop computers to view and input data (e.g., notes and orders) | 242 (39%) | ||
| Voice-recognition software to dictate patient progress notes | 101 (16%) | ||
| Overall technology use | Domain: structure subdomain: workflow | ||
| At least one (tablet/phone/laptop/voice recognition) | 527 (85%) | ||
| No technology | 94 (15%) | ||
| Competing clinical responsibilities while roundingc | Domain: structure subdomain: workflow | ||
| Outpatient clinic | 556 (90%) | ||
| Performance of kidney biopsy | 330 (53%) | ||
| Placement of dialysis catheters | 286 (46%) | ||
| Number of competing clinical responsibilities | Domain: structure subdomain: workflow | ||
| 0 | 33 (5%) | ||
| 1 | 191 (30%) | ||
| 2 | 210 (34%) | ||
| 3 | 187 (30%) | ||
| Missing | 0 (0%) | ||
| Most valuable for building clinical skills as a nephrologist | Domain: perception subdomain: value for clinical skill-building | ||
| Analyzing laboratory results | 57 (9%) | ||
| Formulating a differential diagnosis and management plan by writing consults and progress notes | 138 (22%) | ||
| Bedside discussion of differential diagnosis and management plans with the attending | 210 (34%) | ||
| Remote discussion of differential diagnosis and management plans with the attending | 201 (32%) | ||
| Missing | 15 (2%) | ||
| Does interviewing and examining patients before attending-rounds improve patient care? | Domain: perception subdomain: value for patient care | ||
| Never | 12 (2%) | ||
| Rarely | 65 (10%) | ||
| Sometimes | 176 (28%) | ||
| Most of the time | 188 (30%) | ||
| Always | 159 (26%) | ||
| Missing | 21 (3%) | ||
a
Values are expressed as count (percent).
b
For a typical inpatient consult service during the week.
c
The responses for these questions are not mutually exclusive and the percent may not add to 100.