Patients treated at clinics that conducted sit-down rounds at least once a month were more likely to have healthy levels of the blood proteins albumin and hemoglobin than those seen at clinics that performed only walking rounds, in which a nephrologist typically assessed more immediate needs of patients as they received dialysis. They also were 32 percent less likely to be admitted to the hospital, and 29 percent less likely to die.

These results are published in the December issue of the Journal of the American Society of Nephrology and available online Nov. 19.

Sit-down rounds provide an opportunity for the patient care team to thoroughly assess progress, address problems and tailor strategies, says Neil R. Powe, M.D., M.P.H., M.B.A., senior author of the study and director of Hopkins' Welch Center for Prevention, Epidemiology and Clinical Research. They are meant to complement a nephrologist's "walk-rounds" from patient to patient. The latter are brief and often focus on urgent issues, he says.

"Our results provide evidence that time spent meeting to discuss each patient's progress is as important as direct patient care in chronic disease management, in that this rounding practice is associated with better outcomes," Powe says. "Previous studies have shown that sit-down rounds also make sense for acute-care settings, like intensive care units. In addition, sit-down rounds may be warranted for patients with multiple chronic illnesses - a growing concern among the aging baby boomer population."

Powe and colleagues recruited and collected data on 644 dialysis patients being treated at 75 dialysis clinics in 17 states. The patients all had participated in a national k
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Contact: David March
dmarch1@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
19-Nov-2004