Historically, morning rounds were completed with the entire team present. The mindset was that rounds would take as long as they needed and that the psychiatrist led the team. Additionally, historical rounds did not emphasize including the patient in care planning. Rather, one could argue that the patient was informed of the plan and given an opportunity to ask questions.
This could be an intimidating process. Rounds could be long, with the entire team posing questions at once. Also, patients might not want to ask their questions when faced with an entire team of medical professionals standing over their bed.
Rounding practices have improved over the years, but there are still compromises that a patient will likely see during their first few days in a psychiatric hospital.
Most patients will find that team rounds still occur, and that they are still first thing in the mornings. But the goal is not to complete detailed interviews or screenings during rounds. Rather, the goal is for everyone to share their thoughts, and to quickly agree on a general work plan for the day. The detailed work is then done separately.
In essence, over the years care teams have had to learn how to balance two key inpatient care needs:
An opportunity for the entire care team to meet with a patient, so that everyone can participate in a shared conversation, and
The need for adequate time to complete detailed assessments
Most patients will find that after morning rounds, individual team members will circle back to complete specialty interviews or meetings. For example, the physician may return to speak more about any medication decisions or any medical testing that needs to be completed. Social workers may return to speak about care options in the area, and how the hospital liaises with them. Occupational therapists may return to evaluate skills related to day to day function, like dressing oneself, or solving daily challenges like budgeting or prioritizing daily tasks.
This information is then all recorded in the patient's medical chart over the course of the day, so that during the next set of team rounds, the results can be summarized and shared with the entire group.
I always like to cover this workflow with those who are new to hospital settings, because a question I'm frequently asked is: Well, why can't we just get everything done at once? Why do people keep coming into my room, saying they need to do their own assessment?
Hopefully this helps clarify why hospitals have moved towards individual assessments for each team member and shorter team rounds.
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