Rounding

Psychiatric measurements for clinical rounding

Clinical measures for rounding should be relevant to the condition for which the patient is hospitalized.     The measures selected for the condition should be key measures.  For the purposes of monitoring in the hospital, the patient should be able to perform somewhat on the measure, but not completely. This avoids floor and ceiling effects. In the initial follow-up phases ask the person the same question each day on rounds until they reach ceiling or floor and then shift to a measure with a new level of difficulty. 

The table shows three common conditions for which psychiatry consult services will follow a patient. Note that these measures are done ins real time with the patient and provide a snapshot view.

Condition	Focus area	Sample measures to be repeated on daily rounds
Delirium	Attention	Months of the year backwards Spelling “World “backwards   Repeat the memory phrase “John Brown…”   Follow a 2 step command
Suicide Risk	Suicidal ideation	Suicide Severity Risk Scale
Depression	Mood	Patient self-report of mood scored on scale of 1 (markedly depressed,   5 normal, 10 manic)