Rounding: A Model for Consultation and Training Whose Time Has Come

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Ethics rounds in clinical ethics have already taken hold in multiple venues. There are “sit-down rounds,” which usually consist of a bioethicist setting a specific, prescheduled time aside for residents and/or others to bring a case or two for discussion with the bioethicist. Another kind of rounds that occurs on an ad hoc or infrequent basis is to have either a staff or outside bioethicist give hospital-wide and/or departmental “grand rounds.” Grand rounds is a traditional educational format in medicine and adding bioethics to the topics covered in grand rounds is an important means of elevating ethical awareness within a department or throughout a healthcare organization. Newer is the rounding practice of adding a bioethicist to other established rounding processes, such as case management and utilization review rounds. All of these kinds of ethics rounds are important opportunities to elevate the level of moral discourse within a healthcare setting and are becoming part and parcel of any full-service hospital bioethics program.Some of the content of this paper was delivered by DeRenzo in her talk, “Having a Bioethicist Round Weekly in the Intensive Care Unit: Benefits to Patients and Staff of Upstream Preventive Ethics versus Conflicted Downstream Consultations,” presented at the Second International Conference on Clinical Ethics Consultation, Basel, Switzerland, March 2005.