Geographic rounds: Who’s using unit-based rounds?

How popular are geographic rounds, also known as unit-based rounds, in hospital medicine? Exactly half of the hospitalists who treat adults and who responded to our survey said their group uses these types of rounds. But there are big differences in the type of hospitalist groups using them.

Larger groups and groups working at bigger hospitals, for example, are more likely to use geographic rounds. This rounding model is also more popular at teaching hospitals and less popular with independent hospitalist groups.

Among the half of hospitalists who said their groups don’t use geographic rounds, just over one-third (34.5%) said their group has never done so—and has no plans to use them. Another 15.5% said their group had once done unit-based rounds at one point but stopped using them.

Here’s a look at who is—and isn’t—rounding by geography in hospital medicine.

Geographic rounds by employer type

Geographic rounds are most frequently employed in universities/medical schools. In this setting, 57.9% of hospitalists in our survey said their groups use unit-based rounds.

Such rounds are much less popular among local hospitalist groups (34.1% are using them) and multispecialty/primary care groups (35.0%). Nearly half (48%) of hospitalists working at local groups said their practice had never used geographic rounds.

What type of hospitalist groups are using unit-based rounds?

Employer type: Using geographic rounds

• University/med. school: 57.9%

• Hospital/hosp. corp.: 53.3%

• Nat. hosp. mgmt. group: 44.9%

• Multispecialty/PC group: 35.0%

• Local hosp. group: 34.1%

Geographic rounds by group/hospital size

Survey data show that geographic rounds are more popular at larger groups and larger hospitals.

Among hospitalists working at hospitals with more than 500 beds, for example, nearly three-quarters (71.8%) said that rounds are unit-based. At hospitals with fewer than 100 beds, by comparison, only 22.1% of hospitalists said they use geographic rounds.

Also at hospitals with under 100 beds, 74% of hospitalists said their groups had never used unit-based rounds and that they have no plans to ever try them.

Hospital size and unit-based rounds

Hospital size: Using geographic rounds

• <100 beds: 22.1%

• 100-249 beds: 44.0%

• 250-500 beds: 55.4%

• >500 beds: 71.8%

We found a similar trend with hospitalist group size. Among hospitalists working at groups with more than 50 physicians, 82.3% were using geographic rounds. By comparison, just 28.1% of hospitalists working for groups with nine or fewer physicians employed unit-based rounds.

Geographic rounds and FTE hospitalists

Group size: Using geographic rounds

• 1-9: 28.1%

• 10-20: 38.5%

• 21-30: 61.7%

• 31-50: 69.6%

• >50: 82.3%

Burnout among hospitalists and geographic rounds

Our survey found limited data linking geographic rounds to slightly lower rates of burnout among hospitalists, but the numbers are far from definitive. Hospitalists at groups using unit-based rounds were more likely to say that burnout was insignificant (a good thing) compared to hospitalists at groups not using unit-based rounds.

Burnout among groups using geographic rounds

• Burnout ranking: Using geographic rounds

• Very significant: 46.4%

• Significant: 50.2%

• Insignificant: 53.1%

VIEW DATA ON HOSPITALIST PAY from both the 2024 and the 2023 Today’s Hospitalist Compensation & Career Surveys. Our annual surveys examine how hospitalist compensation is affected by factors such as the type of patients hospitalists treat, the number of shifts they work, the number of patients they see per shift and more.