Open Letter
To: Hospital Executive Leadership and Medical Executive Committee
From: Attending Physicians and Advanced Practice Providers
Date: [Insert Date]
Dear Members of Executive Leadership and the Medical Executive Committee,
We, the undersigned physicians, respectfully submit this petition to request the establishment of defined patient census caps during daily physician rounds.
Our shared objective is to provide consistently high-quality, safe, and patient-centered care. In recent practice, however, rounding volumes have frequently exceeded levels that allow for thorough clinical assessment, effective communication, and timely coordination of care. When patient census during rounds becomes excessive, it places clinicians at increased risk of cognitive overload, delays in decision-making, and diminished ability to address patient and family concerns adequately.
Establishing census caps during rounds would support multiple institutional priorities, including:
-
Enhanced patient safety and reduction of preventable adverse events
-
Improved quality of care, documentation accuracy, and discharge planning
-
Stronger patient experience and satisfaction
-
Improved physician well-being, engagement, and retention
-
Alignment with organizational risk management and quality benchmarks
We respectfully request that leadership develop and implement a clear, specialty-appropriate maximum patient census per rounding physician, with consideration of patient acuity, teaching responsibilities, and available team support. Additionally, we recommend establishing transparent escalation and surge protocols when census exceeds safe rounding thresholds.
This request is made in a spirit of collaboration and shared accountability. We welcome the opportunity to participate in discussions, pilot initiatives, or quality improvement efforts to ensure a balanced and sustainable solution that supports both operational efficiency and clinical excellence.
Thank you for your consideration and continued commitment to patient care and physician professionalism. We look forward to constructive dialogue on this important matter.
