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We, the undersigned physicians, respectfully submit this petition to request the formal establishment of patient census caps during daily rounding to ensure high-quality, safe, and sustainable patient care.
Over recent months, many clinicians have experienced consistently elevated patient volumes during rounds, often exceeding levels that allow for thorough clinical assessment, effective communication, and timely documentation. While we remain deeply committed to patient care and organizational goals, current rounding expectations increasingly place physicians in situations that compromise:
Clinical decision-making quality
Patient safety and satisfaction
Teaching effectiveness (where applicable)
Physician well-being and retention
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To: Hospital Executive Leadership, Medical Executive Committee, and Department of Medicine Leadership
From: Attending Physicians and Advanced Practice Providers
Subject: Request to Implement Patient Census Caps During Daily Rounds
Date: [Insert Date]
We, the undersigned physicians, respectfully submit this petition to request the formal establishment of patient census caps during daily rounding to ensure high-quality, safe, and sustainable patient care.
Over recent months, many clinicians have experienced consistently elevated patient volumes during rounds, often exceeding levels that allow for thorough clinical assessment, effective communication, and timely documentation. While we remain deeply committed to patient care and organizational goals, current rounding expectations increasingly place physicians in situations that compromise:
Clinical decision-making quality
Patient safety and satisfaction
Teaching effectiveness (where applicable)
Physician well-being and retention
Extensive evidence links excessive patient loads with increased medical errors, burnout, depersonalization, and turnover—all of which directly impact institutional quality metrics and financial performance.
Implementing a defined census cap during rounds would:
Enhance Patient Safety
Allow adequate time for history review, bedside assessment, and care coordination
Reduce cognitive overload and error risk
Improve Quality of Care and Patient Experience
Support meaningful patient and family communication
Improve compliance with best practices, documentation accuracy, and discharge planning
Support Physician Well-Being and Workforce Stability
Reduce burnout and moral injury
Improve job satisfaction, retention, and recruitment
Align with Organizational Quality and Risk Management Goals
Lower readmission rates and adverse events
Support regulatory compliance and quality benchmarks
We respectfully request that leadership:
Establish a clearly defined maximum patient census per rounding physician, adjusted for:
Acuity
Teaching responsibilities
Availability of APP or resident support
Implement overflow or surge protocols when census exceeds safe rounding thresholds
Reassess caps periodically based on quality metrics, physician feedback, and patient outcomes
(Suggested example: a maximum of ___ patients per rounding physician, with defined escalation pathways when exceeded.)
We emphasize that this petition is not adversarial in nature. We seek collaborative dialogue and partnership with leadership to develop solutions that balance operational demands with safe, patient-centered care. We are eager to participate in workgroups, pilots, or quality initiatives to support successful implementation.
Capping patient census during rounds is a proactive, evidence-based measure that supports patient safety, physician sustainability, and organizational excellence. We respectfully request leadership’s consideration and timely response to this proposal.
Thank you for your attention and continued commitment to high-quality care.
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