Surgical ward rounds in England: a trainee-led multi-centre study of current practice

Patient Safety in Surgery

Sean Strong⁶  Jennifer Smith⁴  Sarah K Richards³  Steve T Hornby¹  Andrew Hollowood⁷  Alexander Brown⁵  Natalie S Blencowe⁶  Shelly N Griffiths²  Ceri Rowlands⁷ 

[1] Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, England;Torbay Hospital, Torquay, Devon TQ2 7AA, England;Royal United Hospital Bath NHS Trust, Combe Park, Bath BA1 3NG, England;Royal Preston Hospital, Preston PR2 9HTLancashire, England;Musgrove Park Hospital, TauntonSomerset TA1 5DA, UK;Centre for Surgical Research, School of Social & Community Medicine, University of Bristol, Canynge Hall, Bristol BS8 2PS, England;Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, England

关键词: Consultant;    Seven day working;    Ward rounds;    Health manpower;   

Others  :  790264
DOI  :  10.1186/1754-9493-8-11

 received in 2014-01-20, accepted in 2014-02-08,  发布年份 2014

【 摘 要 】

Background

Recent guidance advocates daily consultant-led ward rounds, conducted in the morning with the presence of senior nursing staff and minimising patients on outlying wards. These recommendations aim to improve patient management through timely investigations, treatment and discharge. This study sought to evaluate the current surgical ward round practices in England.

Methods

Information regarding timing and staffing levels of surgical ward rounds was collected prospectively over a one-week period. The location of each patient was also documented. Two surgical trainee research collaboratives coordinated data collection from 19 hospitals and 13 surgical subspecialties.

Results

Data from 471 ward rounds involving 5622 patient encounters was obtained. 367 (77.9%) ward rounds commenced before 9am. Of 422 weekday rounds, 190 (45%) were consultant-led compared with 33 of the 49 (67%) weekend rounds. 2474 (44%) patients were seen with a nurse present. 1518 patients (27%) were classified as outliers, with 361 ward rounds (67%) reporting at least one outlying patient.

Conclusion

Recommendations for daily consultant-led multi disciplinary ward rounds are poorly implemented in surgical practice, and patients continue to be managed on outlying wards. Although strategies may be employed to improve nursing attendance on ward rounds, substantial changes to workforce planning would be required to deliver daily consultant-led care. An increasing political focus on patient outcomes at weekends may prompt changes in these areas.

【 授权许可】

   
2014 Rowlands et al.; licensee BioMed Central Ltd.

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