PA.26 Reviewing the practice of Ward Rounds in Obstetrics and Gynaecology: A snapshot at a busy District General Hospital

Abstract

Background The ward round often represents the mainstay of doctor-patient contact during a hospital stay. They give the opportunity for the multi-disciplinary team to tailor individual patient care and improve patient safety and experience. In 2012 the Royal Colleges of Physicians and Nursing created a set of best practice principles for ward rounds. This audit aimed to compare current practice to these best practice principles. Methods A prospective audit of 45 inpatients on the Obstetric and Gynaecology wards of Walsall Manor Hospital in nine days of April 2013. Standards set out in the document “Ward Rounds in medicine – Principles for best Practice” were used as a benchmark. Results 89% (40/45) patients were reviewed by a doctor, 58% (23/40) of whom were reviewed before 10am, with 30% (12/40) being reviewed between 10:00 and 13:00. There was considerable variation between consultants as to the percentage of their patients which were reviewed (50–100%), the time of day at which the review took place and who reviewed the patient. Conclusions The majority of patients are probably being reviewed on most days of their hospital stay by a senior doctor. However there is considerable variation depending on the consultant responsible for the patients’ care. Reducing this variability may be important in improving patient experience and safety. By creating guidelines based on the best practice principles it may be possible to reduce variability and better involve members of the multidisciplinary team. It will also help define future audits and provide for meaningful national comparisons.