Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Future Healthcare Journal

  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Future Healthcare Journal

futurehosp Logo
  • FHJ Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About FHJ
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Implementation of structured ward round pro formas on an acute frailty unit

Sam Kleeman, Zainab Khan, Joanna Brecher, MD Mofijur Rahman, Nihethana Jegatheeswaran, Hannah Costelloe, Sharose Shiraz, Christopher Chung, Jonathan Graff and Benjamin Jacobs
Download PDF
DOI: https://doi.org/10.7861/futurehealth.6-2-s55
Future Healthc J June 2019
Sam Kleeman
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Zainab Khan
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joanna Brecher
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
MD Mofijur Rahman
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nihethana Jegatheeswaran
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hannah Costelloe
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sharose Shiraz
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christopher Chung
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jonathan Graff
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Benjamin Jacobs
Barking, Havering and Redbridge University Hospitals NHS Trust
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Introduction

Guidance from the Royal College of Physicians and the National Institute for Health and Care Excellence (NICE) recommends the use of structured approaches to ward rounds. There is evidence that such approaches increase staff satisfaction, reduce adverse events and reduce length of stay. The aim of this project was to implement a structured approach to ward rounds in an acute frailty unit at a busy district general hospital in the UK.

Materials and methods

Using a Plan, Do, Study, Act (PDSA) approach, a structured ward round pro forma was implemented over a 4-week pilot period. Each week, we reviewed notes of 10 randomly selected patients to monitor adoption of the pro forma as well as utilisation of specific pro forma components (safety checklist, Gold Standard Framework (GSF) status, treatment escalation plan (TEP)). We used this data alongside feedback from the multidisciplinary team (MDT) to iteratively improve the pro forma design. MDT members were sent a survey to assess perception of the ward round documentation before and after the pilot period.

Results and discussion

Baseline survey data (n = 13) showed that MDT members felt that clear ward round documentation was important for the functioning of the MDT (9.46 ± 0.32/10) and that existing documentation was poor (5.0 ± 0.58/10). 13 out of 13 responses (100%) indicated that they felt a structured ward round pro forma would improve the quality of ward round documentation. At week 1, pro forma adoption rate was 50% (5/10), of which 40% (2/5), 60% (3/5) and 60% (3/5) included use of safety checklist, GSF status and TEP respectively. At week 2, adoption rate was 100% (10/10), of which 50% (5/10), 70% (7/10) and 40% (4/10) included use of safety checklist, GSF status and TEP respectively. At week 3, adoption rate was 100% (10/10), of which 70% (7/10), 80% (8/10) and 80% (8/10) included use of safety checklist, GSF status and TEP respectively. Results from a repeat survey of MDT members are awaited.

Conclusion

There is evidence of an unmet need for improved ward round documentation in our acute frailty unit. In this setting, it is feasible to introduce and rapidly adopt a structured ward round pro forma reflective of national guidelines. We aim to institute sustainable change through ongoing education and development of an electronic record-based pro forma.

  • © Royal College of Physicians 2019. All rights reserved.

References

    1. Royal College of Physicians
    . Ward rounds in medicine. London: RCP, 2015. www.rcplondon.ac.uk/projects/outputs/ward-rounds-medicine-principles-best-practice [Accessed 5 February 2019].
    1. National Institute for Health and Care Excellence
    . Emergency and acute medical care in over 16s: service delivery and organisation (NG94). London: NICE, 2018. www.nice.org.uk/guidance/ng94/chapter/Recommendations [Accessed 5 February 2019].
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Implementation of structured ward round pro formas on an acute frailty unit
Sam Kleeman, Zainab Khan, Joanna Brecher, MD Mofijur Rahman, Nihethana Jegatheeswaran, Hannah Costelloe, Sharose Shiraz, Christopher Chung, Jonathan Graff, Benjamin Jacobs
Future Healthc J Jun 2019, 6 (Suppl 2) 55; DOI: 10.7861/futurehealth.6-2-s55

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Implementation of structured ward round pro formas on an acute frailty unit
Sam Kleeman, Zainab Khan, Joanna Brecher, MD Mofijur Rahman, Nihethana Jegatheeswaran, Hannah Costelloe, Sharose Shiraz, Christopher Chung, Jonathan Graff, Benjamin Jacobs
Future Healthc J Jun 2019, 6 (Suppl 2) 55; DOI: 10.7861/futurehealth.6-2-s55
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Introduction
    • Materials and methods
    • Results and discussion
    • Conclusion
    • References
  • Info & Metrics

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Watchpoint: an NHS-grown electronic communication system shown to improve patient safety
  • A quality improvement project on improving the compliance of ‘oxygen prescription with target saturations’ in a district general hospital
  • Therapies in ACS: the pitfalls of prescribing
Show more Quality Improvement and Patient Safety

Similar Articles

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home

Other Services

  • Advertising
futurehosp Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians