SP2.1.5Does the introduction of ward round stickers improve surgical ward rounds?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Vivek Sharma ◽  
Emma Fitz-patrick ◽  
Dhiraj Sharma
Keyword(s):  
Quality Improvement ◽  
Good Practice ◽  
Ward Round ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Vte Prophylaxis ◽  
Baseline Performance ◽  
Surgical Ward ◽  
Ward Rounds ◽  
Surgical Teams

Abstract Aims With surgical teams in the NHS pushed to their limit under unprecedented demands, simple and effective ways for maintaining standards of patient care are necessitated. This quality improvement project aims to implement user-friendly and coherent ward round stickers as an adjunct to surgical ward rounds to deliver standardised care. Methods Baseline performance was measured against The Royal College of Surgeons of Edinburgh Surgical Ward Round Toolkit. Five recorded items were studied including: bloods, venous thromboembolism (VTE) prophylaxis, regular medications, observations, and handover to nursing staff. The surgical team was informed of the audit but not over which dates it would be conducted. In the first cycle, data was collected over a 4 week period. Ward round stickers were then implemented and a second cycle was completed 2 months later over another 4 week period. Results Baseline performance recorded from 74 ward round entries showed checking of bloods, VTE, regular medications, observations and handover ranged from 0% to 65%. After the introduction of ward round stickers, a second cycle was performed from 81 ward round entities. There was significant improvement from baseline with compliance in recording all five items > 85%. Conclusion This quality improvement project showed that the use of stickers as an adjunct to surgical ward round is a simple and effective way of evidencing good practice against recommended standards.

scholarly journals 264 Does the Introduction of Ward Round Stickers Improve Surgical Ward Rounds?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
V Sharma ◽  
E Fitzpatrick ◽  
D Sharma
Keyword(s):  
Quality Improvement ◽  
Good Practice ◽  
Ward Round ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Vte Prophylaxis ◽  
Baseline Performance ◽  
Surgical Ward ◽  
Ward Rounds ◽  
Surgical Teams

Abstract Aim With surgical teams in the NHS pushed to their limit under unprecedented demands, simple and effective ways for maintaining standards of patient care are necessitated. This quality improvement project aims to implement user-friendly and coherent ward round stickers as an adjunct to surgical ward rounds to deliver standardised care. Method Baseline performance was measured against The Royal College of Surgeons of Edinburgh Surgical Ward Round Toolkit. Five recorded items were studied including: bloods, venous thromboembolism(VTE) prophylaxis, regular medications, observations, and handover to nursing staff. The surgical team was informed of the audit but not over which dates it would be conducted. In the first cycle, data was collected over a 4-week period. Ward round stickers were then implemented, and a second cycle was completed 2 months later over another 4-week period. Results Baseline performance recorded from 74 ward round entries showed checking of bloods, VTE, regular medications, observations and handover ranged from 0% to 65%. After the introduction of ward round stickers, a second cycle was performed from 81 ward round entities. There was significant improvement from baseline with compliance in recording all five items > 85%. Conclusions This quality improvement project showed that the use of stickers as an adjunct to surgical ward round is a simple and effective way of evidencing good practice against recommended standards.

scholarly journals Do ward round stickers improve surgical ward round? A quality improvement project in a high-volume general surgery department

2018 ◽  
Vol 7 (3) ◽  
pp. e000341 ◽  
Author(s):  
Jimmy Ng ◽  
Ahmed Abdelhadi ◽  
Peter Waterland ◽  
Jonathan Swallow ◽  
Deborah Nicol ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Care ◽  
Good Practice ◽  
Ward Round ◽  
Quality Improvement Project ◽  
Medical Council ◽  
Improvement Project ◽  
Baseline Performance ◽  
Surgical Ward ◽  
Surgery Department

IntroductionIncreasing pressure and limitations on the NHS necessitate simple and effective ways for maintaining standards of patient care. This quality improvement project aims to design and implement user-friendly and clear ward round stickers as an adjunct to surgical ward rounds to evidence standardised care.Project design and strategyBaseline performance was measured against the recommended standards by the Royal College of Physicians, General Medical Council and a study performed at the Imperial College London. A total of 16 items were studied. All members of staff in surgery department were informed that an audit on ward round entries would be implemented but exact dates and times were not revealed. In the first cycle, ward round sticker was implemented and results collected across three random days for use and non-use of sticker. Feedback was collected through the use of questionnaires. In the second cycle, the ward round sticker was redesigned based on feedback and results collected for use and non-use of sticker.ResultsBaseline performance noted in 109 ward round entries showed that checking of drug chart, intravenous fluid chart, analgesia, antiemetic, enoxaparin, thromboembolic deterrents ranged from 0% to 6%. With the introduction of ward round stickers in both cycles, there was noticeable improvement from baseline in all items; in ward round entries where stickers were not used, performance was similar to baseline.ConclusionThis quality improvement project showed that the use of stickers as an adjunct to surgical ward round is a simple and effective way of evidencing good practice against recommended standards. Constant efforts need to be made to promote compliance and sustainability. Commitment from all levels of staff are paramount in ensuring standardised patient care without overlooking basic aspects.

scholarly journals Improving patient access to medication information: a quality improvement project on patient-centred prescribing

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S225-S225
Author(s):  
Anna Todd ◽  
Rosy Blunstone
Keyword(s):  
Quality Improvement ◽  
Good Practice ◽  
Ward Round ◽  
Discussion Groups ◽  
Quality Improvement Project ◽  
Routine Practice ◽  
Improvement Project ◽  
Information Leaflets ◽  
Medication Information ◽  
The Impact

AimsWard rounds are sometimes the only opportunity for patients to discuss medication. Patient and professional feedback on an acute male inpatient ward in South London highlighted a demand for more medication information outside the formal ward round setting. We aimed to have 100% of patients meet our criteria for “Patient-Centred Prescribing” on the ward by March 2021. To fulfil criteria, all patients are offered: (1) ward round discussion, (2) written patient information leaflets (PILs), (3) informal discussion groups, all regarding medication.The principles of this quality improvement project (QIP) were drawn from definitions of patient-centred care and standards of good practice; patients should have access to a variety of information formats, relevant to the individual, and the knowledge gained empowers patients.Patient experience data revealed that 30% of clients answered passively to the question, “Do you feel involved in your care?” We hypothesized that medication discussion groups positively impact patients’ wellbeing, by providing a safe space that facilitates conversation surrounding medication issues.MethodWe conducted weekly audits on patients whose admission duration was >7 days, and recorded fulfilment of the above criteria. At week 1, we introduced a program of weekly medication discussion groups led by members of the wider multi-disciplinary team covering a broad topic range. At week 6, we developed a rolling rota of the discussion groups and posters were displayed in advance. At week 14, all patients were offered PILs through a 1:1 interaction and this continued as routine practice. Medication discussion group feedback was obtained via questionnaires and “The Blob Tree”, a psycho-emotional assessment tool commonly used in healthcare settings.ResultIn 19 weeks, the median percentage of patients who fulfilled our criteria for Patient-Centred Prescribing was 92.86%. After 11 medication discussion groups, 79.3% of questionnaire responders wanted further sessions. 88% of “The Blob Tree” responses collected inferred a positive emotional response after the group discussions and half of those noticed an improvement in their emotional state.ConclusionThis QIP was overall a success; it fulfilled a requirement to meet good standards in information sharing and became embedded in the fabric of the ward, continuing to run as part of the activities program. It demonstrated the impact of education on patients’ mental wellbeing through empowerment and peer support. As a by-product it established multidisciplinary connections and improved therapeutic relationships. Challenges included patient engagement secondary to acute mental illness or negative symptoms and maintaining project momentum following a COVID-19 outbreak.

scholarly journals 1702 A Proforma To Improve Documentation of Surgical Ward Rounds

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
E Armstrong ◽  
M Koronfel
Keyword(s):  
District General Hospital ◽  
Ward Round ◽  
Post Intervention ◽  
Improvement Project ◽  
Vte Prophylaxis ◽  
Surgical Ward ◽  
Management Plans ◽  
Ward Rounds ◽  
Assess Quality

Abstract Aim The ward round is an important vehicle in the care of surgical inpatients. Good quality documentation is essential in recording patient progress over time and communicating clearly between multidisciplinary team (MDT) members. This quality improvement project aimed to implement a standardised proforma to improve the quality of ward round documentation, improving MDT communication and patient safety. Method Ward round entries from an elective surgical unit at a District General Hospital were retrospectively reviewed using a fifteen-item checklist to assess quality of documentation. These criteria were divided into: A re-audit was performed following introduction of a ward round proforma using the same criteria. Results The pre-intervention arm included 41 entries and the post-intervention arm included 27 entries. Improvements were seen in twelve of the fifteen criteria assessed. The greatest improvements were seen in documentation of management plans; documentation of discharge plan improved from 58.5% to 100%, VTE prophylaxis from 42% to 100% and drain/ catheter plan from 42 to 93%. Documentation of two criteria (signature and bleep) decreased and documentation of date remained at 100%. Conclusions The use of a standardised proforma improves documentation of surgical ward rounds, particularly patient’s’ onward management plans. Further modifications to the proforma could aim to improve documentation of bleep and signature.

scholarly journals Ward round template: enhancing patient safety on ward rounds

2018 ◽  
Vol 7 (2) ◽  
pp. e000170 ◽  
Author(s):  
Niall Gilliland ◽  
Natalie Catherwood ◽  
Shaouyn Chen ◽  
Peter Browne ◽  
Jacob Wilson ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Antibiotic Stewardship ◽  
Ward Round ◽  
Early Warning Score ◽  
Improvement Project ◽  
Inpatient Ward ◽  
Improve Compliance ◽  
Safety Parameters ◽  
Ward Rounds

Introduction and aimsConcerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety. These parameters were based on Trust patient safety guidance and CQUIN targets.MethodThe quality improvement technique of plan–do–study–act (PDSA) was used in this project. We retrospectively reviewed ward round entries to record baseline measurements, based on the above described parameters, prior to making any changes. Following this, the change applied was the introduction of a ward round template to include the highlighted important baseline parameters. Monthly PDSA cycles are performed, and baseline measurements are re-examined, then relevant changes were made to the ward round template.Summary of resultsDocumentation of baseline measurements was poor prior to introduction of the ward round template; this improved significantly following introduction of a standardised ward round template. Following three cycles, documentation of VTE risk assessments increased from 14% to 92%. Antibiotic stewardship documentation went from 0% to 100%. Use of the TEP form went from 29% to 78%.ConclusionsFollowing introduction of the ward round template, compliance improved significantly in all safety parameters. Important safety measures being discussed on ward rounds will lead to enhanced patient safety and will improve compliance to Trust guidance and comissioning for quality and innovation (CQUIN) targets. Ongoing change implementation will focus on improving compliance with usage of the template on all urology ward rounds.

A patient-centred check sheet improves communication on the trauma ward round

2019 ◽  
Vol 80 (8) ◽  
pp. 472-475
Author(s):  
Oliver S Brown ◽  
Teri HH Toi ◽  
Pedro R Barbosa ◽  
Patra Pookarnjanamorakot ◽  
Alex Trompeter
Keyword(s):  
Patient Survey ◽  
Management Plan ◽  
Ward Round ◽  
Improvement Project ◽  
Orthopaedic Department ◽  
Number Of Patients ◽  
Surgical Ward ◽  
Ward Rounds ◽  
Transfer Of Information ◽  
Initial Results

Background: Effective communication on surgical ward rounds should clarify for patients their management plan and answer questions adequately. Pressures on time conspire against this interchange of information. A patient-centred surgical communication check sheet was devised to enable rapid two-way transfer of information between surgeon and patient. Methods: A quality improvement project involved three cycles. Through the use of a patient survey, distributed following the daily ward round, areas for improvement in communication were highlighted in cycle one. The surgical communication check sheet was introduced in cycle two, and modified before cycle three following discussion with the orthopaedic department. The surgical communication check sheet was handed out to patients before the ward round, and its efficacy was measured by evaluating ward round communication using the survey as in cycle one. Results: Initial results showed a variable standard of communication, which improved following the introduction of the surgical communication check sheet in cycle two. In cycle three, 84.7% patients felt that the check sheet aided communication on the ward round. Measures of communication improved between cycles one and three: the percentage of patients with unanswered questions fell from 21.8% to 16.7%, the number of patients unsure why a test was done fell from 25.9% to 12.7%, and average understanding of the management plan rose from 64.7% to 83.3%. Conclusions: The introduction of the surgical communication check sheet improved ward round communication, and was welcomed by almost 85% of patients. Accounts from patients indicate two benefits of the check sheet: the surgeon is immediately aware of a patient with questions or concerns, allowing these to be adequately addressed, and patients can formulate questions before the ward round which bolsters their confidence to ask them.

scholarly journals 1250 Introduction of a New Electronic System in Surgery during the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Jacob ◽  
O Chaudhary ◽  
N Darwish ◽  
H Pardoe
Keyword(s):  
Quality Improvement ◽  
Current System ◽  
Electronic System ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Social Distancing ◽  
Surgical Department ◽  
Information Governance ◽  
Ward Rounds ◽  
The Impact

Abstract Aim The ongoing COVID-19 pandemic has impacted all aspects of clinical practice. Preventative measures to avoid spread of the virus has included maintaining social distancing, thus making surgical handovers and ward care particularly challenging. The surgical department at PAH were able to reflect on what improvements could be made to the current system during this time, with a particular focus on efficiency and information governance, while also maintaining social distancing. Due to the advancement in information technology, electronic systems have become widely used throughout the NHS and a quality improvement project was introduced to try and improve our department using an electronic handover Method A quality improvement project was carried out, with questionnaires sent out pre- and post-implementation to evaluate the impact of the new electronic handover. Results Implementation of the electronic handover improved the safety and efficiency of the surgical department, particularly with information governance (p < 0.001), efficiency of ward rounds (p = 0.002) and social distancing. Less doctors were taking lists home (p < 0.001) and fewer doctors needed to return to the MDT room during ward rounds to check key clinical information (p < 0.001). Close to 50% of doctors said that the implementation of an electronic system reduced the need to be in crowded MDT rooms to check patient information. Conclusions There were clear benefits to using an electronic healthcare system both for satisfaction of workers and for patient care. The project used pre-existing IT software that was modified through collaboration with the IT department and is something that will continue to be improved in the future.

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