Improving Communication and Coordination in Medical Ward Rounds: A Quality Improvement Initiative in an Acute Teaching Hospital.

Q3 Medicine Acute Medicine Pub Date : 2025-01-01 DOI:10.52964/AMJA.1005

Marie E Ward, Barry Kennedy, Sharon O'Hara, Susie O'Callaghan, Una Geary, Fiona Keogan, Declan Byrne, Bláthnaid Mealy, Ricardo Paco, Joe Deegan, Shadan Kahatab, Jennifer Sheerin, John Drought, Conor MacDonnchadha, Cormac Kennedy

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Abstract

Background: Medical ward rounds are essential to support care delivery, however a lack of multi-disciplinary team rounding may have a knock-on effect on care coordination and may lead to delayed discharges and increased length of stays.

Methods: The aim of this study was to improve patient outcomes by improving communication and coordination surrounding medical ward rounds through bringing disciplines together during medical ward rounds or at post-round operational huddles. The primary outcome measure was to improve the number of patients discharged by noon.

Results: At the end of the study there was no impact on our primary outcome measure. Efforts for improvement were redirected from the micro- to the meso- and macrosystem of the organisation.

Conclusion: While developing this complex project, we found reforms at a macrosystem of how care is provided are needed including ward-based care. Reforms must balance system resilience and efficiency while ensuring 'slack' in the system to support communication, relationship building and coordination of care.

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加强病房查房的沟通和协调：急症教学医院的质量改进举措。

背景：医疗病房查房对支持护理提供至关重要，然而，缺乏多学科小组查房可能对护理协调产生连锁反应，并可能导致出院延迟和住院时间延长。方法：本研究的目的是通过在查房期间或查房后的手术会议中将学科聚集在一起，通过改善查房周围的沟通和协调来改善患者的预后。主要结局指标是提高中午前出院的患者数量。结果：在研究结束时，对我们的主要结局测量没有影响。改进的努力从微观转向了组织的中观和宏观系统。结论：在开发这个复杂的项目时，我们发现需要对如何提供护理的宏观系统进行改革，包括病房护理。改革必须平衡系统弹性和效率，同时确保系统的“松弛”，以支持沟通、建立关系和协调护理工作。

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来源期刊

Acute Medicine Medicine-Emergency Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： These are usually commissioned by the editorial team in accordance with a cycle running over several years. Authors wishing to submit a review relevant to Acute Medicine are advised to contact the editor before writing this. Unsolicited review articles received for consideration may be included if the subject matter is considered of interest to the readership, provided the topic has not already been covered in a recent edition. Review articles are usually 3000-5000 words and may include tables, pictures and other figures as required for the text. Include 3 or 4 ‘key points’ summarising the main teaching messages.