Ward round template: enhancing patient safety on ward rounds

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Clinical Governance

Background:

• Clinical governance raised concerns about inpatient ward round safety, specifically regarding documentation of clinical observations, National Early Warning Score (NEWS), venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care, and treatment escalation plans (TEP).
• These parameters are crucial for patient safety and aligned with Trust guidance and Commissioning for Quality and Innovation (CQUIN) targets.

Purpose of the Study:

• To enhance patient care and safety by ensuring key parameters are consistently considered and documented during inpatient ward rounds.
• To improve compliance with Trust patient safety guidance and CQUIN targets through a structured quality improvement project.

Main Methods:

• A quality improvement project utilizing the plan-do-study-act (PDSA) methodology.
• Retrospective review of ward round entries to establish baseline measurements for key safety parameters.
• Introduction of a standardized ward round template to incorporate essential documentation elements.
• Monthly PDSA cycles involving re-examination of measurements and iterative refinement of the ward round template.

Main Results:

• Baseline documentation for critical safety parameters was initially poor.
• Introduction of the ward round template led to significant improvements in documentation compliance.
• Venous thromboembolism (VTE) risk assessment documentation increased from 14% to 92%.
• Antibiotic stewardship documentation improved from 0% to 100%.
• Treatment escalation plan (TEP) form usage increased from 29% to 78% after three PDSA cycles.

Conclusions:

• The implementation of a standardized ward round template significantly improved compliance across all assessed patient safety parameters.
• Enhanced discussion and documentation of safety measures during ward rounds contribute to improved patient safety and adherence to Trust guidance and CQUIN targets.
• Future efforts will focus on sustaining and expanding the use of the template across all urology ward rounds.