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Improving Communication and Coordination in Medical Ward Rounds: A Quality Improvement Initiative in an Acute
Marie E Ward1, Barry Kennedy2, Sharon O'Hara2
1Quality and Safety Improvement Directorate, St James's Hospital, Dublin, Ireland; Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, Ireland.
Acute Medicine
|October 17, 2025
Summary
Improving medical ward rounds by integrating multidisciplinary teams did not speed up patient discharges. System-level changes are needed for better care coordination and efficiency.
Area of Science:
- Healthcare Management
- Patient Care Coordination
- Hospital Operations
Background:
- Multidisciplinary team rounding is crucial for effective medical ward rounds.
- Lack of integrated teams can negatively impact care coordination, leading to longer hospital stays and delayed discharges.
Purpose of the Study:
- To enhance patient outcomes by improving communication and coordination during medical ward rounds.
- To increase the number of patients discharged by noon through interdisciplinary collaboration.
Main Methods:
- Implementing integrated medical ward rounds and post-round operational huddles.
- Focusing on bringing different healthcare disciplines together for improved communication.
Main Results:
- The primary outcome measure (noon discharges) showed no significant improvement.
- Improvement efforts shifted focus from micro-level interventions to meso- and macro-level organizational systems.
Conclusions:
- Complex projects reveal the need for macrosystem reforms in healthcare delivery, including ward-based care.
- Reforms should balance system resilience and efficiency, incorporating 'slack' for communication and coordination.
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