Implementation of a considerative checklist to improve productivity and team working on medical ward rounds

Abstract

PurposeIn the changing environment of the National Health Service (NHS) medical ward rounds have become increasingly complex. With complexity comes the inevitable risk that things will go wrong. Serious failures in care can have important consequences for individual patients, their families, cause distress to health care staff and undermine public confidence in the NHS. The paper's aim is to introduce the concept of a medical ward round considerative checklist to improve ward round processes, effectiveness, reliability and efficiency, aid team working and foster better communication.Design/methodology/approachThe checklist includes aspects of ward round preparation, the consultation, progress assessment, discharge planning and handover. It is a “considerative checklist” as it not simply checking if an essential component has been done but rather that it has been considered, discussed, action identified and communicated effectively and involves an “at the point of care check and correct” process.FindingsThe introduction of the checklist has provided a systemic approach to medical ward rounds, provided reassurance that quality care is given, aided active participation from all health care professionals and reignited team work. It has streamlined handover, improved patient and professional communication, improved medical documentation and provided an audit tool for ongoing improvement.Research limitations/implicationsThe diversity of general medicine makes standard measures of quality of care such as length of stay, morbidity and mortality outcomes hard to measure; however, qualitative data can be obtained.Originality/valueThe authors have developed a systemic ward round approach which ensures attention to quality and safety at the point of care, encourages team working and improvements can be documented.