Interventions to Improve Patient Care on Surgical Ward Rounds: A Systematic Review

Abstract

Background Ward rounds are an essential component of surgical and perioperative care. However, the relative effectiveness of different interventions to improve the quality of surgical ward rounds remains uncertain. The aim of this systematic review was to evaluate the efficacy of various ward round interventions among surgical patients. Methods A systematic literature search of the MEDLINE (OVID), EMBASE (OVID), Scopus, Cumulative Index of Nursing and Allied Health (CINAHL), and PsycInfo databases was performed on 7 October 2022 in accordance with PRISMA guidelines. All studies investigating surgical ward round quality improvement strategies with measurable outcomes were included. Data were analysed via narrative synthesis based on commonly reported themes. Results A total of 28 studies were included. Most were cohort studies (n = 25), followed by randomised controlled trials (n = 3). Checklists/proformas were utilised most commonly (n = 22), followed by technological (n = 3), personnel (n = 2), and well-being (n = 1) quality improvement strategies. The majority of checklist interventions (n = 21, 95%) showed significant improvements in documentation compliance, staff understanding, or patient satisfaction. Other less frequently reported ward round interventions demonstrated improvements in communication, patient safety, and reductions in patient stress levels. Conclusions Use of checklists, technology, personnel, and well-being improvement strategies have been associated with improvements in ward round documentation, communication, as well as staff and patient satisfaction. Future studies should investigate the ease of implementation and long-term durability of these interventions, in addition to their impact on clinically relevant outcomes such as patient morbidity and mortality.

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“…Among various interventions, evidence suggests that proformas outperform other initiatives [ 13 , 14 ]. He et al conducted a systematic review of 28 studies, concluding that proformas improve staff satisfaction, communication, and documentation quality [ 13 ].…”

“…Among various interventions, evidence suggests that proformas outperform other initiatives [ 13 , 14 ]. He et al conducted a systematic review of 28 studies, concluding that proformas improve staff satisfaction, communication, and documentation quality [ 13 ]. Bozbiyik et al echoed these findings in their analysis of 450 operation notes, comparing different interventions, including educational initiatives similar to those used by Faraz et al and the implementation of proformas [ 12 , 14 ].…”

“…Moreover, this intervention helps to prevent miscommunication [ 13 , 18 ]. Acronyms are often misinterpreted; however, this system provides clinicians with a universal definition of what constitutes a neurovascularly intact patient, without the associated documentation burden.…”