Standardization of rounds on a general paediatric ward: Implementation of a checklist to improve efficiency, quality of rounds, and family satisfaction

Abstract

Objective The purpose of this study was to develop a standardized rounding tool for use on the general paediatric ward and to determine if its use can improve quality of rounds as well as patient and parent satisfaction. Methodology The study used a pre- and post-intervention prospective observational methodology. The intervention consisted of the implementation of a Checklist Rounding Tool (CRT) entitled the ‘Paediatric Inpatient Rounding Checklist (PIRC)’ which outlined items deemed essential to discuss during rounds for all patients admitted to the paediatric ward. The PIRC was created by the research team after reviewing the literature and it was peer reviewed by a panel of expert paediatricians. Performance on rounds based on discussion of checklist items as well as patient and parent satisfaction were evaluated by an external observer both pre- and post-PIRC implementation. Results Four of the five less frequently addressed checklist items were discussed significantly more post-intervention. The Rounds Quality Score was significantly improved after checklist implementation, the pre- and post-intervention scores being 8.24 and 9.61/10, respectively (P-value <0.001). Patient and parent satisfaction were rated higher with the use of the checklist. There was no difference in the duration of rounds between the pre- and post-implementation phases. Conclusion In summary, utilization of a standardized rounding tool on an inpatient paediatric ward led to improvement in quality of rounds as well as patient and parent satisfaction.

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

“…Subjective improvements in staff and patient communication were demonstrated with the use of checklists or proformas during the surgical ward round [ 13 , 27 , 29 , 32 , 34 ]. Documentation during the ward round is an important means of communication between clinical teams, with improvements in communication shown to mitigate medical errors and improve patient safety and outcomes [ 2 , 9 , 38 , 48 , 49 ]. Future studies should aim to develop more objective measures of staff and patient communication to improve assessment of different perioperative quality improvement strategies.…”

Can Checklists Solve Our Ward Round Woes? A Systematic Review

“…Checklists serve as a platform to empower junior doctors to ask important questions regarding patient care in an otherwise intimidating environment [27]. The overall perception of ward round checklists (from this systematic review and previous studies) is positive [30, 49–53]. However, some clinical staff are hesitant incorporate checklists into the ward round as they feel it will increase time spent on the ward round [54].…”

“…However, two out of three studies reporting on time taken during ward rounds demonstrated a reduction in time taken when checklist was used [7, 28]. Other studies that have implemented checklists during ward rounds have shown that there was either no difference or less time spent on ward rounds [5, 53, 57, 58]. Time limitations should not be an issue when checklists are designed well.…”