Use of a proforma to improve documentation of the post-take ward round and encourage initiation of the comprehensive geriatric assessment in the care of the older people's service

Xu, Allan; Chan, Li Yuan; Abedin, Muhammad Raisul; Sivapathasuntharam, Dhanupriya

doi:10.12968/hmed.2020.0604

Cited by 3 publications

(5 citation statements)

References 6 publications

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“…However, the use of a structured round (that is, one that includes checklists and clinical decision-making aids, such as is included in a rounding proforma) can enhance the quality of care and consistency in documentation. [3][4][5] Through a Plan-Do-Study-Act (PDSA) approach, this project has two aims. First, to measure the adherence of documentation to the Royal College of Physicians (RCP) best practice guidelines and predetermined key unique components of a stroke round (see Table 1).…”

Section: Problemmentioning

confidence: 99%

See 1 more Smart Citation

A Structured Rounding Proforma in the Hyper Acute Stroke Unit (HASU): A Quality Improvement Project

Ludley¹,

Bahk²,

Al-Shihabi³

2022

J Healthc Qual

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Section: Problemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Structured Rounding Proforma in the Hyper Acute Stroke Unit (HASU): A Quality Improvement Project

Ludley¹,

Bahk²,

Al-Shihabi³

2022

J Healthc Qual

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“…This model fosters a more patient-centered and e cient care approach, reducing the need for investigations and overall hospital usage (BGS, 2019, Leahy et al, 2021, Veronese et al, 2022. Ideally, a multidisciplinary assessment proforma should underpin the intervention plan enhancing the quality and consistency of documentation and promoting Comprehensive geriatric Assessment (CGA) initiation (Xu et al, 2021). Barry et al (2023) identi ed speci c barriers and facilitators to screening adults in emergency care settings (ED's, AAUs), forming the foundational synthesis for this study-the rst focused on screening in these environments.…”

Section: Introductionmentioning

confidence: 99%

“…Visibility of screening impact and addressing con icting screening goals are essential components. The value of proformas in informing and underpinning older person-centred care are well recognised within the literature(Xu et al, 2021; BGS, 2019, HSE, 2017. Participants within this study unanimously favoured a comprehensive CGA proforma.…”

mentioning

confidence: 99%

Healthcare workers experience of screening older adults in emergency care settings: A qualitative descriptive study using the Theoretical Domains Framework

Barry,

Leahy,

O’Connor

et al. 2024

Preprint

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In emergency care settings, screening for disease or risk factors for poor health outcomes among older adults can identify those in need of specialist and early intervention. The aim of this study was to identify barriers and facilitators to implementing older person-centred screening in emergency care settings in the Mid-West of Ireland. Methods This study employed a qualitative descriptive design underpinned by the theoretical domains framework (TDF). This design informs implementation strategy by establishing a theoretical foundation for focused objectives. One on one semi-structured interviews were conducted with a purposive sample of healthcare workers (HCWs) to explore their screening experiences with older adults in emergency care settings. Information power guided sample size calculation. In data analysis, verbatim interview transcripts were deductively mapped to TDF constructs forming meta-themes that revealed specific barriers and facilitators to person-centred screening for older individuals. These findings will directly inform implementation strategies. Results Three themes were identified; Preconditions to Implementing Older Person-Centred Screening; Knowledge and Skills Required to Implement Older Person-centred Screening and Motivation to Deliver Older Person-Centred Screening. Overall, screening in emergency care settings is a complicated process which is ideally undertaken by knowledgeable and skilled practitioners with a keen awareness of team dynamics and environmental challenges in acute care settings. These practitioners serve as champions and sources of specialist knowledge and practice. Less experienced clinicians seek supervision and support to undertake screening competently and confidently. Education on frailty and aged related syndromes facilitates screening uptake. Recognition of the value of screening is a clear motivator and leadership is vital to sustain screening practices. Conclusions Screening serves as an entry point for specialist intervention, necessitating a specialist multidisciplinary team (MDT) approach for effective implementation in emergency care settings. Strengthening screening practices for older adults who attend emergency care settings involves employing audit, supervision and tailored supports. Skilled and experienced practitioners play a key role in mentoring and supporting the broader MDT in screening engagement. Long-term and sustainable implementation relies on utilising existing managerial, practice development and educational resources to underpin screening practices. Communication between ED staff, the specialist team and wider geriatric team is vital to ensure a cohesive approach to delivering older person-centred care in the ED.

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“…Similarly, multiple studies have demonstrated improvement in documentation, when measured against set criteria, following the introduction of a proforma for medical post-take ward rounds [ 5 - 7 ]. Other reported benefits of ward-round checklists in medical settings include a reduction in the time spent in documentation by junior medical staff [ 8 ] and an increase in the initiation of comprehensive geriatric assessment following admission [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

A Standardized Ward Round Proforma Improves Documentation in a Specialist Stroke Unit

Armstrong¹,

Carpenter²

2022

Cureus

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Background and aim Ward-round documentation is important for clinical communication and patient safety. Standardized checklists have improved ward-round documentation in surgical and medical settings. This quality improvement project aimed to introduce a standardized ward round proforma to improve documentation in a UK specialist stroke unit. Methods Ward round entries were assessed against internally agreed standardized criteria. A stroke-specific ward round proforma was designed and introduced with input from the multidisciplinary team. A repeat audit was performed, including assessment of the use of different proforma sections. Multidisciplinary team members were invited to provide feedback via an anonymous online survey. Results A total of 111 ward round entries were reviewed before the proforma was introduced. Ninety-five ward round entries were reviewed following introduction of the proforma, and 84.2% of these used the proforma for documentation. Overall documentation of standardized criteria improved from 48.7% to 62.1% with substantial improvement seen in documentation of neurological examination, presence/absence of mechanical venous thromboembolism prophylaxis, and blood test results. Multidisciplinary team feedback was positive. Conclusions The stroke-specific ward round proforma improved the quality and consistency of documentation in the unit. An updated proforma was designed using these results and multidisciplinary team feedback.

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Use of a proforma to improve documentation of the post-take ward round and encourage initiation of the comprehensive geriatric assessment in the care of the older people's service

Cited by 3 publications

References 6 publications

A Structured Rounding Proforma in the Hyper Acute Stroke Unit (HASU): A Quality Improvement Project

A Structured Rounding Proforma in the Hyper Acute Stroke Unit (HASU): A Quality Improvement Project

Healthcare workers experience of screening older adults in emergency care settings: A qualitative descriptive study using the Theoretical Domains Framework

A Standardized Ward Round Proforma Improves Documentation in a Specialist Stroke Unit

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