Ward Round: Complex Clinical Process
Medical ward round is a complex clinical process during which the clinical care of hospital inpatient is reviewed1. Ward round is the key for coordinating inpatient care in any health care setup. Ward round is conducted by a multidisciplinary team consisting doctors, nurses, pharmacists and allied health professionals. Ward round is an opportunity to inform and involve patients in health care delivery. It also provides a joint learning opportunity for the healthcare staff involved in patient care. It should be done daily preferably in the morning so that proper planning and execution of the plan can be carried out.
Purpose of ward round: Main purpose of ward round is to establish, refine or change the clinical diagnosis and execute proper
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An effective ward round should enable all individuals involved in the health care delivery process to express a shared aspiration to make the patient the centre of attention empowered in his or her own care. This will help the patient to co operate and develop confidence in health care delivery system. Ward round should ensure the delivery of good quality, safe, efficient, compassionate patient care. A successful ward round should enhance the patient’s confidence with health care delivery system. Ward round is the key for proper inpatient management, to facilitate speedy discharge, avoid any harm to the patient during health care delivery and to improve team communication among the health care delivery staff4.
Preparation for ward round: The steps involved in preparation of ward round are bed allocation and pre round, preparing and briefing the patient about the ward
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At the bedside consultant should introduce the patient to the team. He should ensure that the patient’s dignity is respected. He should review all information about the patient and update the patient and the team. He should review the drug chart. Using the ‘situation, background, assessment, recommendation’ (SBAR) structure, the team should discuss the clinical scenario4. Using safety checklists, the team members should review the clinical status and care according to their assigned tasks. Ward round team should utilise locally adapted checklists to reduce omissions, improve patient safety and strengthen multidisciplinary communication. Drug charts must be reviewed by the consultant for each patient during the ward round. At the end, after discussion the consultant should summarize the daily plan for the patient. During the ward round an educational point may be highlighted. Consultant should use every opportunity to discuss and teach the team members. Consultant can ask questions to the team members and discuss the case. Team members should actively participate in discussion and should come out with ideas and suggestions regarding the management of the patient. Consultant should identify deficiencies if any in the delivery of health care service to the patient and suggest how to rectify
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