Hospital ward rounds must return, say medical leaders

 Hospitals must prioritise ward rounds as a key element of clinical teamwork and patient-centred care, according to leading doctors and nurses.

In a joint statement, the College of Physicians and the Royal College of Nursing said a “concerted culture change” was needed to restore the team-based ward round.

Currently, doctors often conduct ward rounds on their own – wasting opportunities to share experience and insights, the colleges argued.

Pressure on hospital resources means that the formal ward round, where the clinical team visits each patient, has largely been discontinued – indeed, many wards have no distinct clinical teams.

According to the colleges, ward rounds serve key clinical functions: to make and refine the diagnosis; to review treatments and investigations; to communicate with family and other carers; to ensure safety; and to provide training.

“Ward rounds are critical to developing rapport and building trust with patients, while discharging a duty of care,” the statement noted.

“[They] also enable all individuals involved to express a shared aspiration to make the patient the centre of attention, empowered in his or her own care.”

The statement recommended that:

• Ward rounds should be led by consultants, include a nurse, and take place in the morning to allow decisions to be acted on the same day.

• Patients and carers should be given a summary sheet outlining the decisions made.

• Patients’ records should be kept centrally, and ward round teams should use locally adapted checklists.

Noting the financial barriers to these changes, the colleges argued: “Managers and the executive board bear a responsibility to protect time and resources, enabling all members of the multiprofessional team to prioritise the ward round.”