Bedside-oriented ward rounds: efficiency and satisfaction in patients and care providers

Q. de Mast, I. Schouten, E. Buit, B.J. Schouwenberg, J.W.A. Smit

Woensdag 20 april 2016

15:50 - 16:00u in Zaal 2.1

Categorie├źn: Parallelsessie

Parallel sessie: Parallelsessie 5: Case reports/research

Background: The ward-round is a key component of daily in-patient care. Unfortunately, with the advent of electronic patient registries, rounds are increasingly conducted behind computer screens in separate rooms instead of at the patients' bedside. We reintroduced the bedside visit as the starting point of the round and evaluated efficiency and satisfaction of participants.

Methods: Starting April 2014, a patient-centered, bedside-oriented ward round was introduced in which patients were actively involved in their own care plan. Duration of the round was monitored in the 3 months before and after introduction. Experiences and preferences of patients, nurses and residents were explored using focus groups and consumer quality (CQ) indexes.

Results: The mean (SD) duration of the daily ward round decreased from 120.7 (12.8) to 82.3 (11.8) minutes (P<0.001). Nurses (n=20) and residents (n=6) participating in focus groups named the improved time efficiency and the fact that treatment decisions were based on more directly obtained information from patients as main advantages. Disadvantages included privacy-issues on multi-patient rooms and that immediate decision making at the bedside may be more challenging for junior residents. The new ward round was preferred over the former by 8/12 residents and 26/27 nurses one year after introduction. CQ indexes completed by admitted patients in the quartile prior (n=73) and after (n=118) introduction did not show significant differences in any of the items scored.

Conclusion: Bedside-oriented ward rounds are more time efficient and preferred by care providers and present an opportunity to improve patient involvement in their care.