Philip H Pucher1, Rajesh Aggarwal2, Pritam Singh3, Muaaz Tahir3, Ara Darzi3. 1. Department of Surgery and Cancer, St. Mary's Hospital, Imperial College London, London, UK. Electronic address: p.pucher@imperial.ac.uk. 2. Department of Surgery, McGill University, Montreal, Canada; Arnold & Blema Steinberg Medical Simulation Centre, Faculty of Medicine, McGill University, Montreal, Canada. 3. Department of Surgery and Cancer, St. Mary's Hospital, Imperial College London, London, UK.
Abstract
BACKGROUND: The surgical ward round (WR) represents the primary interface between the clinical team and the patient and is integral to the quality of postoperative care and subsequent patient outcomes. This study aims to explore key issues pertaining to the surgical WR, defining challenges in current practice, and identifying potential means of quality assessment and improvement. METHODS: A qualitative, semistructured interview-based approach was adopted, including patients, nurses, interns, residents, and attendings. RESULTS: Twenty-five interview subjects were recruited across 8 hospitals. Twenty-three of the 25 (92%) subjects believed that there was significant variation in the quality of WRs and that this affected patient care. Lack of thoroughness (18/25, 72%) and poor communication (12/25, 48%) were the most commonly identified causes. Nontechnical skills such as communication (25/25, 100%) were seen as crucial to WR quality. Quality markers for surgical WRs were identified. Simulation-based training was recommended (13/25, 52%) to improve performance. CONCLUSIONS: Clinical staff and patients alike perceive there to be significant variability in current surgical WR practice. Further development of interventions to assess and improve surgeons' performance is necessary to standardize and improve WRs and patient care.
BACKGROUND: The surgical ward round (WR) represents the primary interface between the clinical team and the patient and is integral to the quality of postoperative care and subsequent patient outcomes. This study aims to explore key issues pertaining to the surgical WR, defining challenges in current practice, and identifying potential means of quality assessment and improvement. METHODS: A qualitative, semistructured interview-based approach was adopted, including patients, nurses, interns, residents, and attendings. RESULTS: Twenty-five interview subjects were recruited across 8 hospitals. Twenty-three of the 25 (92%) subjects believed that there was significant variation in the quality of WRs and that this affected patient care. Lack of thoroughness (18/25, 72%) and poor communication (12/25, 48%) were the most commonly identified causes. Nontechnical skills such as communication (25/25, 100%) were seen as crucial to WR quality. Quality markers for surgical WRs were identified. Simulation-based training was recommended (13/25, 52%) to improve performance. CONCLUSIONS: Clinical staff and patients alike perceive there to be significant variability in current surgical WR practice. Further development of interventions to assess and improve surgeons' performance is necessary to standardize and improve WRs and patient care.
Authors: Paul Perversi; John Yearwood; Emilia Bellucci; Andrew Stranieri; Jim Warren; Frada Burstein; Heather Mays; Alan Wolff Journal: BMC Health Serv Res Date: 2018-08-17 Impact factor: 2.655