Evaluation of a standardized ward round in a prenatal inpatient setting

Abstract

Objective: To evaluate the impact of incorporating a standardized ward round (SWR) tool including checklists for communication, safety, and efficiency into ward rounds. Methods: A prospective non-randomized, before-and-after observational study was conducted at a tertiary maternity hospital in Brisbane, Australia, between October 1, 2014, and October 1, 2015. Obstetric team members performing prenatal ward rounds used role-specific lanyards prompting the structure of each consultation. Rounds were audited before and after the introduction of the SWR for safety checks, hand hygiene, the duration of patient encounters, and plan congruity. Patients completed a paper-based satisfaction survey. Results from before and after the introduction of the SWR were compared. Results: There were 71 conventional ward rounds and 79 SWRs audited, and no difference was found in the mean duration of patient encounters (P=0.566). SWRs were associated with increased rates of each of the five safety checks being performed and of hand hygiene being observed correctly (all P<0.001). SWR was also associated with a greater proportion of patients indicating that they understood their plan of care. Conclusion: The use of a structured tool for ward rounds improved communication with patients, increased the frequency of safety checks being performed, and improved hand hygiene without prolonging ward rounds.