However, in the context of their presenting acute mental health problems and the perception that the ward round feels too intimidating to cope with, it is unsurprising that a patient’s memory of what happened may be skewed. A ward round is where the service user, consultant, ward doctor, a ward nurse, and maybe some members of community teams meet to discuss the previous week and to make a plan for the forthcoming week. executives all fully engaged and focused on improving the quality of ward rounds. Pond Ward, Pine Ward, Shore Ward: Park Royal Mental Health Centre. You can also follow these hashtags on Twitter for highlights of the latest achievements across the country. School of Nursing, Midwifery and Social Work, University of Manchester, This paper is dedicated to the lead author, Dr Magdalen Fiddler, who unexpectedly and tragically died before this paper could be submitted. Tailor Patient leaflets . Patients seemed quite separate from any decision-making process. Read more . Ward rounds. 2. Dr Services. If the independent researcher’s categories agreed with this research, the categories were likely to be reliable. and emergency care at rapid improvement guides. Five women and three men were interviewed, ranging in age from 18 years to 70 years (mean = 43.5 years, standard deviation = 19.12). The issues covered include a patient’s right not to attend, having set appointment times, asking questions in a respectful and sensitive manner, thinking about seating arrangements and keeping the number of professionals present to a minimum. Add this result to my export selection SAFER patient flow bundle: ward rounds. The co-ordination of these multiple inputs/processes is a central function of the clinical ward round. Then in my second year I had a CAMHS inpatient placement, so that's child and adolescent mental health. 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Eleven statements indicated feelings of satisfaction with ward rounds. An independent researcher was asked to assign data to one of the emergent categories in the same way. Their length of stay in hospital ranged from one to 24 weeks (mean = 8.5, SD=8.36) and the number of previous admissions ranged from one to nine (mean = 3, SD=2.64). For UK health professionals only The roundtable discussion and this associated article…, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. Adopting these Alternatively, it may be that the format of psychiatric ward rounds differs to that of non-psychiatric ward rounds, in ways that lead to greater levels of dissatisfaction among its participants. They require a well-organised multidisciplinary team to take part in the rounds, and nurses play an essential role in their smooth running. Source: NHS Improvement (Add filter) … These were refined through cross-referencing and collapsing some categories into one, or constructing new ones, until a list of relevant, exclusive categories was established. The journal Open Mind (Wolf, 1997) has, however, outlined a code of conduct for ward rounds, with the suggestion of standardising the code across NHS psychiatric services. ), 'Ward rounds in medicine: principles for best practice', Gloucestershire Hospitals NHS Foundation Trust’s website. Type: Guidance . This may, however, be a methodological issue. The term is taken from medical/surgical practice. What Is Comorbidity? Collaborative care in ward rounds is essential because it is a common place for all health professionals to provide input for the patient’s well-being. This raises questions about the necessity of including all professionals directly in every patient’s ward review, despite how useful this might be in improving communication between professionals, as it seems to shift the power balance away from the patient and may contribute to feelings of intimidation. The suggestion made only to increase the number of health care professionals present as the patient becomes less distressed and more accustomed to the ward environment may be worth considering. This seems to be reflected by the poor awareness some had regarding the role of each professional present in the ward round. Service users and carers. usually delivered by several teams of clinicians, allied health professionals and others. Our services . Medical ward rounds are complex clinical activities, critical to providing high quality, safe care for patients in a timely, relevant manner. Inpatient Services - Adults already receiving mental health support folder; Can my family support me during ward round? The task may be considered as analogous to a team assembling a very difficult jig- saw puzzle „against the clock‟. There are many resources from across the NHS that show some of the things to consider when running an effective ward round. Four participants did not want their interview audiotaped, so responses were recorded in writing as it was felt to be important to include their views in the study. I became familiar,’ and ‘I tend to ignore the people outside - those I don’t know.’, Nine statements commented on the way decisions were made. Our elective care team has also produced these useful videos. Eight patients agreed to participate. Many referred to decisions being made prior to attendance, and being informed of these in the meeting. The checker must highlight anything omitted, speak up and get it done! The above author further state that delivery and organisation of care has been influenced by management ideas and theory throughout its history. The aims of the management round are to ensure detailed assessments take place, multidisciplinary care plans are developed, the patient's history, medical investigations and physical health medication are checked with their GP. If you have any questions, contact IT.support@improvement.nhs.uk. Meet the team. Surprisingly, there has been little research into the structure of the ward round or its clinical outcomes (Birtwistle et al, 2000). Mental health issues are often overlaid with issues of physical health. Each interview lasted approximately half an hour. 'Ward rounds in medicine: principles for best practice' from the Royal college of Nursing and the Royal College of Physicians, looks at how to include senior nurses and other members of the multidisciplinary team in ward rounds. However, there has been considerable variability in the way ward rounds are conducted. Some recognition of poor recollection at this time of treatment may be advisable when providing patients with information. from those who are seeing benefits from improving their ward rounds. Medical ward rounds are complex clinical plan of care, while facilitating full engagement of the patient and/or carers It may be a limitation in terms of obtaining reliable data, and has been used as a criticism of patient satisfaction surveys in the past (Crawford and Kessel, 1999). I had the time of my life! Non-attendance can result in ineffective communication between nurses and doctors ultimately affecting patient outcomes. Internal processes, which related to the participants’ feelings, included: satisfaction with the ward round; negative feelings about the ward round; feelings about the outcome and consequences of the ward rounds; and issues to do with coping with the ward round. PALS line. In most cases, virtual ward rounds are carried out by the Practices’ lead GP for the care home and the senior nurse or carer at the home. In over twenty years working with inpatients (in Old Age Psychiatry) I never did a ward round: 1. Levels of distress may have contributed to the discrepancy between participants’ recollections of whether they were introduced to unknown faces, and the first author’s own recollection that in fact all patients were introduced to new faces. Share your improvement stories and resources with colleagues across the NHS by submitting them to our Improvement Hub. It is important for qualitative researchers to consider how participants view the interviewer - for example as someone involved in their care, as an advocate or as a researcher - as this may influence the outcome of the research (what participants are willing to say) and the process of data interpretation (what researchers are willing to report) (Salmon, 1996). Each interview took place within one week of their last ward round. Productive mental health ward toolkit; The toolkit contains a range of tools to support each module as you go along. Forensic mental health units, or “secure hospitals” have a range of facilities to support an individuals’ recovery journey. Gordon Caldwell, consultant physician at Western Sussex Hospitals NHS Foundation Trust led No studies have focused solely on inpatient perceptions of psychiatric ward rounds. Key = these sections must be checked in all patients Follow us on Twitter The aim of this study was to explore patients’ perspectives of ward rounds using qualitative methods. The ward rounds vary in nature from a phone call to discuss all the patients with a focus on those highlighted by the care home, to a video ward round. For example: ‘You know I coped with it. As with many of the admission wards in the Trust, we work in an environment which is ever changing. can also access all our rapid improvement guides to support improvements in urgent Ward rounds may have become too institutionalised in terms of how they attempt to meet the needs of the patient. Coombe Wood. You will still have access to all the products and services you had access to previously. this guidance to your local circumstances, to support engagement and continuous Do not include any personal, sensitive or confidential information. The guidance helps ward based teams to conduct multidisciplinary assessments while maintaining a safe and secure environment that protects both patients and healthcare staff from the risks of... Read Summary . Our first challenge … Cherrywood Mental Health Unit. –So, only 1.6% of doses that were omitted were omitted inappropriately. This was a very small study, providing a snapshot of patient views at one point in time on one ward. Magdalen Fiddler. The ward admitted patients from four community mental health trusts and outreach/rehabilitation teams. For example: ‘I’ve never been to a ward round where anyone, or very few, other than the consultant or charge nurse actually speak.’ One participant expressed the wish to change this focus on the medical team as the main communicators in the ward round, saying: ‘If they’re all making a decision on my treatment, I’d expect that they’d all come and talk to me.’, Nine statements referred to the number of people present. They are an opportunity to inform and involve patients, and for joint learning for healthcare staff. activities, critical to providing high quality, safe care for patients in a The interviews were transcribed and responses to open questions were analysed using content analysis (Day, 1993; Weber, 1990) with emergent themes being identified once the data was collected. Using Cohen’s Kappa (Fleiss, 1981), the content analysis was shown to be reliable (Cohen’s Kappa = 0.75). Patients were attached to one of five consultant psychiatr… It was a ward for 12 to 17 year olds and again you get quite a wide variety of presentations in CAMHS units. We do not actually go round the ward - instead the patient comes to us. Contact us . This would be an important area to explore in future studies. If a person needs treatment in hospital a referral is usually made by their GP or CMHT. Many hospitals have on-sight gyms, gardens and allotments, workshops and cafés run by patients. The South London Mental Health and Community Partnership, together with our partners including local authorities and community organisations, have launched a major listening campaign called South London Listens to support and protect people's mental health following Covid-19. A semi-structured interview was developed in conjunction with previous findings and informal discussion with ward staff. › Frequently asked questions for adults who are already receiving support from mental health services ... › Can my family support me during ward round? 'Making ward rounds count' is an audit from Health and Social Care Knowledge Exchange that aimed to identify aspects of good practice and areas for improvement in post take ward rounds post-take ward rounds and prescribing standards to ensure that patients receive high quality care. Ward rounds where I work occur once a week. Some of these issues were identified in the Open Mind publication (Wolf, 1997), so this small study certainly provides evidence to support the recommended changes. The ward admitted patients from four community mental health trusts and outreach/rehabilitation teams. The Ward Round: Ready, steady, test your staff Staffing is the issue keeping NHS leaders awake at night - and which consumes two-thirds of trusts’ spending. It is encouraging that there were several indications that participants were satisfied with the ward round, some identifying useful aspects such as confidence-building. Although one participant said that they would not change anything about the arrangement of the ward round, five participants were concerned with the layout of the room. Although various quantitative and qualitative studies of general patient satisfaction suggest that patients perceive psychiatric ward rounds as intimidating and distressing (Lovell, 1995; Ballard and McDowell, 1990) and tend to rate them as one of the least useful aspects of inpatient care (Sharma et al, 1992). All participants were white and British. Contact me in confidence. These resources will help you understand and adopt the principles governing best practice for ward rounds. 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