1102 Maximising Safety on Surgical Ward Rounds with a Concise Ward-Round Template: A Quality Improvement Project

Abstract Aim Concerns raised at clinical governance meetings highlighted incomplete ward round documentation and near miss events in prescribing. Checklists have demonstrated improved patient safety and ensure standards of care are maintained. We evaluated documentation and prescribing accuracy in a baseline audit and sought to improve these with the implementation of a concise ward-round template. Method We identified essential patient safety orientated criteria for ward round documentation from trust and departmental guidelines. Compliance with criteria was assessed by audit before and after the introduction of a standardised ward-round template. A root cause analysis was performed to identify reasons for errors between cycles and to optimise the design of the ward-round template. A poster promoting the template was circulated to junior doctors and the results presented in clinical governance. Each cycle included fifty consecutive patients. Results The baseline audit identified no ward-round documentation in 8% of inpatient days. Prescribing errors with near misses were identified in two cases. Poor documentation and communication were the most significant contributing factors in root cause analysis. After implementation of a ward-round template all inpatient days had a ward round entry, 96% using the template. Documentation of essential criteria improved from 32% to 93% (p0.05) and there were no prescribing errors. Compliance with VTE guidelines improved from 70% to 98% (p0.05). Conclusions This quality improvement project implementing a ward-round template improved documentation of essential patient safety orientated criteria and compliance with trust guidelines. Adherence to the ward round template was high several months after implementation, suggesting that ongoing use is viable.