Identifying quality markers and improvement measures for ward-based surgical care: a semistructured interview study
Author(s)
Pucher, PH
Aggarwal, R
Singh, P
Tahir, M
Darzi, A
Type
Journal Article
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.
Date Issued
2015-08-01
Date Acceptance
2014-10-18
ISSN
0002-9610
Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Start Page
211
End Page
218
Journal / Book Title
AMERICAN JOURNAL OF SURGERY
Volume
210
Issue
2
Copyright Statement
© 2015 Elsevier Inc. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
National Institute for Health Research
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000356230500002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
NF-SI-0510-10186
Subjects
Science & Technology
Life Sciences & Biomedicine
Surgery
Ward round
Postoperative care
Quality improvement
Patient round
RANDOMIZED-CONTROLLED-TRIAL
IMPROVING COMMUNICATION
TECHNICAL PERFORMANCE
PATIENT PERCEPTIONS
NONTECHNICAL SKILLS
OUTCOMES
SURGERY
IMPACT
VALIDATION
SIMULATION
1103 Clinical Sciences
Publication Status
Published
Date Publish Online
2015-03-27