gms | German Medical Science

Introduction: As shown in previous studies and confirmed by our local experience, residents often face challenges in conducting effective inpatient daily ward rounds. With the purpose to develop a tailored intervention, we needed a more accurate picture of our residents’ way of conducting rounds.

Methods: An online anonymous questionnaire was sent to the residents of the Service of Internal Medicine at the Lausanne University Hospital between July and October 2015. Round structure, location and interruptions were assessed. Closed questions required rating on a Likert scale. Free text answers were treated using thematic content analysis.

Results: 29 of the 41 eligible residents (71%) completed the questionnaire. Mean age was 29.0 ±1.6 (mean±SD) years, 62% were women and 52% reported ≥3 years of training in Internal Medicine. 86% declared following a structure to conduct daily rounds. Six steps emerged from the free text answers:

1.

interaction with the nurse; review of

2.

vital signs,

3.

laboratory results,

4.

treatment;

5.

interaction with the patient and

6.

plans.

There was some heterogeneity in the order in which these steps were carried out. Residents were reactive to the problems raised by the nurse, but little was reported on how they integrated the patients’ medical problem list. Furthermore, many interruptions were reported. 31% of participants declared that phone calls and arrival of other healthcare professionals occured ≥5 times per daily round. Interruptions by consultants and informatic problems were also very frequent. Conducting rounds outside the patient’s room before clinical evaluation was preferred by the majority (73% of the participants).

Conclusions: Residents self-reported description of ward rounds helps identify key areas of improvement and related interventions, such as developing a more defined structure to improve efficiency. Finding strategies to minimize the number of interruptions is also needed.