Arero primary Hospital

Multidisciplinary Ward Rounds

Protocol

Prep. By

November 2013 E.C

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Introduction

 In the hospital setting the range of professionals involved in the ward

round /care of individual patient varies across clinical specialties. It largely
depends on the way in which the service is organized in a given inpatient
environment.
 Ward rounds should be conducted by a multi_ professional team (e.g.
doctors, nurses, pharmacists, dietician, related health professionals, patient
and caregivers). It creates an opportunity to review the patient’s condition
and develop a coordinated plan of care and action, strengthens
communication channels and builds a team culture, sharing information and
joint learning through active participation of all members of the
multidisciplinary team. In contrast, failure to communicate actions and
information could result in discontinuity of care or unnecessary repetition of
efforts.

 Detailed round visits i.e. Multi disciplinary Ward Rounds should be

conducted at least twice a week;

 Daily business round by the attending physicians should be conducted

Definition of Multidisciplinary Ward Rounds

MDWR a structured round where key clinicians involved in the patient's care meet
together to discuss the patient’s care and the coordination of that care. The round is a
place where dialogue and feedback occurs in relation to the needs of the patient and
provides the multidisciplinary team an opportunity to plan and evaluate the patient’s
treatment and transfer of care together. The round is patient centered and is based on the
needs of the patient and their carers. The frequency of the round is determined by the
needs of the patient/carer population.

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The following are positive characteristics of effective multidisciplinary ward rounds
 They are structured, efficient and non-hierarchical;
 Accurate, legible notes are made;
 Notes are taken by a member of the team who is able to understand and record
complex medical information and instruction. This is not necessarily the most junior
medical officer or clinician;
 Those on the ward round introduce themselves to the patients.

Benefits of the Multidisciplinary Ward Round

Interdisciplinary collaboration across the patient’s continuum of care improves patient

outcomes, capitalizes on the strengths of the team, reduces errors, streamlines services and
promotes the effective use of available resources.
In order to develop and evaluate the patient’s integrated plan of care a diverse range of
health professionals are required to work closely together. It has been suggested that to
provide seamless patient care healthcare teams must move from a mindset of
independence to one of interdependence.
An effective multidisciplinary ward round presents a valuable opportunity for both staff
and the patient/carer to share information, problem solve and plan treatmentas an
interdependent team.

Multidisciplinary Ward Rounds

 Improves Patient Care
 Promote Interdisciplinary Dialogue
 Promote the effective use of available resources
 Patient, carer and family involvement in care planning
 Using and promoting leadership

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 Goals and Intended Outcomes of MDWR

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 Implementation of MDWR
Implementation plan that is specific and will support implementation of MDWR should be
developed agreement of all stakeholders should be sought regarding:

 Patients to be included
 Logistical issues such as frequency, day and time and location of MDWR
o Round should be 7 days a week,
o At 8:30 A.M in morning
o In every ward
o Physicians at least once a day for stable patients &>2 for critical patients
o Nurses 1 hourly for all patients
 Identification and source of resources that will be required to support the rounds
 MDWR participants –
o Doctors
o Nurses
o Pharmacists
o Dietician
o Physiotherapist
o Related health professionals
o Patient and
o Caregivers
 Documentation requirements and responsibilities
 A communication strategy for staff and patients
 Strategies to promote attendance of identified participants
 Staff and patient education
 Ensure that all understand the key goals and outcomes to be achieved
 Identification of strategies to support and foster the active engagement of patients
in MDWR

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  Strategies to ensure that the language used is understood by clinical staff and
patients
 Strategies to ensure that team members roles and input are valued, encouraged and
respected
 Discussion of issues with regard to patient safety

How would you evaluate MDWR effectiveness?

These tools will give more specific feedback on evaluation of effectiveness of MDWR
 Patient satisfaction
 Staff satisfaction
 Readmission rates
 Observation of process
 Identification of barriers interfering with patient discharge
 Length of stay

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