Improving Communication and Coordination in Medical Ward Rounds: A Quality Improvement Initiative in an Acute Teaching Hospital

Background: Medical ward rounds are essential to support care delivery, however a lack of multi-disciplinary team rounding may have a knock-on effect on care coordination and may lead to delayed discharges and increased length of stays. Methods: The aim of this study was to improve patient outcomes by improving communication and coordination surrounding medical ward rounds through bringing disciplines together during medical ward rounds or at post-round operational huddles. The primary outcome measure was to improve the number of patients discharged by noon. Results: At the end of the study there was no impact on our primary outcome measure. Efforts for improvement were redirected from the micro- to the meso- and macrosystem of the organisation. Conclusion: While developing this complex project, we found reforms at a macrosystem of how care is provided are needed including ward-based care. Reforms must balance system resilience and efficiency while ensuring ‘slack’ in the system to support communication, relationship building and coordination of care.