The current ward round model where multidiscipline team members walk round and document plans separately in different sets of documentation and parents being reliant on memory recall can result in miscommunication and lack of clarity for all.

Aims

Using quality improvement methodology, we tested a whiteboard in the patient’s bed space or cubicle as a tool to improve communication of ward round plans. Driven by ward nurses, at each ward round the team, patient and parents would gather around the board and a written plan would be constructed. Patients and carers were invited to write on the board.

Making the Case for Change

We did a small test of change using only a small number of patients in a large mixed specialty ward. Change spread when others saw the benefit of clearer communication.

A test of change was carried out over two weeks in a mixed specialty ward in a children’s hospital. Qualitative and quantitative measures of use, acceptability and culture was collected using semi-structure interviews of staff, carers and patients by a medical student. Usage data was collected by daily direct observation.

Staff and patients all reported improved communication. Boards were updated twice daily. Non-use occurred on two occasions when nursing staff was absent from the round and when the pen was missing. There was high patient and parent engagement with the visible plan.

Learning and Next Steps

This simple and low cost tool improved communication of care plans. There was visible culture change with improved patient engagement and involvement of all multidiscipline team members. There has been sustained usage and spread within our hospital.

The project was presented at RCPCH 2014 annual meeting and has been approved by the Hospital Trust.