The Round : An Observational Study of Ward 4 at Norrtälje Hospital

Sammanfattning: Healthcare is generally characterized by deep traditions, old working methods, and clear hierarchies. A central part of medical wards is the so-called “round”. During the round, physicians and nurses visit the patients and decide on further action. The round is a central process at wards and affect the rest of the working day, both for physicians and nurses. In this study, the round process was observed at Ward 4 at Norrtälje Hospital. The staff at Ward 4 experienced high-stress levels and this was related to an ineffective round according to a prestudy conducted by Clinical Innovation Fellowships. The project aimed at producing a new optimized round routine that would reduce the high-stress levels. The study was conducted through observations, dialogue with staff, interviews, surveys, comparative observations at other wards at Norrtälje Hospital and other hospitals as well as theoretical studies. The main difficulties discovered in our study with the round process at Norrtälje Hospital were that (i) information was communicated dual, (ii) the round process was too time-consuming, (iii) late decision-making, (iv) inefficient role for nurses and the (v) priority of work. The study resulted in a recommendation of a new round routine in which we have taken the staff’s interests into account as well as literature and research within the field of how developing healthcare processes. Our target was to increase communication and collaboration between physicians and nurses and furthermore exploiting human resources in the best possible way. Our main recommendation was to introduce a seated pre-round prior to commencing the daily round routine and to introduce a reconciliation meeting afterwards.