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Restore the prominence of the medical ward round

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6451 (Published 31 October 2013) Cite this as: BMJ 2013;347:f6451

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Re: Restore the prominence of the medical ward round

I greatly enjoyed reading your article and entirely agree with the importance of protecting the importance of the medical ward round.

What I would add is the impact of the fragmentation of ward teams on the fluidity of the round and cohesiveness of care. Come on to any medical ward at 9.30 in the morning, you will no doubt find nurses doing the 'drug round,' pharmacists checking the drug charts (taken from the nurse doing the drug round), a rehab team planning the non medical aspects of a patient's discharge, and doctors doing the medical ward round trailing a junior doctor trying to prise the drug charts from the nurse and pharmacist, and the notes from the rehab team who still require clarity on whether a patient is 'medically fit for discharge.' When the chaos begins to abate at 11.30, we try to have an 'MDT' with the aforementioned teams to discuss the patients together.

A combined ward round with the whole MDT would streamline patient care, improve channels of communication, reduce the endless delays introduced by interruptions to look for drug charts and talk to other teams, and improve the experience of patients who get fed up answering the same questions multiple times over.

Competing interests: No competing interests

23 November 2013
James B Maurice
Gastroenterology Registrar
Southend Hospital
Prattlewell Chase, Westcliff-on-Sea