Improving Thoracic Surgery Ward Round Quality and Enhancing Patient Safety in a referral centre

Introduction: Ward rounds are complex clinical processesthat provide an opportunity for daily review and management of thoracic surgery inpatients (1). The aim of this study was to evaluate the thoracic surgical ward round documentation against the guidelines and recommendations and facilitate a pathway template to improve this process and enhance patient care. Materials: and Methods Data for this audit was collected retrospectively and prospectively. Data was collected during three auditing periods and managed on Microsoft Excel. Descriptive statistics were used for its analysis. Chi-square and Fisher’s Exact tests were used to test for difference in reporting rates. Results: and Discussion Initially, a total of 199 ward round notes were reviewed. Imaging results (19%) and discharge planning (23%) were not reported. eCARE (electronic Clinical Assessment for Round Evaluation) was developed to ensure that all aspects of patient evaluation recommended by the guidelines were included. Reporting rates significantly improved after such changes. We analysed the effect of the new ward round note on discharge planning (23.3 vs 41%, p<0.001), complication rates (32.6 vs 21.9%, p=0.03), post-surgical length of stay (LOS) (7.0 vs 5.0, p<0.001). Conclusion: Over a year, we audited the compliance of the Thoracic Surgery Department against national standards for ward round documentation. Several important items were not regularly reported. Using closed-ended questions improved reporting rates, and patient safety was optimised. Further research should explore the impact of this new documentation method on patient care and postoperative outcomes in our Trust as well as other Cardiothoracic centers.