Abstract
Introduction
Board round is essential in geriatric care for clinical prioritisation, planning discharges and identifying any barriers to discharge. This process can be limited by poor handover, lack of roles and a defined structure. This project aimed to improve board round efficiency in an inpatient acute frailty setting.
Methods
The project involved a 2 stage PDSA cycle including data collection at baseline and after each successive intervention.
Stage 1: Role allocation and Board round proforma
Stage 2: Doctor education
Data related to several outcomes was collected retrospectively over 4-5 days per cycle. Inclusion criteria included all inpatients on the acute frailty unit at the time of each daily morning board round. Qualitative data was collected at baseline and after cycle 1.
Results
Improvement was shown in all outcomes after two cycles:
- Board round length (<30 minutes)
- Principal problem listed correctly (33% to 76%)
- Medically fit patients marked correctly (57% to 83%)
- Time since problem list last reviewed (11 days to 1.9 days)
- Proforma completed (89%)
- Proforma visible in the patient notes (68%)
Conclusion
This project demonstrated improvement in terms of accuracy and efficiency to the board round process. This has implications for geriatric patient care and flow.
The format has been rolled out to other medical wards across the trust helping to standardise the board round process.
A further intervention of a ‘Smartphrase’ and teaching sessions to facilitate updating the problem list has been implemented with further data collection planned.