Patient Preference and Adherence (Aug 2019)
Patients, health professionals, and the health system: influencers on patients’ participation in ward rounds
Abstract
Victoria Walton,1 Anne Hogden,1 Janet C Long,2 Julie K Johnson,3 David Greenfield11Tasmanian School of Business and Economics, Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia; 2Faculty of Medicine and Health Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; 3Department of Surgery, Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USACorrespondence: Victoria WaltonAustralian Institute of Health Service Management, University of Tasmania, Locked Bag 5052, Alexandria, NSW, 2015, Sydney, AustraliaTel +61 24 0841 7814Email [email protected]: The ward round is an opportunity to plan and deliver patient-centered care. Benefits include an effective and safer clinician-patient relationship, patient empowerment, reduced anxiety and increased trust in the health care system. Factors contributing to patient involvement in ward rounds is shaped by their preferences, ability, and opportunity.Aim: To investigate ward rounds and the patient experience with them, the relationship between the patient and clinicians, and how rounds facilitate collaboration between them.Patients and methods: A multimethod study was conducted in a single Australian facility in acute medicine and rehabilitation specialties. An observational study of ward rounds in each setting was conducted with 14 patients, aged between 55 and 89 years followed by semi-structured interviews conducted with the patients observed. Descriptive and thematic analysis was undertaken.Results: One third of participants had not heard of the term ward round or could describe their purpose. Three main influencers on the patient experience of rounds were: self; the health system; and medical officers. No meaningful difference was found between patients in acute medicine and rehabilitation although all wanted to receive information from the senior medical officers. Patients more familiar with the health system were more active participants and took greater responsibility for their involvement in rounds and described higher satisfaction.Conclusion: There is a level of acceptance within the health system that patients understand what a ward round is. However, their role on the round is complex and this may only be developed through experiencing them. High system users teach themselves to navigate rounding processes to ensure their needs are met. To ensure equity in participation patients should be educated on ward rounds, what to expect and how to they can participate.Keywords: ward rounds, patient participation, interview, education
