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Ward rounds in medicine: principles for best practice

This guidance, jointly produced by the RCP and the Royal College of Nursing, sets out core recommendations and principles for best practice for conducting medical ward rounds.

Key recommendations

Ward rounds play a crucial part in reviewing and planning a patient’s care. They are an opportunity to inform and involve patients, and for joint learning for healthcare staff. However, there has been considerable variability in the way ward rounds are conducted.

This guidance calls for the multidisciplinary team – doctors, nurses, pharmacists, therapists and allied health professionals – to be given dedicated time to participate, with clarity about individual roles and responsibilities during and after ward rounds. The guidance covers:

  • structuring ward rounds: preparation, scheduling and post-round review with allocation of tasks
  • patient participation: preparing patients in advance and promoting shared decision-making and self-management
  • protecting vulnerable patients, with nurses and junior doctors ensuring that their needs are articulated and addressed
  • ensuring nursing involvement, sharing information about the patient and being informed of all key decisions about their care
  • use of safety checklists to reduce omissions and variations in practice
  • discharge planning: setting a date for discharge and giving patients a detailed plan on how to manage their care outside hospital.

This comprehensive guidance will be invaluable to all those involved in ward rounds, setting clear standards to provide maximum efficiency in the complex ward environment. It is also addressed to managers and the executive board who need to protect time and resources for ward rounds, and support the cultural change that may be needed to maximise success.

The RCP has set up a working party with the Royal College of Nursing, Royal Pharmaceutical Society and the Chartered Society of Physiotherapy to update this guidance, and expects to publish an updated version in the Autumn. Read more here.