A systems analysis of ward rounds in plastic surgery at a single center.

Ward rounds permeate health care delivery worldwide and form an important daily activity within all hospitals. In this study, the daily morning ward round in plastic surgery was examined from a teleological and systems point of view.

Methods: Data were gathered from the following sources to inform the systems analysis: patient interviews, staff interviews, direct observations of the ward round on multiple occasions, and through process mapping.

Results: To better understand the ward and its layout, a schematic of it was developed. Following observations of the ward round and the way in which decisions are made on it, an IDEF0 map was developed. Three patients were invited to take part in the study. Three members of staff were interviewed. The overarching themes from the interviews related to aspects of communication which this paper details.

Conclusions: This small-scale study demonstrates how the ward round as a process can be assessed, including product quality, process quality, the measurement and management of capacity, the role of standardization, the role and significance of bottlenecks, the key information flows, including the role of feedback, and the motivation and incentives of system participants and ideas for improvement generated.