Conduct of ward rounds in SG hospitals needs improvement: study

Patients in acute care hospitals in Singapore express satisfaction regarding ward round organization and structure. However, the conduct of ward rounds requires further improvement, especially the opportunity for patients to ask questions and the type of information they receive, according to a study. 

“The varying experiences between patients of different life stages and ward types should be noted and bridged where possible,” the researchers said. “Understanding what is valued by patients and providing them with necessary information can facilitate patients’ health literacy and improve health outcomes.” 

Questionnaires were used in this cross-sectional study to examine the organization, structure, and delivery of ward rounds among 527 adult inpatients and/or caregivers of paediatric patients. 

The researchers calculated patient satisfaction levels by aggregating individual ratings, which were then assessed based on age group, ward type, and gender. They also performed statistical analyses using one-way Anova test, with statistical significance considered at p≤0.05. 

Most of the patients found the duration (86.6 percent) and timing (88.4 percent) of ward rounds acceptable. However, dissatisfaction was noted when patients or families were not informed on plans for discharge, provided information on tests and procedures, and given opportunities to raise questions or concerns. [Proc Singap Healthc 2025;doi:10.1177/20101058251380381] 

Patient satisfaction correlated with age groups (p<0.001; n2=0.069) and ward types (p=0.001; n2=0.031). Additionally, more than half of the patients (58 percent) preferred the presence of nurses during ward rounds. 

“Ward rounds are an integral part of patient care in the hospitals, not only to enable clinical examinations and provide medical care, but also to facilitate patient engagement,” the researchers said. “It has been well-documented that a better engaged patient experience can improve health outcomes and consume less healthcare resources.” [Perm J 2008;12:67-69; BMC Health Serv Res 2016;16:94] 

Timing 

While the majority of responses to the organization of ward rounds were positive, a third of the patients did not know what to expect of ward rounds and when these will be conducted. The lack of knowledge can be an unpleasant experience when the medical team unexpectedly shows up, according to the researchers. [Eur J Intern Med 2008;19:309-313] 

“In addition, patients may not have considered beforehand what they would like to ask or clarify,” they said. “Patients not knowing when to expect ward rounds suggests that the rounds are conducted at variable timings from one day to another, which can be frustrating for them.” [Scand J Caring Sci 2014;28:297-304] 

Poor communication of discharge and treatment plans, followed by the lack of opportunity to ask questions, were also noted by participants. 

An earlier study by Lateef stated that these unmet expectations can result in disappointment and anger. However, such negative emotions can be avoided if patients know what to expect. [J Emerg Trauma Shock 2011;4:163-167] 

“Patient-centred ward rounds allow patient participation to be organized into the rounds, providing them with the opportunity to be an active participant and speak with the medical team,” the researchers said. [Discourse Stud 2022;24:24-46] 

“Cultivating such a participatory environment by inviting patients to collaborate in the treatment planning process can also cultivate a sense of respect and empowerment through active patient engagement,” they added. [BMJ Qual Saf 2019;28:15-23]