NHS Greater Glasgow and Clyde: getting it right one ward at a time

Afternoon Board Rounds

There is a second daily board round at around 3pm on each ward. The purpose is to bring staff together to begin to 'lockdown' the ward going into the evening and nightshift. The team discusses patients who are causing concern, as well as today's new admissions and tomorrow's discharges. They also look beyond the next day to plan in advance for staffing challenges, admissions and discharges.

Dr Millar commented:

"We have been doing something like this informally for years but this is the first time it has been formally organised and structured. The meetings take place at the nurses' station and because all of the patients now have private rooms, we can talk in complete confidence. I really appreciate having the morning board round. I can see exactly what I have to do that day, it brings the whole team together, it encourages better timekeeping and it helps with the smooth running of the ward."

"When I arrived at the Queen Elizabeth University Hospital, I didn't particularly want to change the way I'd always worked, but now I wouldn't change back."

Senior Charge Nurse, Ann Green

Alisdair added:

"Wards are busy places so the board round needs to be time-efficient and effective. To achieve this, they are carefully structured as follows:

1. Discuss patients who are giving clinical concerns

2. Discuss patients for discharge that day, focusing on what needs to be done to facilitate discharge

3. Discuss planned discharges for the next 48 hours and what needs to be done to facilitate this

4. Discuss today's planned admissions

5. Discuss any ward safety concerns e.g. staffing levels."

"There are no more evening admissions or discharges, which are very disruptive. Everything is far more streamlined. Staff are finishing their shifts on time. Senior Charge Nurses feel empowered again. The process has handed control of the ward back to them."

Dr Alisdair MacConnachie,
Consultant Physician and Unscheduled Care Clinical Lead