title: Surgical ward rounds in England: a trainee-led multi-centre study of current practice.
abstract: BACKGROUND
  Recent guidance advocates daily consultant-led ward rounds, conducted in the morning with the presence of senior nursing staff and minimising patients on outlying wards. These recommendations aim to improve patient management through timely investigations, treatment and discharge. This study sought to evaluate the current surgical ward round practices in England.
  
  
  METHODS
  Information regarding timing and staffing levels of surgical ward rounds was collected prospectively over a one-week period. The location of each patient was also documented. Two surgical trainee research collaboratives coordinated data collection from 19 hospitals and 13 surgical subspecialties.
  
  
  RESULTS
  Data from 471 ward rounds involving 5622 patient encounters was obtained. 367 (77.9%) ward rounds commenced before 9am. Of 422 weekday rounds, 190 (45%) were consultant-led compared with 33 of the 49 (67%) weekend rounds. 2474 (44%) patients were seen with a nurse present. 1518 patients (27%) were classified as outliers, with 361 ward rounds (67%) reporting at least one outlying patient.
  
  
  CONCLUSIONS
  Recommendations for daily consultant-led multi disciplinary ward rounds are poorly implemented in surgical practice, and patients continue to be managed on outlying wards. Although strategies may be employed to improve nursing attendance on ward rounds, substantial changes to workforce planning would be required to deliver daily consultant-led care. An increasing political focus on patient outcomes at weekends may prompt changes in these areas.
authors.forename: Ceri
authors.initials: C
authors.lastname: Rowlands
authors.forename: Shelly N
authors.initials: SN
authors.lastname: Griffiths
authors.forename: Natalie S
authors.initials: NS
authors.lastname: Blencowe
authors.forename: Alexander
authors.initials: A
authors.lastname: Brown
authors.forename: Andrew
authors.initials: A
authors.lastname: Hollowood
authors.forename: Steve T
authors.initials: ST
authors.lastname: Hornby
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Richards
authors.forename: Jennifer
authors.initials: J
authors.lastname: Smith
authors.forename: Sean
authors.initials: S
authors.lastname: Strong