Clinical Practice Supports image

SAFER-f Patient Flow Medicine Bundle

About Senior Review

Recommended Processes

MRHCPs will:

  • Complete an initial assessment for newly admitted patients within first 24 hours.
  • Include inter-disciplinary team members.
  • Include frailty, mobility and delirium assessment tools.
  • Ensure assessment findings are understood, documented and accessible to all unit team members.

Tips for Patient Rounds

Rounds are crucial to decision-making and care coordination.

  • Should add value, leading to clear actions, written up in notes and acted upon.
  • Should be undertaken daily by noon, to enable teams rapidly to assess the progress of every patient in every bed.
  • Patients, families and their essential care partners should be informed of progress, and any delays to treatment or discharge need to be addressed and communicated.
  • Use checklists to reduce variation and prevent actions being omitted.
  • Always include a most responsible health care provider (MRHCP), qualified nurse, other member of the multidisciplinary team (MDT), Continuing Care and/or other community partners, and involve patients, families and essential care partners from the outset.
  • Use a ‘dedicated member of staff’ to lead on the management of ward patients.
  • Let specialty colleagues focus on elective and other activities.
  • Complete most tasks (e.g. writing/preparing discharge prescriptions or ordering tests) while in rounds, if possible, to avoid overloading junior staff, batching tasks and creating delays.
  • A second afternoon board round is best practice to review progress.
  • Consider use of the SHOP method to facilitate order of patient rounding.