Increasing staff time for patient facing care on an inpatient geriatric unit through modification of multidisciplinary board rounds: a quality improvement project

BACKGROUND: NHS staff recruitment and retention have failed to keep pace with service demands and workforce burn-out is of significant concern. This quality improvement project (QIP) aimed to increase staff time for patient facing care through reducing duplication of hospital board rounds within a 36-bedded NHS inpatient geriatric ward. INTERVENTION: Thirty-minute board rounds were reduced from twice daily (Monday–Friday) at 08:30 hours and midday to once daily at midday with the aim of freeing up staff time for patient care. A multidisciplinary team (MDT) safety briefing at 08:30 hours lasting 5–10 min was implemented to enable review of shift pressures and identification of patients who are unwell, newly admitted or due for discharge. Safety briefing format was amended to further support staff prioritisation. METHODS: This QIP was underpinned by the model for improvement, using Plan-Do-Study-Act cycles. Data were collected through a staff questionnaire alongside calculation of staff time spent at board rounds and safety huddles. Staff verbal feedback and questionnaire results were also used to improve and modify process’. Patient discharge data were collated via trust metrics as a balancing measure. RESULTS: Through board round modification, 25 hours of MDT time was saved each week, with all responding staff reporting increased time for patient facing care following QIP implementation. >85% of questionnaire respondents agreed that board round changes resulted in improvement. Balancing measures collected as part of the project also revealed an increase in weekly ward discharges from an average of 15.75–17.5 confirming no negative impact on patient flow following board round amendments. CONCLUSION: While significant staffing shortages continue, local innovations focused on staff time may have the potential to support effective use of limited resources.