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Implementation of a considerative checklist to improve productivity and team working on medical ward rounds

Roselle Herring (Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK)
Gordon Caldwell (Worthing Hospital. Western Sussex NHS Trust, Worthing, UK)
Steve Jackson (University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, UK)

Clinical Governance: An International Journal

ISSN: 1477-7274

Article publication date: 26 April 2011




In the changing environment of the National Health Service (NHS) medical ward rounds have become increasingly complex. With complexity comes the inevitable risk that things will go wrong. Serious failures in care can have important consequences for individual patients, their families, cause distress to health care staff and undermine public confidence in the NHS. The paper's aim is to introduce the concept of a medical ward round considerative checklist to improve ward round processes, effectiveness, reliability and efficiency, aid team working and foster better communication.


The checklist includes aspects of ward round preparation, the consultation, progress assessment, discharge planning and handover. It is a “considerative checklist” as it not simply checking if an essential component has been done but rather that it has been considered, discussed, action identified and communicated effectively and involves an “at the point of care check and correct” process.


The introduction of the checklist has provided a systemic approach to medical ward rounds, provided reassurance that quality care is given, aided active participation from all health care professionals and reignited team work. It has streamlined handover, improved patient and professional communication, improved medical documentation and provided an audit tool for ongoing improvement.

Research limitations/implications

The diversity of general medicine makes standard measures of quality of care such as length of stay, morbidity and mortality outcomes hard to measure; however, qualitative data can be obtained.


The authors have developed a systemic ward round approach which ensures attention to quality and safety at the point of care, encourages team working and improvements can be documented.



Herring, R., Caldwell, G. and Jackson, S. (2011), "Implementation of a considerative checklist to improve productivity and team working on medical ward rounds", Clinical Governance: An International Journal, Vol. 16 No. 2, pp. 129-136.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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