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The writing is on the wall: use of an LCD projector to aid communication at the ward round

  • Martin Baggaley (a1), Gary Inglis (a2) and Andrea Malizia (a2)
Extract

A key element of good in-patient psychiatric care is the multidisciplinary review, with accurate and legible recording of the outcome of the discussion. Traditionally, the junior doctor and nurse act as ‘scribes' on the ward rounds, recording the outcomes in the multidisciplinary or separate medical and nursing notes. There are a number of ways in which this process can fail. First, the scribe may simply misunderstand the decision of the team, given the complexity and variety of decisions in a psychiatric setting. Second, the scribe may understand what to record, but what is written may be illegible. Finally, people present at the ward round can have different beliefs about what has been decided, but unless they immediately review what has been written, they may not realise the discrepancy. One or more of these failings can result in serious untoward incidents, such as a patient being allowed off the ward on unescorted leave when the responsible medical officer believed the team had decided against permitting such leave. It is only when there is a serious incident that discrepancies can and do emerge.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Wing, J. K., Curtis, R. H. & Beevor, A. S. (1996) Health of the Nation Outcome Scales. London: College Research Unit, Royal College of Psychiatrists.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The writing is on the wall: use of an LCD projector to aid communication at the ward round

  • Martin Baggaley (a1), Gary Inglis (a2) and Andrea Malizia (a2)
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eLetters

The writing is on the wall

Namrta Sinha, Senior House Officer
02 August 2005

I read with interest the article by Baggaley et al - “The writing is on the wall: use of an LCD projector to aid communication at the ward round” (Psychiatric Bulletin, May 2005, 29,180-181).This seems to be a modern & exciting way of conducting the ward round.

I was involved in an audit on the same topic. In my current placement, one of the consultants conducts his ward round using a LCD projector & laptop while another consultant conducts his ward round in the traditional hand written way. I conducted a small retrospective audit comparing these two different ways of conducting the ward rounds. My auditwas based on a six month period. I had randomly selected case notes for each team for both types of ward rounds. My interpretation was that the documentation was better in typed ward round notes but there were no major changes found in clinical outcome in both of them (the basis of clinical outcome was whether action plans made in previous ward round were completed or not).

I also concluded that there are benefits and potential problems with using LCD projector which are mainly similar to that mentioned in your article. In addition I would like to add that it is medico-legally more safe but on the other hand it may affect the documenting skills of the SHOif the ward rounds are being typed by someone else like a secretary. As itis more time consuming and involves more paperwork, Consultants might be apprehensive to adapt this new way of ward round. In my view it needs moreevaluation and debate.
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Conflict of interest: None Declared

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