SP 10.12 Improving Efficiency and Outcomes in Emergency General Surgery Ward Rounds: A Systematic Review
Shifa Bangi, Elizabeth Mainwaring, Adrija Bhattacharyya, Jasmine ThomasAbstract
Background
Ward rounds (WRs) are essential for safe inpatient care and maintaining patient flow in Emergency General Surgery (EGS), yet lack specialty-specific guidelines. EGS presents unique challenges: high patient volumes, rotating on-call teams causing poor continuity, and time pressures due to senior surgeons’ theatre and clinic commitments. These constraints make many WR recommendations designed for medical specialties impractical.
Aim
To systematically review the literature and identify evidence-based interventions that enhance the efficiency of EGS ward rounds, improving patient outcomes and multidisciplinary communication.
Methods
A systematic search of major databases identified studies evaluating WR interventions for adult EGS inpatients. Two reviewers independently screened and selected studies, excluding elective cohorts or mixed populations without EGS-specific data. Outcomes included clinical impact, team communication, patient understanding, decision-making, and documentation quality.
Results
Out of 344 studies screened, 6 studies met inclusion criteria. Evidence specific to EGS was limited, as many surgical studies lacked sub-group analysis of emergency patients. Most interventions targeted documentation rather than patient-centred outcomes. Checklist-based approaches, often combined with education, improved record completeness and guideline adherence. Technology solutions enabling real-time access to clinical information reduced duplication and non-rostered work. None of the studies examined whether WRs improved patient flow, decision-making, or clinical outcomes.
Conclusions
Current interventions improve documentation but fail to address patient flow, decision quality, or clinical outcomes. Future work should prioritise strategies that enhance patient progression and safety, including prioritisation frameworks, senior review standards, patient engagement, and digital prompts within electronic health records, evaluated against care progression and outcome metrics.