What have medical ward rounds got to do with the ED?

Yesterday the RCP and RCN published a joint statement on the conduct of medical wards rounds. This document details best practice guidance for the conduct of multidisciplinary medical ward rounds. What has this got to do with emergency medicine?
 Access to inpatient beds is well recognised as a key contributor to emergency department crowding. The recently revised College ofEmergency Medicine guideline on crowding states that “The main reason for crowding in almost all EDs is lack of hospital capacity”. Unfortunately today’s publication fails to mention the significant impact that the timing of medical wards rounds has upon the flow of patients through an emergency department.

The RCP/RCN report acknowledges that “Consultant-led ward rounds should be conducted in the morning to facilitate timely completion of tasks during the working day.” However it should also be recognised that the early morning review of patients is vital so that appropriate patients may be discharged and beds made available in time for the predictable rise in the requirement for inpatient beds that occurs from late morning until the evening.

It will be interesting to see if renewed focus upon consultant ward rounds can alleviate the problems of ED crowding in the UK as we approach the most demanding time of year. 

Ward rounds in medicine: Principles for best practice

Thomas Locker