Patients' experiences of clinical team meetings (ward round) at an adult inpatient eating disorders ward: A mixed-method service improvement project

ABSTRACT

Introduction: Ward round is a key component in inpatient settings for treatment-related decision making. However, the meeting is often stressful and anxietyprovoking. Participating in ward round discussions is also little mentioned in clinical education in disciplines such as clinical psychology and nursing. Aim(s) This study aimed to explore and improve patients' experiences of the virtual clinical team meeting (CTM, historically known as ward round) in an eating disorders inpatient ward during COVID-19. Method(s) A mixed-method approach was used. Five clinical team meetings were observed, and six patients were interviewed through focus groups and video interviews. Former patients were involved in data analysis, improvement and dissemination. Result(s) The mean CTM duration was 14.3 min. Patients spoke roughly half of the time, followed by psychiatry colleagues. 'Request' was the most-spoken category. Thematic analysis identified (1) CTM is important but feels impersonal, (2) they generate a sense of palpable anxiety;and (3) the differing views of staff and patients. Using the findings, and co-produced with a former patient, the description of the CTM was revised in the admission induction booklet. A new CTM agenda sheet as well as guidance sheet for nurses were devised. Nursing staff and patients found them more helpful than the existing versions. Discussion(s) The findings and the co-produced guidance documents provided concrete contribution for nurses to improve patient's experiences despite the challenges brought by COVID-19. The ward's power hierarchy, culture and language use also need to be considered to facilitate shared decision-making.