Acrostic for Quality Pediatric Post-take Ward Rounds Documentation

Pediatric Post-take Ward Rounds DocumentationIt is very important to maintain quality and accuracy when documenting pediatric post-take ward rounds (PTWR) since care is evaluated, and coordinated care plans are formulated during this time. This documentation task often left to junior doctors is quite challenging as these rounds are multidisciplinary and a great deal of information is shared. In the wake of previous studies that showed failure in documenting important aspects of post-take ward rounds, a group of researchers in the UK investigated the impact of acrostic, a particular type of mnemonics (mnemonics is any learning technique that helps learners remember large pieces of information) on documentation and got positive results.

Acrostic is a prominent mnemonics learning technique that uses a memorable sentence that helps individuals retrieve letters (actually the first letter of each word used) while the letters represent the information they need to remember. This study evaluated the use of acrostic in improving the completeness of post-take ward rounds documentation. For that, the study used ‘Please Verify Information For Doctors, Please Note Every Plan’ which represents Problem; Vital signs; Investigations; Fluids; Drugs; Patient/parental concerns; Nursing concerns; Examination; Plan. This acrostic was formally introduced to all the consultants at a teaching session and included in the mandatory induction programme for all new doctors.

The introduction of the acrostic resulted in tremendous improvement in the documentation of the following key elements of ward rounds.

  • Problem (84% vs. 94%)
  • Investigations (26% vs. 72%)
  • Fluids (16% vs. 74%)
  • Drugs (26% vs. 76%)
  • Patient/Parental concerns (16% vs. 72%)
  • Nursing concerns (4% vs. 48%)

Overall, patient notes reflected the input of patients, their parents and caregivers and the involvement of the entire multi-professional team much more clearly after using acrostic as a template for documenting ward rounds. Further, around 95% of the junior doctors confirmed that the acrostic offered an easy format to document vital aspects of post-take ward rounds while 90% agreed it helped to reduce the time taken for retrieving information from patients’ notes later for a review.

Mnemonics has been used by medical professionals to promote faster and effective learning of patient details. As this study confirms the importance of acrostic in clinical documentation, mnemonics opens better possibilities for providers to improve their documentation and enhance the quality of patient care. However, support from experts having in-depth knowledge in medical terminology would help in a more effective use of this strategy.

Julie Clements

About Julie Clements

Joined the MOS team in March of 2008. Julie Clements has background in the healthcare staffing arena; as well as 6 years as Director of Sales and Marketing at a 4 star resort. Julie was instrumental in the creation of the medical record review division (and new web site); and has especially grown this division along with data conversion of all kinds.