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Lost in Transcription – How accurately are we documenting the surgical ward round?

Lost in Transcription – How accurately are we documenting the surgical ward round in patients admitted to the Department of Surgery at The Queen Elizabeth Hospital?

Status
Completed
Phases
Unknown
Study type
Observational
Source
ANZCTR
Registry ID
ACTRN12624001128583
Enrollment
135
Registered
2024-09-18
Start date
2020-05-12
Completion date
2023-07-01
Last updated
2024-09-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

The purpose of this study was to understand how accurately surgical ward round patient case notes are. This was achieved by comparing audio-visual recordings of the ward round, to patient case notes. The hypothesis of this study is that ward round case notes are accurate and capture what is discussed in the ward round.

Interventions

General Surgical Patients admitted to South 2 Ward of the Queen Elizabeth Hospital were enrolled in this study. Patients were audio-visually recorded using a small camera during ward rounds. The videos were then transcribed verbatim and compared to the patient case notes retrospectively to assess how accurately the notes captured the discussions had and decisions made. Observations that were being collected involved, number of times patient asked a question and duration of speaking time from the

General Surgical Patients admitted to South 2 Ward of the Queen Elizabeth Hospital were enrolled in this study. Patients were audio-visually recorded using a small camera during ward rounds. The videos were then transcribed verbatim and compared to the patient case notes retrospectively to assess how accurately the notes captured the discussions had and decisions made. Observations that were being collected involved, number of times patient asked a question and duration of speaking time from the patient. Patients were note asked to complete any questionaries. The overall time of observation was for the duration of the surgical ward round which usually lasted between 2 and 10 minutes. The video recording started when the surgical team walked in, and was stopped as soon as the last member left.

Sponsors

The University of Adelaide
Lead SponsorUniversity

Eligibility

Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Patients will be eligible and approached by study investigators if admitted to the South 2 ward of The Queen Elizabeth Hospital, over the age of 18 and under the care of clinician(s) enrolled in the study.

Exclusion criteria

The absence of informed consent, either by lack of capacity or rejection of participation. Non-English speaking patients will also be excluded

Outcome results

None listed

Source: ANZCTR · Data processed: Feb 4, 2026