A Considerative Checklist to ensure safe daily patient review

Clin Teach. 2013 Aug;10(4):209-13. doi: 10.1111/tct.12023.


Background: Ward rounds are complex clinical activities, and are an integral part of hospital life. Failures in care can have a direct consequence on patient safety. Recently, simulation ward rounds have allowed medical students and junior doctors to practise their skills in a safe environment, yet there is no commonly accepted and taught framework on how to conduct a ward round.

Context: After the success of the WHO Surgical Safety checklist in reducing patient morbidity and mortality, Dr Gordon Caldwell designed a Considerative Checklist for his ward rounds to ensure a comprehensive patient review. Although it does not ensure that the clinical decision-making is adequate, it does ensure that various hospital protocols have been adhered to, for example assessing patient venous thromboembolism (VTE) risk and prescribing prophylaxis. I spent 8 weeks as a part of Dr Caldwell's medical team, and during this time I was assigned the role of 'checker'. This role allowed me to actively participate in the ward rounds, and gave me a framework for the ward round that was easy to learn and follow.

Implications: Clinical checklists have become integral to improving patient outcomes, and Dr Caldwell's checklist could be used to improve patient safety while they are in-patients. The Considerative Checklist could be a vital tool in teaching this skill to students and junior doctors, but further qualitative and quantitative research is required to investigate whether using the checklist improves student performance, learning and engagement on the wards, and whether this improves patient outcomes.

MeSH terms

  • Checklist / methods*
  • Humans
  • Inpatients
  • Patient Safety / standards*
  • Teaching Rounds / methods
  • Teaching Rounds / standards