An anonymous questionnaire was completed by 35 cardiac in-patients at AMNCH. All patients surveyed found staff conduct to be satisfactory. Five (14%) expressed dissatisfaction with communication skills, describing how doctors spoke too quickly and tended to use medical terminology. Doctors were found to be too busy and unapproachable while on rounds. Sixteen patients (46%) commented on a breach in confidentiality and expressed embarrassment as their personal details may be overheard. One suggested that knowledge of other patients’ conditions would cause them to feel concerned. Three (9%) were dissatisfied with personal or room space. Five or more staff was described as too many and closed curtains contributed to the sense of crowding. One (3%) commented negatively on the presence of students. One (3%) indicated that the most senior doctor present should initiate the consultation while two patients (6%) found it difficult to hear the doctor. Twenty-three (66%) considered it very important to see the doctor every day while several others interpreted it as a sign of improvement if they were not reviewed by the doctor on a daily basis.
Discussion
WRs have been in existence for centuries and yet very little is known about the patient’s opinion of this long-standing routine. Its traditional style remains impersonal.  Almost half of our cohort reported a breach in confidentiality for this reason. Launer has challenged the ‘professional convention’ of WRs, suggesting that the meeting between doctor and patient be changed to a private consultation in a ward office or day room⁴. Over-crowding is difficult to avoid especially in a teaching hospital³ and the presence of students can create tension between the patients’ need to be heard and opportunities for student teaching. Consideration should be given to separating service and teaching rounds. The fact that a low number of patients (14%) expressed dissatisfaction with communication skills may reflect how undergraduate curricula now address this issue. Additional post-graduate training may be required. The details of patients expressed requirements may also help to shape the conduct of rounds in the future.In conclusion, we hope that improved patient care and contentment may arise from changes prompted by this audit. There is doubtless more to be learned and we would suggest further audits, including ones tailored to the needs of patients admitted under other disciplines.
B Molony, S Horgan, I Graham
Cardiology Department, AMNCH, Tallaght, Dublin 24
Email: [email protected] 

Acknowledgements 
Anne Reynolds, Audit Nurse and CNM II at AMNCH. 
References 
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2. Mahar P, Lake H, Waxman BP. Patient perceptions of the surgical ward round. ANZ Journal of Surgery. 2009; 79:584-585.
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4. Launer J. Doing the rounds. Q J Med. 2003; 96:321–322.