Background Nursing staff are at the heart of communication on an inpatient unit and spend the most time at the bedside (Costello, 2006). However their shift working pattern is not shared by the multi-professional team. Previously identified as a "communication hotspot" (British Medical Association, 2004) handovers had been reduced to a single-dimensional recorded message and daily bed meeting between a doctor and a senior nurse.

Aim In February this year following a review a new initiative was introduced into the inpatient unit called "Board Round". The aim was to bring together representatives from every multidisciplinary team involved in patient care at the start of each day to share information and plan care.

Approach Replacing the taped handover with a live "virtual" ward round led by the nursing shift leader and the care coordinator, involving representatives from all teams, facilitates greater communication and a true holistic overview of the patient. Perspectives are shared, and care for the current in-patients as well as planned admissions can be coordinated. Furthermore, dependency levels can also be monitored more closely to aid decisions about admissions and staffing levels.

Outcomes Although the meeting has only been running for a few months the feedback from the teams has been positive. At the end of each meeting planned admissions are discussed ensuring the patient is admitted to the unit in a timely way with all the relevant people in attendance. Discharge arrangements are also shared, and by augmenting the positive effect of the care coordinator role, a rise has been observed in bed occupancy figures.

Conclusions Despite initial reluctance to try a new way of working the "Board Round" has enhanced multi-disciplinary communication in the inpatient unit and improved the patient experience.