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October 12, 2012

Member Asks: What rounding strategies are hospitals testing to improve the patient experience?

Daily Briefing

    Recently, a member institution working on improving its patient satisfaction scores inquired whether peer hospitals are experimenting with rounding practices as a way to improve the patient experience.

    The answer from our researchers at the Nursing Executive Center and the Marketing and Planning Leadership Council: an emphatic “yes.” At many hospitals we’ve spoken with, nurses (and doctors) are gathering information about patients’ satisfaction in the moment and working to act on what they discover, in hopes of improving the patient experience. Here’s what we’ve learned.

    Incorporating 'service' into physician rounds

    Marketing and Planning Leadership Council researchers identified several ways to impact patient satisfaction during physician rounds: by establishing behavioral guidelines for physicians, providing communication and service excellence training, as well as making infrastructure changes that enhance physician-patient communication during rounds.

    To learn more, members of any Advisory Board program can access the brief: Tactics to Improve Patient Satisfaction During Rounds.

    The power of nursing rounds

    Beyond physician rounding, however, having nurses round on each other’s patients can be an effective way to improve the patient experience.  The Nursing Executive Center study on Instilling Frontline Accountability explains how to implement an “inter-assignment rounding practice.” Researchers highlighted two components:

      1. Focus Rounding with Standardized Questions: Each rounding nurse asks patients and families the same three questions focused on patient experience and satisfaction; the goal is to ensure rounding nurses gather all needed information but spend no more than 10 minutes with each patient.

      2. Require Immediate Peer Follow-Up: Immediately after speaking with the patient and family, the rounding nurse debriefs with the assigned nurse while the information is still top-of-mind and needed service improvements can be enacted 

    In addition, two tools from the Building Peer Accountability Toolkit provide a template and customization guide to implement inter-assignment rounding. The Inter-assignment Service Rounding Template provides scripting for eliciting patient feedback and a framework for delivering the feedback to a peer (15 minutes). The Inter-assignment Rounding Customization Guide offers a process to make a customized template for focusing on a targeted unit improvement area (3 hours). 

    As part of the Patient Experience Toolkit resource, the Nursing Executive Center also created a guide for managers on to introduce (or re-introduce) hourly rounding on their units: the Hourly Rounding Design and Implementation Guide. This handbook ensures that nurse managers have a system for soliciting frontline staff input into the hourly rounding process, so frontline staff are invested in the success of hourly rounding.

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