This blog post continues our series of patient experience best practices. It demonstrates our expansive understanding of the challenges faced by healthcare organizations and offers solutions for improving the patient experience, as well as patient and business outcomes.
We are currently focusing on hourly rounding as a component of improving the patient experience. Hourly rounding is a structured means of promoting patient-centered communication in a healthcare setting between staff, patients, and their loved ones to ensure the best outcomes.
What Hourly Rounding is NOT
Hourly Rounding Compared to Traditional Practice
Traditionally, interactions with patients can be characterized as:
Purposeful rounding is different. It is:
Why Hourly Rounding Fails?
We have already mentioned that establishing a successful hourly rounding program is not easy. There are lots of reasons that, as we have mentioned earlier, “Despite significant efforts being made in terms of staff time, training, and re-training, most organizations are failing to see improved outcomes, and therefore are experiencing significant frustration due to the perception that their efforts are not producing results. Here are some reasons we have seen hourly rounding efforts falter:
1. Staff ownership and motivation
Oftentimes, hourly rounding can be perceived as optional. Staff would never “skip” quality requirements of Core Measures, checking vital signs, medication administration; however, we have encountered perceptions that Hourly Rounding is a luxury for when staff has time and is not short-staffed or in peak volumes. This has to change. Leaders need to engage staff to be a part of owning hourly rounding as non-negotiable; as well as contributing and giving feedback in the process.
Motivation is also critical. Leaders need to celebrate those staff members that excel with hourly rounding. Additionally, improvements in quality (e.g., Falls, Pressure Ulcers), decreases in call lights, and improvements in HCAHPS and patient experience results should also be recognized. Failure to celebrate wins (even small gains) can have a negative impact on staff engagement.
2. Staff skills
It is often thought that hourly rounding can be rolled out in a classroom setting with DVDs, articles and worksheets, and then staff would know how to round. However, conceptually hearing about the practice of hourly rounding and actually changing behaviors and developing the communication to be effective is a very different skill set. HEI spends significant time coaching, skill developing, and certifying to support adoption among our clients.
3. Leader accountability
Leaders must first hold up the mirror to themselves. It is unfair for leaders to expect
staff to round on every patient, every time, if they themselves are not:
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