2008 National Conference
November 17–19
Grapevine, TX
INSIDE THE POST EDITION
2008 National Client Conference, Texas Style
CEO Forum Focuses on Leadership and the Future
Hourly Rounding a “Win-Win Situation” for Patients and Staff
Crucial Conversations Enhance Safety Culture in Health Care
Success Starts With Leadership
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Hourly Rounding a “Win-Win Situation” for Patients and Staff
The practice of hourly rounding is a proactive measure that raises patient and staff satisfaction, said health care professionals at the Nov. 18 session “Hourly Rounding: Delivering Results.”
Sara Richmond, system consultant with Press Ganey who served as session moderator, said hourly rounding is a fundamental tool that impacts multiple areas in health care, including enhancing patient trust, reducing stress for the nursing staff, and improving patient satisfaction and HCAHPS outcomes.
“Hourly rounding is really meeting patients’ needs proactively,” she stated. “It improves patient satisfaction but also improves staff satisfaction. It’s really a win-win situation.”
Studies have shown that rounding can reduce call-light volume, patient falls, and patient bedsores, the latter because patients are repositioned during each visit. Patients also have reported a decrease in anxiety because they know a nurse will visit within a specific time period.
In one study at North Mississippi Medical Center in Tupelo, Mississippi, patient satisfaction before hourly rounding was listed at 79.9% but when hourly rounding was implemented, this number rose to 90.6%. And patient satisfaction jumped more than 20%, from 70.4 to 91.5, when two-hour rounding replaced pre-two hour rounding.
Marguerite Guignard, nursing director at Baptist Hospital of Miami, said patient satisfaction rates have increased to 90% or more in the last five quarters since her hospital implemented the practice.
“And patient satisfaction is at 99% and holding in this quarter,” she added.
However, convincing some nursing staffs of the benefits of hourly rounding can prove challenging both Richmond and Guignard said. Reasons can range from feeling overloaded to fearing change.
“We do encounter some resistance initially but once it gets implemented and people work through it, staff tend to turn around and see that improvement,” Richmond said. “It’s one of those initiatives that can really be powerful. The benefits far outweigh the work that goes into it.”
She said nursing managers should devise a plan to help address potential obstacles and hold staff accountable for their actions.
“Do some thinking ahead of time, so if you encounter resistance, you know how to handle it. And keep those doors of communication open, so the plan can be adapted as needed as you go along.”
Guignard agreed that managers need to hold staff accountable and that communication is key to the success of the hourly rounding program.
“Talk to staff about how to make hourly rounding part of their routine. It has to be a daily thing,” she said. “Listen to them. Ask, ‘What’s getting in your way?’”
Guignard said managers also should conduct hourly rounds.
“You have to set the example,” she stressed.
In her own hourly rounding, Guignard follows up with patients to see if nurses have been hourly rounding and asking the three Ps–pain, potty (or personal needs), and positioning. She then graphs the results, places the data on a communications board, and shares the information in staff meetings. To encourage hourly rounding, she recognizes an employee of the month, with a photo, certificate of acknowledgement, thank you letter, and a coupon for free food in the hospital cafeteria.
“Eventually staffs get it. It gets better over time because it’s an expectation; it’s the practice,” she said.
Ultimately, the hourly rounding protocol improves nurse retention, Richmond said.
“Nurses want to work in a place where they can have that personal connection with patients,” she said. “And when it comes down to it, it’s just the right thing to do for the patient.”
Other session speakers were Gwendolyn Neal, patient satisfaction data analyst at North Mississippi Medical Center and Judy Zbierajewski, chief nursing officer at St. Charles Mercy Hospital in Oregon, Ohio.
