Leading by Example: Inspiring Engagement in Employee and Patient Rounding
With 15 years of experience as a national nursing excellence consultant, I have had the opportunity to work with literally hundreds of healthcare leaders from over 200 facilities. One thing that always stands out is the difference between those who actually ‘walk the talk’ and become role models for processes, professional behaviors, work ethic, attitude, and accountability, and those who don’t. Successful leaders know that effective delegation is key to handle a broad scope of command by leading through systems. But they also know when they need to be visible and accessible to staff and patients during periods of stress or change.
I recently had the opportunity to visit with Steve Heatherly, CEO of Harris Regional Hospital in Sylva, NC. We are proud to have Harris as one of our partners and their successful employee engagement through ‘praise-based’ leadership is definitely an industry best practice. After spending 30 minutes talking to Steve, I know that his leadership commitment to round daily on all new admissions, with a follow-up round on the second day of the stay by the CNO, is making a difference to both patients and staff. He shared this with me about patient rounding.
“I've been doing this now for four or five years. So, there's this obvious benefit of engaging directly with patients and it speaks to patients and their families when senior leadership is willing to come into their room… There's this immediacy in terms of truly getting to the root of a problem… We were able to address some things in real time - whether it be the temperature of the room, a really busy nurse not able to respond to a call or that the food could be improved. Whatever. Patients began to experience our ability to quickly address some pretty basic concerns.”
Besides the benefit to the patient experience, he also noted that staff engagement has also changed.
“When I first started doing it [rounding on patients, staff, nurses’ stations, etc] there was some degree of skepticism on the part of staff. Like, ‘Why are you here? If someone says something bad to you, is that somehow going to affect me negatively?” And what I think people would tell you today, it's all a part of supporting each other. I'm there, frankly, to hear more good things.
Nearly every facility that becomes a Nobl hospital rounding software client has key priorities they hope to accomplish by implementing our platforms. Some are working to address employee engagement and opt to roll out Employee first. Others want to impact efficiency, responsiveness, and safety at the unit level and launch hourly rounding and the Friends & Family portal initially. Just as often, patient experience and HCAHPS patient satisfaction are the focus and the Nobl is rolled out for all levels of leadership – executive, nursing, and support department leaders. After over four years as the CNO at Nobl, I have observed what works and what doesn’t, and in my opinion, and in an ideal world, every facility should roll out leader rounding first – at all levels. Let me tell you why.
5 Reasons Why Leader Rounds on Patients Should Lead Off Rounding Implementation
1. Validates the Standard Process
Rounding by leaders offers them ‘lived experience’ data to validate how well rounding processes are working before those processes are converted to a digital format. Converting a bad process into a digital platform, that will hold individuals accountable for completing rounds can serve to disengage leaders when system barriers are really the issue, not staff compliance or behaviors.
2. Increase Leader Credibility
Leaders who have used the process, or software, have more credibility with staff when they are asked to implement a digital rounding program. If leaders have successfully mastered the standardized steps, and role model that performance where all can see them, it prepares them to positively coach others to adopt similar skills or processes.
3. More effective Go-Live Support
Supporting go-live for a limited number of leaders rounding on patients in specific areas makes it easier to assure a successful launch. One-on-one coaching or co-rounding with leaders sets the standard so that individual adaptations don’t change the intent of the program or overlook rounding best practices.
4. Making leader rounding a key performance indicator (KPI) supports ownership sooner for some individuals.
If annual compensation is related to personal mastery of rounding techniques and software, individual leaders cannot pass off the lack of engagement around the initiative to unit level barriers or lack of engagement by their staff. It is easier to measure their own usage and compliance first. If the leader doesn’t learn the process and make it a priority, the chance of them being a true champion for the initiative with their staff is slim.
5. Leader rounds make a difference on patient experience scores.
Besides listening and caring, leader rounding on patients is how to increase patient satisfaction in hospitals. When patients remember a leader rounding on them, they answer patient experience questions more positively, which improves HCAHPS, even if there has been an issue - as long as that issue is resolved before discharge. When an executive, who wouldn’t normally be viewed as a bedside provider, visits a patient it reinforces the patient’s feelings of being valued and improves their perceptions of the care that they receive.
At Nobl, we work hard to make every rounding go-live a success, regardless of whether the organization leads off with Hourly, Leader or Employee Rounding Platforms. But as a seasoned leader, I do have an opinion. If you’ve read any of my other blogs, you know I usually do. Happy rounding!
Written by Teresa L Anderson, EdD, MSN, NE-BC, Nobl Chief Nursing Officer