January 2010 Quarterly Meeting Presentation Highlights

Why does it sound so easy but challenge so many?

Teams from the North Bay Healthcare System  and San Francisco General Hospital shared their practical and tactical suggestions for implementing a reliable rounding program.

North Bay Healthcare’s  journey began several years ago with a nursing leader who knew hourly rounding was the right thing to do.  She educated her staff and had them all sign letters of commitment to initiate this strategy, but she didn’t stop there.  To make something happen day in and day out takes considerable effort. Doubts about the effectiveness and ability of the staff to perform this task were rampant and the initial staff reaction was not unexpected. Despite these doubts, several unit based nursing and nursing assistant champions took on the responsibility to implement the hourly rounding program.  Success begot success when the fall rate dropped as the reliability of rounding improved.  The staff also noticed that as a result of purposefully and proactively attending to the patients needs when they were in the room during hourly rounding, the need to return to the patients’ room in between rounds was greatly diminished.  Another collateral benefit was the dramatic reduction in the use of call lights.  Despite these obvious advantages there were some who failed to document their rounding efforts.  When such circumstances were identified through periodic auditing, the unit based champions coached their fellow staff members.  The nursing leader only got involved if repeated coaching sessions proved ineffective.

At San Francisco General Hospital the purposeful rounding journey is in its infancy.  Like North Bay, the SFGH folks have identified unit based champions.  Due to the differing patient populations on their various units and the rounding implementation team’s input, the individual units have been given latitude to customize the program to conform to their unit’s culture.

Common themes at both hospitals:

•  Leadership dedicated to the process of rounding to prevent patient harm

•  Unit based champions to provide peer-to-peer feedback and program evaluations

•  Ongoing monitoring and feedback, not just assuming it’s happening because everyone was in-serviced

•  Sharing successes

Download Highlights from the January 2010 Quarterly Meeting "Practical and Tactical"