Three missed opportunities with patient rounding
Responding to patient needs requires versatility
Nurse leader rounding is a critical, daily activity that monitors patients and identifies potential threats to their safety, recovery and satisfaction—but that is just the beginning of what is needed.
In today's world, hospitals are pushing their direct care staff to prioritize value-based, consumer-centric care by continually seeking out ever-greater efficiencies within existing workflows and processes, and meeting or exceeding evolving quality measures.
Narrow solutions will not help hospitals or their clinical staff achieve those goals. If each tool available to aid clinical process only does one job, soon our nurses will have a tool belt filled with devices. We need integrated technology that "does it all." Today's view of rounding technology needs to be expansionary, imaginative and opportunistic and should meet all of the data needs for point of service data collection. Unfortunately, many nurses are limited by the tools at their disposal.
While the past 10 years have emphasized the shift from paper to digital data collection, the next 10 years will focus on how we use the data in real time to improve the patient experience and improve quality, at the individual patient level. Precision engagement will be key.
Here are three critical ways the right nurse rounding solution can enhance better care, optimize patient experiences, and identify opportunities to assess and enhance the workflows of direct-care staff.
1. Giving Patients a Voice
A mix of technological advances and legislative reforms have incentivized hospitals and health systems to assure patients are at the center of care. Gone are the days of patients acting as passive recipients of treatment directives. Today's patient is expected and encouraged to be active and confident advocates for their own healthcare.
The right rounding solution should give a voice to the patient—and their families—about their experience, preferences, and concerns. Care providers can help by directing patients to the appropriate education about their own health and offering them the right tools to ask questions and provide feedback on the care they are receiving.
A good solution should also offer convenient options for patients, such as providing feedback via their own personal devices, in any setting, such as smartphone, tablet, or laptop, from any setting. Capturing the patient voice through a variety of technology devices is a powerful adjunct to nurse rounding.
Seamless data integration, distribution and notification is essential to holistic patient care, and vital for identifying trouble areas and driving enduring improvements to workflows and patient interactions.
2. Real-Time Problem Solving
Because nurse rounding touches so many aspects of the patient care process—from monitoring patient recovery and satisfaction to collecting and distributing data across multiple users and care settings, the ability to customize configurations, scripts, reports, dashboards, alerts, and devices is essential.
In the past, without the aid of integrated technology, a critical incident would require a lot of manual investigation to determine root causes. Information was not always consistently captured.
Today, technological advances and the push toward ever greater integration enables direct care staff to leverage data before a problem becomes serious—and communicate critical information to the right person at the right time, making patient concerns instantly actionable. Proactive management of data can lead to lower rates of critical incidents.
For example, standardizing care through customized scripting enables direct care staff to configure survey questions tailored to the patient needs (i.e., an adult vs. a child) and the ultimate goals of the unit or hospital. In addition, the ability to customize alerts allows for real-time responses to patient complaints or concerns, because feedback and notifications are routed through preferred channels (i.e., e-mail, text or page) to the right department in real time.
An example of this comes from a large Midwestern children's hospital: they identified a need to improve patient satisfaction with pediatric pain management in the Pediatric Surgery/Transplant unit. To do this, the clinicians wanted to keep patients and families invested in the pain management process. They worked to engage the patients in decision making regarding pain treatments and providing consistent and clear communication with direct care staff, especially during daily nurse leadership rounding. Improvements were measured by patient experience scores related to pain management.
Using a versatile rounding tool, the hospital raised patient satisfaction scores related to pain, from 75% to 86%, by customizing and deploying a customized patient survey about pain and pain management techniques at admission.
3. Real-Time Data Collection and Benchmarking
Increased efficiency and HCAHPS scores are great—but nursing staff should be able to do so much more with their rounding tools, including real-time data collection and benchmarking. How do their workflows and process improvements compare with peers on different units—or in hospitals across the region?
Moreover, real-time data collection and the ability to automatically update the patient record cuts down on information gaps; after all, notes scribbled on paper can only be used by those in possession of the notepad. Additionally, the collection of real-time data creates a historical record that allows direct care staff to proactively use actionable, evidence based data in real time.
Finally, the right rounding technology should allow for benchmarking, evaluation, and process improvement. The Midwestern children's hospital used in the example above is able to use benchmarking, as well as feedback from direct care staff and patients, to identify areas for improvement and scale the solution to other units within the hospital. In addition, CNOs, nurse managers and other executive leaders can use the solution to quickly and consistently record, track and analyze staff performance and fulfillment. Clinical staff and nursing leaders can hardwire best practices into their daily auditing and rounding processes.
In a value-based, patient-centric world, direct-care staff are expected to do more with fewer resources. A good nurse rounding solution will improve HCAHPS scores and increase patient satisfaction, but the right solution will empower direct care staff to uncover creative and versatile solutions that will positively impact the entire organization.
Karen Drenkard, PhD, RN, NEA-BC, FAAN, is Senior Vice President/Chief Clinical Officer and Chief Nurse of GetWellNetwork/The O'Neil Center.
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