Rounding in the 21st Century

Leveraging Technology to Improve Critical Communication

In today's patient-centered healthcare environment, the sustained commitment to quality and safety is an absolute imperative. The practice of rounding by nurses, physicians, support services and hospital administrators is one of the most effective and necessary functions in hospital and medical centers and can greatly increase an organization's safety and communications, enhance patients' well-being and satisfaction, and result in positive outcomes.

Rounding in the modern era has a variety of challenges when done manually. In viewing practices in facilities across the country, the most common issues related to rounding include:

• Difficulty in prioritizing tasks and resulting actions

• Lack of consistency in data gathering that leads to variability

• A disconnect in strategic alignment among risk, quality and safety due to a lack of integrated feedback

• Timeliness of data in terms of getting information from the floor to their leadership team to support data-driven decision-making

Collecting Data
Collecting data is essential to improving healthcare outcomes. Critical information can be collected during just a few moments of personal contact, and cataloging and analyzing both the singular event and aggregate information provide a healthcare system with the ability to see issues clearly. By pushing findings into a centralized data system, messaging around critical issues such as adverse events, employee safety, or even often-overlooked issues like shortcomings in cleaning protocols can be addressed more rapidly and effectively.

How do we standardize our approach so it has relevance and impact to everyone?

Data provide insights into health system operations and give meaning to improvement initiatives. By collecting timely data through rounds, health systems can better understand what happens day-to-day and then identify insights and trends. Study results published in American Nurse Today illustrate that routine, deliberate rounding practices increased both patient satisfaction and communication by physicians as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems surveys. The added benefits of collecting data and holding staff accountable help to improve transparency within the hospital and enhance the journey toward a high reliability, safer organization.

Improving Safety
Communication is the easiest way to improve an organization's safety, and routine rounding allows participants to increase communication daily. The practice of hospital rounding is said to have been coined in reference to the Johns Hopkins School of Medicine's dome-shaped building as doctors walked "round" circular routes to visit patients. Another theory suggests that rounding never ends—one round ends, then another round begins, around and around and around. Regardless of the actual origin, the practice of rounding has weathered centuries of medical tradition, and practitioners everywhere continue to make rounds and reap benefits from the in-person interactions.

A major benefit of rounding is to demonstrate to staff and the patients and families served that the organization is committed to quality and safety. We know that safety is embedded in today's healthcare culture; however, more than just paying attention to safety, healthcare team members are empowered to take action when they see problems that may create an adverse result.

As a blog on Becker's Hospital Review reminds us, rounds can be used to view the hospital from the patient's perspective. By checking in on practitioners, administrators can determine if any compliance issues or adverse events have occurred and attend to them efficiently. Whether it is an environment of care rounds, leader rounds, hourly rounds or purposefully focused rounds, rounding allows medical practitioners to understand what is working well and to have a quick pulse on any issues that need to be addressed.

Today: Collecting Rounding Data on Mobile Devices
Due to advances in technology, we have the ability to perform rounding digitally, which ensures that rounding is happening and that it is happening consistently and effectively. Historically, hospital technology has not been leveraged to facilitate rounding because the focus was on patient interaction and resolving immediate issues rather than documentation. The majority of this process still occurs on sticky notes and clipboards and thus creates opportunities to miss important information or at best generate additional administrative work.

When the clipboard is replaced by a mobile application, the benefits of digital rounding are considerable given the amount of "misses" that are typical over a very busy day. With the ability to record notes directly into a phone or tablet and immediate communication going out to all areas that need to respond to an issue, suddenly patient health and satisfaction become the focus. A health system no longer just complies with regulatory guidelines, but uses these tools to react quickly and in an effective manner. Mobile rounding allows administrators to respond and communicate about patients' issues during their stay; therefore; creating a safer environment and enhancing the patient experience. And mobile rounding can facilitate—

• Rapid identification of trends to make widespread performance improvement initiatives rather than handling as one-offs

• Tracking information in a central system to create a more robust view of the patient; being able to see rounding information on a patient with an adverse event, patient complaint or compliment

• Ensuring loop closure for all issues found during the course of a round, not for just the most severe

Rounding digitally makes data quantifiable, searchable and instantly shared. It's time to move rounding into the twenty-first century along with other critical hospital processes.

Rounding digitally allows for better data coordination, collaboration and management to improve outcomes and streamline workflow across departments and through changing shifts—creating sustainable performance improvement that drives financial margins.

We can do better. It's time to end the paper chase and deliver advanced technology into the critical hospital rounding process.

Lindsey, J. S. & Corkran, B. (2012, May 22). 4 keys to effective administrative rounding [Weblog post]. Retrieved from https://www.beckershospitalreview.com/hospital-management-administration/4-keys-to-effective-administrative-rounding.html

Johnson, B. T. & Conner, B. T. (2014). What works: Physician and nurse rounding improves patient satisfaction. American Nurse Today, 9,12.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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