An Academic Hospital’s “Full Circle” Approach to Patient Engagement

Rounding is an important part of the day for nurses—and for patients and families. This engagement, when supported with meaningful conversations, can build trusted relationships and garner valuable insight into a patient’s healthcare goals, concerns about certain treatment, potential social barriers, and much more.


That is why at UChicago Medicine we conduct nurse leader rounds using the Vocera Rounds app on iPads. Unlike traditional paper-based rounding, iPad rounding ensures our patient and family feedback is captured in real-time at the point care, is easily accessible to the entire care team, and is tracked throughout the hospital stay and during follow-up calls.

By capturing patient and family comments electronically, requests can be escalated to other care team members, tracked, and closed in real time. Real-time communication can speed up response times, enabling us to exceed patient expectations. In addition to improving staff responsiveness and patient experience, the mobile rounding solution provides valuable analytics about trends, and flags patients when additional follow-up is required during or after a hospital stay.

The solution also helps hospital leaders get ahead of potential service issues, proactively pinpoint opportunities for improvement, and identify our top performers. Without an intuitive engagement solution that standardizes the rounding process, facilitates meaningful conversations, captures actionable data, and monitors the overall patient experience, gaps in care or good work by staff could go unrecognized. The rounding solution has been a great experience improvement tool for not only our patients and families, but for our staff members as well. The mobile app helps leaders capture employees’ voices and identify high-performing staff members, who can be celebrated. 

Here are some of our lessons learned that may help other hospitals on a mission to improve patient engagement and compliance with better rounding and follow-up calls.

Start with the “why”

Before deploying mobile rounding, I knew we couldn’t simply tell our nurse leaders, “Here are some iPads, go out and get some patient comments.” Nurses have many responsibilities and competing priorities, and this approach won’t inspire their confidence in or adoption of a new process.

So, my staff and I in the Office of Patient Experience and Experience engaged in conversations with frontline nurses, nurse leaders, and other key or support leaders that started with the “why.” Influencing new behaviors requires understanding the context of nurses’ purpose and passion and supporting them in a way that respects their professionalism and processes. 

I also recommend having data points that support goals you hope to achieve; and when success is realized share it broadly. For example, using data from Vocera Rounds solution, my team discovered the hospital had an issue with food services. We explored patient, family and staff comments captured in the application, and raised the issue to the COO. Because we had trending data and comments, we were able to take action and improve the food service. This experience proved the rounding technology is a valuable platform for collective voices to be heard and to initiate positive change.

Round with the “rounders”

After getting to the heart of the matter with the “Why,” explain how. The focus during mobile rounding needs to remain on the patient, not on the iPad screen. During the initial rollout, identify leaders who can accompany nurses on their initial rounds and, if needed, help guide their conversations with patients. Some might need more coaching to connect more genuinely with the patients. It is important to set up questions in the rounding app that are designed to facilitate meaningful engagement.

Early in the technology adoption process, capture patient and family perceptions of iPad rounding in addition to feedback about the healthcare experience. Obtaining patient and family feedback about the mobile interaction will support your nurse leaders as they help their teams adapt to iPad-based rounding. It will also inform you about whether or not you need to make improvements when educating patients about the purpose of the mobile device.

If you have a complete engagement solution like we do that intelligently connects your rounding solution with your care calls tool, explain to nurse leaders that the information captured in the rounding app will be accessible to care team members making follow-up calls. This transparency helps extend personalized care outside the walls of the hospital.

Engage the patient throughout care experience

Rounding isn’t only about keeping apprised of the patient’s condition during the current hospital stay. It also captures essential data for assuring the patient follows the right care plan post-discharge.  Information collected via the rounding app is used to support post-discharge calls to patients.  

Our nurses who conduct follow-up calls can look in the Vocera system and see verbatim patient comments captured during rounding. They can also see if the patient had specific questions, concerns, or requests during the hospital stay and ensure the patient was and remains satisfied with how their comments were addressed. Follow-up calls with this personal context go a long way to making patients feel valued. They feel like they are respectfully cared for and truly heard.  

Additionally, the rounding and care calls solutions enable care team members to flag patient records for reference in future encounters. If a patient happens to be re-admitted the information captured in both solutions is easily accessible for the next care team. For instance, if a patient previously had an issue with the temperature of his room or the quality of food, the nurse can discuss it with the patient, letting him know that the request or comment was noted during his last hospital stay and will be addressed during the current one.

That brings me to my final and most important suggestion for effective, iPad-based rounding: Always come back to the patient. Is the data collecting improving patient care? Is it being collected in a way that improves communication, engagement and experience?

At UChicago Medicine, the answers have been a rounding—make that, a resounding “Yes.”

Susan Murphy, RN, BSN, MS, is the Chief Experience Officer at the UChicago Medicine. She is also the 2018 recipient of the Kate Granger Compassionate Care Award.

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