hourly rounding - vanderbilt university medical · pdf filein addition to hourly rounding,...

B E S T P R A C T I C E :

S A C R E D H E A R T H O S P I TA L

P E N S A C O L A , F L O R I D A

B E S T P R A C T I C E :

S A C R E D H E A R T H O S P I TA L

P E N S A C O L A , F L O R I D A

HOURLY ROUNDINGHOURLY ROUNDINGS U P P L E M E N T

© 2007 Studer Group

2© 2007 Studer Group

HOURLY ROUNDING HOURLY ROUNDING S U P P L E M E N T

Today, due to organizations around the country that have implemented hourly rounding, patient falls are

down. If every hospital in the country were rounding on inpatients hourly, the cost savings would be two

billion dollars, and most importantly patients would receive better care. Skin breakdown is decreasing

and call lights are down 37.8 percent so staff can do what they want to do, take better care of patients. In

addition to patient care issues, Medicare just announced they would no longer be paying for patients who

fall and have skin breakdown that are acquired while in the hospital.

The hourly rounding tools just got better. We spent hundreds of hours in research, clinical and operational

trials, preparing teaching kits and use of user groups to make sure the material works. With all of that,

we find when more organizations implement the tools and techniques - people like you make the material

better. In their work, Sacred Heart Hospital in Pensacola, Florida, created a best practice to focus on truly

hardwiring the hourly rounds. We have found that organizations that use this tool, combined with the other

methods recommended in hourly rounding, achieve better clinical results than those that do not use this

tool. Due to our mission of making health care better, which we know is also your mission, we wanted to

get this enhancement to you right away.

Thank you for your dedication to doing work with such great purpose, it’s worthwhile and makes

a difference.

Yours in Service

Quint Studer

© 2007 Studer Group3

A. Overview of Organization

Sacred Heart is a 476-bed acute care facility located in Pensacola, Fla., which includes Sacred Heart Hospital, Sacred

Heart Children’s Hospital and Sacred Heart Women’s Hospital. In addition, Sacred Heart Health System, a member of

Ascension Health, includes a 50-bed hospital – Sacred Heart Hospital on the Emerald Coast located in Walton County,

east of Destin, Fla.

B. Hourly Rounding Outcomes and Results

Five months after implementation with 10 nursing units on board, Sacred Heart is seeing the following results on the

units that are practicing hourly rounding:

Call lights reduced by 40-50 percent

Patient falls were reduced by 33 percent

Hospital-acquired pressure ulcer cases were reduced by 56 percent

Overall patient satisfaction has increased 71 percentile points

QUALITY: PATIENT FALLS REDUCED

Patient falls were reduced by 33 percent for the units practicing hourly rounding.

FALLS100

90

80

70

60

50

40

30

20

10

0

Before Hourly Rounding After Hourly Rounding

Patient Falls

HOURLY ROUNDING HOURLY ROUNDING S U P P L E M E N THOURLY ROUNDING HOURLY ROUNDING S U P P L E M E N T

4© 2007 Studer Group

QUALITY: SKIN BREAKDOWN REDUCED

Hospital-acquired pressure ulcer cases were reduced by 56 percent on the units practicing hourly rounding.

In addition to hourly rounding, Sacred Heart Hospital is part of an Ascension system-wide goal to eliminate facility-

acquired pressure ulcers as part of the ministry’s “HealthcareThat Is Safe” initiative. In collaboration with the Institute for

Healthcare Improvement, a comprehensive plan was developed which included participation in an International Pressure

Ulcer Prevalence Study sponsored by Hill-Rom, purchase of new bed surfaces and implementation of a

nursing driven “SKIN” bundle.

SERVICE: PATIENT SATISFACTION INCREASED

Overall patient satisfaction has increased 71 percentile points.

DECUBUTI

20

15

10

5

0

Before Hourly Rounding

NosocomialDecubuti

After Hourly Rounding



C. Hourly Rounding Implementation

Sacred Heart Hospital in Pensacola, Fla., began training nurses in hourly rounding in November 2006. The hospital

began with six pilot nursing units and now has 10 nursing units rounding hourly. Successful implementation of hourly

rounding requires participation of all staff on the unit as well as consistent leader rounding. Variance in practices that

are not addressed will produce inconsistent results and dissatisfaction including staff complaints. Call lights will not see

significant decreases and patient satisfaction results will trend up then down.

Sacred Heart credits their excellent outcomes to the hardwired accountability that they have placed into their

implementation process. They have focused on ways to reduce individual variance from the start. The Hourly Rounding

Dashboard Report (see Tool B) and the Competency Checklist (see Tool F) are key tools to hardwire in the process. One

of the best hardwired tactics implemented has been the weekly hourly rounding meeting led by the CNO or director. This

meeting includes leaders from all units currently participating in hourly rounding as well as those coming on soon. The

meeting allows those involved an opportunity to understand the challenges, transfer learning and best practices and

foster accountability. (See Tool A to review a sample agenda of this critical meeting.)

Consistently connect to purpose by sharing patient or staff feedback about the impact hourly rounding serves. This will

serve as the fuel that ignites the flame which in turn kindles the staff’s passion. The Healthcare Flywheel® turns as staff

feel they have purpose, do worthwhile work and make a difference.

Patient Satisfaction Response: Nursing Breakdown:There were significant increases in the perception of nursing care specifically in promptness to call lights and pain control.

NURSING QUESTIONS

BASELINE CURRENT

Nurses Overall 31 98

Friendliness / courtesy of the nurses 25 94

Promptness response to call 10 95

Nurses’ attitude toward requests 34 98

Attention to special / personal needs 50 99

Nurses kept you informed 42 98

Skill of the nurses 49 96

How well your pain was controlled 42 99



Tool A: Hourly Rounding Standardized

Meeting Agenda

Tool B: Hourly Rounding Dashboard Report

Tool C: Hourly Rounding Welcome Cards

Tool D: Hourly Rounding Pocket Cards

Tool E: Hourly Rounding Pillow Cards

Tool F: Hourly Rounding Competency Checklist

Tool G: Hourly Rounding Flyer – The 3 P’s

Cultivating Patient Care Excellence

Tool H: Hourly Rounding Flyer – The 4 P’s

Cultivating Patient Care Excellence

Tool I: Hourly Rounding Flyer – OB Unit

Tool J: Hourly Rounding – Call Light Log

Tool K: Hourly Rounding – Hourly Rounding

Documentation Log

Tool L: Sacred Heart Hourly Rounding

Implementation Tips and Guidelines

D. Hardwiring Hourly Rounding: Sacred Heart Tools and Examples

The following tools were created by Sacred Heart to hardwire accountability into their hourly rounding

implementation process. They are provided as resources and examples to you.


D: ONGONING

Hourly Rounding Conducted

A Leader Rounding Conducted

Positive Wins are Shared and Communicated

B

C

Prior Oct2006

Nov2006

Dec2006

Jan2007

Feb2007

Mar2007

Apr2007

May2007

C F G

• Foundationtactics in place

• Benefits ofhourly roundingcommunicated

• Leaders round with purpose using specific questions• Rounding questions posted in the staff lounge• Leaders sign the rounding logs when rounding on patients• Hourly rounding logs placed inside the rooms

• Read positive patient letters to the staff• Share results with the staff• Review call light logs and recognize the nures and the unit secretary with the least call

lights recorded• E-round or send out a broadcast note weekly to associates to keep the positive impact

of hourly rounding top of mind

Hourlyroundingbegins 6

pilot units

• Staff trainingconducted

• Competencychecklist andcheckoffs conducted

• Related toolsdistributed(pocket, welcome andpillow cardsdistributed)

Weeklyhourly

roundingmeetings

begin

Hourlyrounding

dashboardreportcreated

Fouradditionalunits begin

hourlyrounding


TOOL A: HOURLY ROUNDING STANDARDIZED MEETING AGENDA

Purpose: A weekly hourly rounding meeting led by the CNO or director to drive accountability works well to accelerate

and hardwire the process. The meeting goals include: understanding challenges, transferring learning

and best practices, rewarding and recognizing success and holding leaders accountable for their results.

Target: The meeting includes leaders from all units currently participating in hourly rounding as well as those

coming on soon.

HOURLY ROUNDING WEEKLY MEETING AGENDA

I What is working well?

II What are the barriers?

III Reward and recognize success

IV Patient letters, stories and staff feedback

V What are the tough questions staff asks?

VI Leader reports on unit patient satisfaction results and reviews the percentage of

“competency checklists” completed for the week

VII What actions will nurse leaders take to improve their hourly rounding results?

VIII Leaders exchange 24 hours worth of completed call light and rounding log to

review and give each other feedback

IX What have they learned at the meeting that they want to implement?

X Next steps are discussed and agreed upon



TOOL B: HOURLY ROUNDING DASHBOARD REPORT

Purpose: Utilize a dashboard report to measure your unit’s return on investment of their time and effort. Reporting

includes (a) fall rate, (b) pressure ulcers, (c) call light volumes, (d) patient satisfaction, (e) pain question, (f) response to

call light, (g) staff worked together as a team, (h) attitude toward personal requests, (i) attention to personal needs and

(j) overall rating of care.

Target: Leaders from all units currently participating in hourly rounding.

BASELINE

Dec-06

Jan-07

Feb-07

Mar-07

Apr-07

May-07

Jun-07

Jul-07

Aug-07

Sep-07

Oct-07

Nov-07

Dec-07

SAFETY PATIENT SATISFACTION

FALL RATE

PRESSUREULCERS

CALL LIGHT

VOLUME

N SIZE

PAINCONTROLLED

RESPONSE TO CALL

LIGHT

STAFF WORKEDTOGETHER AS

A TEAM

ATTITUDE TOWARD YOUR

REQUESTS

ATTENTION TO PERSONAL

NEEDS

OVERALLRATING OF CARE

OVERALLPERCENTILE 5 EAST



TOOL C: HOURLY ROUNDING WELCOME CARDS

Purpose: The welcome card given to every patient upon admission provides the key words meant to set expectations

by “contracting” with the patient and educating the patient/family regarding hourly rounding. These cards, signed by the

admitting nurse, are left in the patient’s room to explain why we round hourly, and also to provide an access number if

anything is needed during the patient’s stay.

Target: Welcome cards are provided to all staff involved in hourly rounding.



TOOL D: HOURLY ROUNDING POCKET CARDS

Purpose: Issue pocket cards to unit staff, float staff and new staff during orientation.

Target: All staff performing hourly rounding.



TOOL E: HOURLY ROUNDING PILLOW CARD

Purpose: Pillow cards are used to place on the pillow when patients are out of the room for tests. They communicate to

the patient that staff came by to check on them during hourly rounds.

Target: All staff performing hourly rounding.



TOOL F: HOURLY ROUNDING COMPETENCY CHECKLIST

Purpose: This tool provides a competency checklist which documents the demonstration of hourly rounding

competencies and behaviors. This competency checklist can be customized and adapted for any unit.

Target: All staff involved in hourly rounding.


DATE

NAME

DEPARTMENT

EVALUATOR

Knock on door prior to entering – ask permissionManage up your skill or that of your co-workerUse good eye contact

Explain the purpose of hourly rounding (initial visit)Use key words “very good” careDescribe rounding schedule (6am-10pm q1hr. 10pm-6am q2hr.)

Place name on white boardUpdate nursing plan of care/goals for patient

How is your pain?Are you comfortable?Do you need to go to the bathroom?

Complete MD ordered treatments, proceduresComplete nursing care as neededAdminister scheduled medications

We will round again in about an hourIs there anything else that I can do for you? I have the timeDocument your rounding on rounding log

Give Welcome Cards to introduce hourly rounding to all patients (new admissions and transfers)We round hourly on our patients to ensure that you receive “Very Good” care. We round every hour between 6am - 10pm & every two hoursbetween 10pm - 6am. We will not wake you if you are sleeping unless we need to. If anytime during your stay, you feel you are not receiving“Very Good” care, please let us know immediately so that we can address your concerns.

Complete Self Assessment, practice and then have a Leader observe you

Move items within reach (table, call bell, phone, water)

INTRODUCTIONS

SELF ASSESSYES NO YES NO

EVALUATOR COMMENTS

EXPLAIN HOURLY ROUNDING UPON ADMISSION

UPDATE WHITE BOARDS

ADDRESS 3P’S PAIN...POSITION...POTTY

PERFORM SCHEDULED TASKS

CLOSING

ASSESS ENVIRONMENT

HOURLY ROUNDING COMPETENCY CHECKLIST


TOOL G: HOURLY ROUNDING FLYER – THE 3 P’S CULTIVATING PATIENT CARE EXCELLENCE

Purpose: This tool serves as a training tool and reminder of the 3 P’s of Pain, Position and Potty.

Target: Posted and provided to all units involved in hourly rounding using the 3 P’s.



TOOL H: HOURLY ROUNDING FLYER – THE 4 P’S CULTIVATING PATIENT CARE EXCELLENCE

Purpose: This flyer provides a training tool and reminder of the 4 P’s of Pain, Position, Potty and Possessions. It

allows you to see how the hourly rounding behaviors can be customized depending on the patient needs. The 4th P

“Possessions” reminds the staff to perform an environmental check and move items within the reach of the patient.

Sacred Heart has adapted and used the 4 P’s throughout most units.

Target: Posted and provided to all units involved in hourly rounding using the 4 P’s.



TOOL I: HOURLY ROUNDING FLYER – OB UNIT

Purpose: This tool provides an example of how hourly rounding can be adapted for an OB unit. In the OB unit, they

determined their patients’ needs to include Pain, Position, Questions and Supplies. These indicators were chosen

because they addressed the reasons the call lights ring.

Target: Posted and provided to OB units involved in hourly rounding using the 4 P’s.



TOOL J: HOURLY ROUNDING – CALL LIGHT LOG

Purpose: This log documents detailed information regarding the call lights by allowing the tracking of the reasons the

call lights ring. This call light log is customized for use in an adult unit and is filled out by the unit secretary. The adult

unit customization includes tracking pain, position, potty, possession, pumps, error and other. Note – this log may be

customized to any unit’s needs. For example, the OB unit might add questions or supplies and a pediatric unit may

include safety and supplies. Daily review by the manager will help to identify variances by a nurse enabling real time

feedback and improvements to occur. Health unit coordinators take ownership by paging out messages to the nurses

when the call light volume begins to increase.

Target: Adult units implementing hourly rounding.

Unit ______________________________________

Shift _____________________________________

Date _____________________________________

HUC _____________________________________

Coordinator _______________________________

Day M T W Th F Sat Sun

No# Pain Position Potty Possessions Pumps Error Other Room # RN Initials

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Check box each time the call light rings indicating reason, RN assigned to patient and the room number

Please turn these logs into your coordinator at the end of your shiftRev. 12.28.06

ADULT HOURLY ROUNDING CALL LIGHT LOG



TOOL K: HOURLY ROUNDING – DOCUMENTATION LOG

Purpose: This log is used for the staff to document hourly rounds. Staff are instructed to inquire about the “P” behaviors

and document on the log the specific ones that they addressed. The logs are collected at the end of 24 hours and given

to the charge nurse, reviewed and forwarded to the nurse manager for compiling data. This log is designed for an adult

unit and can be customized and revised for any specialty unit.

Target: Adult unit implementing hourly rounding.

HOURLY ROUNDING LOG Stamp Patient Information

RN Name _____________________

RN Name _____________________

Tech Name ___________________

Other Name ___________________

In ______

In ______

In ______

In ______

RN Name _____________________

RN Name _____________________

Tech Name ___________________

Other Name ___________________

In ______

In ______

In ______

In ______

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)

Rm # _____________Date: _____________ Bed # ____________ Day M T W Th F Sat Sun

TIME PERIOD STAFFINITIALS

TIMEROUNDING

PAIN POSITION POTTY POSSESSIONS COMMENTSIn chart by exception, note patient need

EVERY 1 HOUR ROUNDS 6 AM - 10 PM

6 AM

7 AM

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

2 PM

3 PM

4 PM

5 PM

6 PM

7 PM

8 PM

9 PMEVERY 2 HOUR ROUNDS 10 PM - 6 AM

10 PM

12 AM

2 AM

4 AM

This is not part of the permanent medical record



TOOL L: SACRED HEART HOURLY ROUNDING TIPS AND GUIDELINES

Purpose: This document provides details of the implementation steps used at Sacred Heart. A sample overall timeline

is provided and the detailed elements including foundational elements, training and hardwiring tools and tactics are

included in the table below.

Target: Organization and all nursing units.

RN Name _____________________

RN Name _____________________

Tech Name ___________________

Other Name ___________________

In ______

In ______

In ______

In ______

RN Name _____________________

RN Name _____________________

Tech Name ___________________

Other Name ___________________

In ______

In ______

In ______

In ______

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)

(Please Print)


D: ONGONING

Hourly Rounding Conducted

A Leader Rounding Conducted

Positive Wins are Shared and Communicated

B

C

Prior Oct2006

Nov2006

Dec2006

Jan2007

Feb2007

Mar2007

Apr2007

May2007

C F G

• Foundationtactics in place

• Benefits ofhourly roundingcommunicated

• Leaders round with purpose using specific questions• Rounding questions posted in the staff lounge• Leaders sign the rounding logs when rounding on patients• Hourly rounding logs placed inside the rooms

• Read positive patient letters to the staff• Share results with the staff• Review call light logs and recognize the nures and the unit secretary with the least call

lights recorded• E-round or send out a broadcast note weekly to associates to keep the positive impact

of hourly rounding top of mind

Hourlyroundingbegins 6

pilot units

• Staff trainingconducted

• Competencychecklist andcheckoffs conducted

• Related toolsdistributed(pocket, welcome andpillow cardsdistributed)

Weeklyhourly

roundingmeetings

begin

Hourlyrounding

dashboardreportcreated

Fouradditionalunits begin

hourlyrounding


IMPLEMENTATIONTIMEFRAME:

IMPLEMENTATION STEPS:

Several months

prior to

implementation

Round on staff, send and manage up thank you notes, implement key words

These are foundational tactics to the successful implementation of

hourly rounding

o When the staff feels valued and has the tools and

equipment to do their job, they are more likely to be

open to working on new behaviors

o The success of hourly rounding is enhanced when all

team members are participating

Discuss the benefits of hourly rounding

Designed to promote high quality patient care

o Increases patient satisfaction by average of 12 raw points

Provides health care that is safe

o Reduces falls up to 50%

o Reduces pressure ulcers up to 16%

Increases efficiency for staff

o Anticipates reasons why the call lights ring

o Reduces call lights up to 38%

o Saves nurses from 150 – 300 hours per month

Item A:

Item B:



Two weeks prior to

implementation

Get a team together to discuss the pilot

o Use this group to make decisions, plan and

monitor processes

Discuss hourly rounding in staff meetings

o Share the results of the Studer Group research in the

September 09, 2006 AJN Article

o Solicit input from staff in the planning and

implementation stages to encourage empowerment

and a sense of pride in the process



Conduct Training

o Select nursing units with strong leaders who have good

communication skills for your pilot units

o Make training mandatory

o Train nurses, techs and unit secretaries

o Train day and night shift

Give staff a Competency Checklist and Hourly Rounding Pocket Cards

o Competency checklist specific behaviors necessary

to master hourly rounding

o Pocket cards are quick reminders of the “P” behaviors

o Have staff perform a self assessment

o Staff then practice for one week prior to leader evaluating

the staff’s competency during hourly rounding

Distribute Hourly Rounding Welcome Cards

o The nurse admitting the patient uses the card to explain

hourly rounding to the patient and describe what the patient

can expect from the staff

o Staff signs their name on the welcome card “contracting”

with the patient to round hourly and address

prescribed behaviors

Distribute Hourly Rounding Pillow Cards

o Use cards when patients are out of the room for tests

o Card states “Sorry I Missed You! We perform hourly

rounding to ensure that you receive Very Good Care.

Let us know if you need anything when you return. I will be

back in about an hour.”

o Staff indicates time of round, signs their name and leaves

the card and a mint [sugar free or regular] on the

patient’s pillow



Item C:



Implementation Date



Ongoing Leaders round with purpose

Round daily to determine if patients are receiving “Very Good Care”

and monitor to see if staff is prompting for the 3P behaviors.

o If logs are complete but call lights are not reduced, staff are

likely “checking on patients” or rounding hourly and asking,

“how is everything?” Patients will commonly respond

“fine”. The patient will then use the call light because the

behaviors (3P’s) were not addressed.

Ensure that rounds occur on night shift and weekends

Leader questions during rounding

o Our goal is to round on patients every hour; did you

receive our hourly rounding welcome card?

o How are we doing with rounding? Are we offering

assistance in positioning, pain and taking you to the

bathroom? How about on night shift and on weekends?

Post rounding questions in the staff lounge communicating that this

is an open book test. Staff will go the extra mile when they know

what is expected.

Item D:

One week after

implementation date

Leaders complete Competency Checklists

o Give staff an opportunity to complete a self assessment

o Staff successfully completing check-offs receive a

special retractable badge holder

o Badge holder is a quick visual indicator at shift change

of who has been trained on hourly rounding

o Manager should not delegate this important function


Implementation begins


Ongoing Sign the rounding logs when making leader rounds to demonstrate

to the staff that you are reviewing their logs and communicate the

importance of the staff signing the logs.

Place the hourly rounding logs inside the rooms vs. on the outside

of the room door allowing families to visualize the staff signing the

log. Use of key words when signing will provide an opportunity to

engage the family, enhance trust and promote care and concern.

Hardwiring

Have unit secretary send out pages or reminders immediately if call

lights begin to increase

Review call light logs daily to spot trends.

Indicate room number and nurse’s name on call light logs so training

can be focused on the appropriate staff nurse.

Develop a float packet with tools including a pocket card

Include hourly rounding in nursing and tech unit

coordinator orientation

Incorporate hourly rounding competency goals into job evaluations

Develop a plan up front to address shift change, breaks and

confused patients

o Decide who will change out logs every 24 hours

o Adjust staff to cover call lights during shift change

o Have staff round before going to lunch and when returning

letting patients know that they will be at lunch and that

someone will be back in about an hour

o Automatically get confused patients up to the bathroom.

Often, they will tell you they do not need to use the

bathroom and then will immediately use the call light for the

same request.

Ongoing Reward and recognize success

Share results with the staff. The more the positive results are shared

with the staff, the quicker understanding will come and behaviors will

be reinforced.

Review call light logs and reward and recognize both the nurse and the

unit secretary with the least call lights recorded.





Weekly Hourly Rounding Meeting

o Initially schedule meeting weekly

o Change to bi-weekly when patient’s perception of care is

indicating consistent practices

The meeting should be led by CNO or Director (someone the leaders

report to) to foster accountability and support cross learning.

Include units currently doing hourly rounding and those planning to

come up in the future.

Agenda

o What is going well? Share wins, letters, stories,

staff feedback

o What are barriers identified? Problem solve solutions

o What are the tough questions?

o Review the % of competency check sheets completed

o Review the call light logs and daily rounding logs for the

past 24-hour period

o Review patient satisfaction results by unit for the week

Item E:

E-round or send out a broadcast note weekly to associates addressing

one of the following topics to keep the positive impact of hourly

rounding top of mind

o Comments you are hearing from the patients

o Positive staff comments and feedback

o Call light percentage reduced

o Hourly rounding stars of the week and why

o Patient’s perception of care – patient satisfaction results

Read positive patient’s letters to the staff which will encourage them

by reminding them why they went into health care




o Leaders trade logs and give each other feedback based

on what they are seeing

o Leaders discuss actions for improving results

o Next steps are discussed and agreed upon



Monthly Hourly Rounding Metrics

Create an Hourly Rounding Dashboard Report to

measure your unit’s

return on investment for their time and effort

o Fall rate

o Pressure Ulcers

o Call light volumes

o Patient Satisfaction

• Pain Question

• Response to call light

• Staff worked together as a team

• Attitude toward personal requests

• Attention to personal needs

• Overall rating of care

Item F:

Item G:



After process is

hardwired

Expand to other units in the hospital and begin same process.



The implementation steps identified are the keys to hardwiring this important tactic. The

nursing leaders at Sacred Heart have worked diligently to stay focused on the results that

this can achieve for the patients and the staff. Here are examples of the key learnings and

results we have experienced.

Key Learnings

Pilots do not have to be perfect, perseverance is key

Allow units to revise logs, handouts etc. as long as main objectives can be met

Communicate target dates and time lines

Offer to discontinue keeping rounding logs when unit reaches and maintains

greater than 95% patient satisfaction results for three months

Celebrate successes often for winners and most improved

Results

Staff indicated less chaos, more control over their day and an

uncanny feeling of calmness during a time of increased census.

Now when call lights ring, the staff encourage each other by

offering each other suggestions for a quick fix. As a result, their

nursing patient satisfaction results have increased.

Staff report stories of picking up clinical changes in patients during

hourly rounds allowing in some cases to transfer the

patient to higher level of care resulting in positive

outcomes for the patient.

Patient satisfaction early results: Nursing scores have increased

31% since baseline in two quarters; overall satisfaction has

increased 45% since baseline in two quarters.

Patient satisfaction current results: Overall satisfaction has

increased 71% from baseline in six months.

A patient recently stated the following in a letter:

“I wanted to take this opportunity to tell you how much I appreciate the wonderful compassionate care from the staff at Sacred

Heart. I had to have a colon resection on 12/19/06, which needless to say, had me scared to death from the beginning. The fear

remained, but, the kindness which I was shown and the excellent care that I received there far exceeded any expectations that I may

have had. These nurses were so good and so attentive that I do not believe that I ever had to call for anything, because they would

be in my room to check on me to see if I needed anything before I ever had time to ask.”

SUMMARY:

hourly rounding - vanderbilt university medical · pdf filein addition to hourly rounding,...

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