What are the barriers to doing this?
The culture of healthcare has been to “cover up” and make excuses for attitudes, behaviors and systems breakdowns leading to errors and a culture lacking a focus on patient safety. Technology to support patient safety is expensive. Internal competition for financial and other resources occurs when organization priorities are not effectively communicated. Leaders who aren’t facing reality assume that care is already safe. Rounding forces leaders out of their office and comfort zone. Although patients and families will share positive stories and experiences, there will likely be just as many complaints and serious safety issues shared as well. Leaders may not be sure how to respond to patients and their families.
Why should we do this anyway?
Patient and family rounding demonstrates a commitment to patient safety and patient-centered care. It is an additional opportunity for patients and families to speak up and be involved in their care. Leaders are obligated to listen to and share, with staff, physicians and other leaders, the perceptions of patients and families. Rounding also give leaders the opportunity to proactively “manage up” physicians, staff and the processes in place to keep the patient safe. Sharing this information comforts, educates and reassures the patient and family. Patients and families are eager to share success stories and tell about staff that made a difference during their stay. Rounding, when sincere, isn’t just about patient safety failures and success. It shows that we truly care.
How can we do this?
- Implement scheduled tasks at specific intervals. Studies show that falls and decubitus ulcers can be significantly reduced when nurses perform specific tasks, such as turning the patient, assisting them to restroom, addressing pain issues, checking/re-setting bed alarms and placing personal items within reach.
- Involve, educate and communicate with the patient and the family. Achieving patient-centered perfection means putting and keeping patients and their families at the center of care; encourage them to speak up if they don’t understand something or have questions, refrain for using medical lingo and acronyms, listen to their concerns, ask them if they have questions, tell them what interventions and safety precautions are in place or available to protect them, use the teach-back method with them, ask if they have any safety or care concerns, talk at their level.
- Take action and follow-up. When a patient or family member raises a concern, make contact with the appropriate person, let the patient and family know what action you have taken and what will happen next.
How have you used patient rounding to support a culture of safety?
Barriers to implementation of patient safety systems in healthcare institutions: leadership and policy implications. Akins RB, Cole BR. J Patient Saf. 2005;1:9-16.