The Case for Leader Rounding

They call it sacred time. That hour between 9 and 10am where the leaders of the hospital go into their assigned rooms out on the floors and talk to patients and their families. It’s an hour when no meetings are to be scheduled. It’s protected time, dedicated solely to patient rounds.  

Sometimes it’s a social visit: how are things going, is there anything we can do to improve your stay, do you need anything, etc. Sometimes, it’s a focus on a particular issue: is it quiet at night, are you able to get enough rest, what kind of noise is keeping you awake, is it equipment, staff, other patients?

After rounding, there’s a huddle to review any big issues that need escalation and recognize any staff that patients said provided outstanding care and service. It becomes very apparent at those huddles who is doing those rounds and who is phoning it in. When day after day, a person says, “My patients were sleeping,” or “My patients said everything was fine,” we know there’s not a whole lot of rounding going on.

It was a source of frustration for me, trying to make those leaders understand the importance of connecting with patients. After all, this was our opportunity to see the hospital through their eyes and find out what’s working well, what’s not, and what’s important to them so we could make things better. Why wouldn’t they make time for that?

Pleading and begging and even data about how leader rounds improves patient experience scores didn’t appear to be having much of an impact. Turns out, nothing is as compelling as a real-life story.

Doug was in charge of facilities, a no nonsense kind of guy who made sure all the engineering, heating and cooling, and equipment was humming. I never would have guessed he’d be so passionate about patient care.

He was in a room one morning trying to have a conversation with the patient and his family members and needed an interpreter. We had interpreter services with an outside company and, while reaching those individuals was sometimes a chore, it was necessary. After connecting with them, it was clear the family was in the dark about what was happening when the physicians and nurses came in.

Doug hung in there. He stayed with them, wanting to know if they knew what the patient’s condition was, if they understood what the medications were for, if they’d had a chance to ask questions, and on and on. He reassured them, told them he’d get them the answers they needed and left to find the manager of the unit.

She, too, did some digging and identified each of the nurses who had been caring for this family. Of the six or seven, only one had documented in the chart the she had used the language assistance program.

From that moment on, everything changed with this family. No one went into that patient’s room without the interpreter service and no one left without checking with the family that all of their questions were answered.

We likely never would have known any of this without the leader rounding program and for Doug’s persistence. He could have reported that the patient wasn’t English speaking and the interpreter services weren’t working. He could have reported that the family said everything was fine. He could have skipped the room altogether and just said the patient was sleeping, But he didn’t. He went in, took the time, and helped this family get answers.

I can only imagine what they must have been feeling up until Doug stepped in.

Some hospitals don’t do leader rounding because they think it’s too much work or they don’t want the nurses to think they’re checking up on them. We do it because we feel that leaders are part of the care team. We bring a different perspective in with us and we’re another set of eyes making sure patients and their families are receiving the best possible care and service.

Doug’s story was just what we needed to light a fire under some of the leaders and help them see just how important it is. I hope it does the same for you.