Doctors aren’t the only people who should be making rounds at your facility. Hospital executives need to get out from behind their desks and make their own patient safety “leadership rounds.”
Not only will it do them good to get their heads out of all of those reports, but it’s the best way to show their commitment to building a culture based around patient safety.
Leadership rounds are also a great informal way for executives to interact with frontline staff about safety issues and ideas for improvement, said Catherine Miller, RN, JD, in a FierceHealthcare interview.
“Staff are the greatest untapped resource in the hospital,” said Miller, the senior risk management and patient safety specialist for the Cooperative of American Physicians Inc. “They are the ones who are ultimately familiar with the work and have the best ideas for fixing things.”
Make the time and the team
Executives’ workloads aren’t acceptable excuses. The hospital’s entire staff is busy. But these rounds are important and will make a huge difference at your hospital, if you just make time for them.
That doesn’t mean saying, “I’ll fit it in sometime today.” If you do, it’ll never get done. You need to formally block out a recurring set time on your calendar for the meetings.
So who should be involved in leadership rounds?
In addition to you and the other C-suite executives, consider including: director of nursing, director of pharmacy, a frontline staff member, patient advisors and a scribe to take notes.
A big team can be broken down into smaller groups with each taking a different floor or section of the hospital. You can cover more ground in a shorter period of time, plus it can be intimidating for some staff to be surrounded by C-suite executives.
When and where?
Before you start your rounds know what your mission and purpose are. Then figure out how often the rounds will be, how much time you’ll spend at each location and where you will physically meet.
Let your managers, supervisors and directors know your plans for implementing leadership rounds, and why you’re doing them. They can convey this information to their staff and let them know everything discussed in these rounds will be strictly confidential.
How often you do the rounds are up to you. Some organizations do them twice a month, others do them monthly. Just make sure you leave enough time in between rounds to follow up on the issues that were discussed in the previous rounds. If you don’t follow up, staff won’t take your commitment to patient safety seriously and won’t share issues with you.
It’s important to track these issues, and keep the people who are involved posted on the progress until a solution is put in place.
As for where your rounds will take place, you’ll want to include patient care units, operating rooms, the emergency department, the radiology department, the pharmacy and labs.
The meetings can be as informal as you want, anything from a conversation in a hallway to a small group meeting in a break room.
Break the ice
At first, conversations with frontline staff may be awkward. People may be afraid you’re on a witch hunt. Let them know you’re starting this new process to identify opportunities for growth and improvement. Also impress on them there won’t be any repercussions for people who point out issues that need improvement.
In fact, let it be known that people who bring problems to your attention or report errors will be seen as patient safety advocates, not whistleblowers.
That means everyone on the leadership rounds need to remain calm, cool and collected – absolutely no negative reactions. The more you project a positive attitude, the more staff will open up and give you their real opinions.
Also, in the beginning you may need to prompt staff with questions. Here are a few examples from the Institute for Healthcare Improvement:
- Can you think of any events in the past few days that have resulted in a prolonged hospitalization for a patient?
- Have there been any near misses that almost caused a patient harm but didn’t?
- Have there been any incidents lately that you can think of where a patient was harmed?
- Is there anything we can do to prevent the next adverse event?
- What specific intervention from leadership would make the work you do safer for patients?
You can also ask questions like:
- What’s working well for you on this unit?
- Are there any new processes you’ve implemented that have improved your job?
- Do you have the resources needed to do your job safely?
Once they see you’re creating a blame-free culture, taking their concerns seriously and implementing solutions, they’ll be more forthcoming with issues and ideas for improvement.
It’ll also make staff feel appreciated and valued for all they do.
One final piece of advice: Keep your questions focused solely on safety. It’ll help guarantee your success at building a safety culture. Save topics like budgets, patient satisfaction, etc., for different meetings, not your patient safety leadership rounds.
