Evaluating Efficiency and Cost Effectiveness in Implementing and Hard-Wiring Structured Rounding

Purpose: Hourly rounding was implemented hospital wide to improve the efficiency of care delivered.  While there is literature on hourly rounding, it is not detailed on efficiency measures or cost effectiveness of implementation strategies.  The purpose was to evaluate quantitative data on efficiencies gained through the SHaRP intervention and the incremental cost of these gains.   

Methods: Efficiency measurements included patient call light use, nursing staff steps, a staff survey, and cost data.  Patient call light use data was collected continuously over the duration of the study.  A stratified simple random sampling method was used to identify random day and night shifts for efficiency measurement.  Pedometers for measuring steps taken by nursing staff during a 12-hour shift were utilized on both units.  At the completion of the shift, a six-item staff perception survey was completed.  Data used in the cost effectiveness analysis included training and coaching implementation salaries and costs of training staff.  Incremental cost analysis was used in determining the cost effectiveness of the intervention. 

Results: Independent t-test, chi-square and correlations were used in the analysis of data. Pre- intervention call light data was compared with study period data.  Interval ratio data between the two units on the pedometer steps and the survey tool were analyzed.  The incremental effects and costs were analyzed for cost effectiveness.  Data was plotted overtime to look for trends in sustainable efficiencies.  A significance level of p<0.05 was used for all analyses.

 Conclusion: Findings and implications will be available for presentation at the time of the conference.