Purposeful Proactive Hourly Rounding: A Positive Influence on Outcomes and Experience

Saturday, 29 July 2017

Deirdre O'Flaherty, DNP, RN, NE-BC, APRN-BC, ONC
Nursing, Surgical Services, Lenox Hill Hospital, New York, NY, USA
Renee Murray-Bachmann, EdD, CDN, RN, CDE, CPT
NEPD, Northwell Health System- Lenox Hill Hospital, New York, NY, USA
Mary J. Deady-Rooney, MSN, RN, CCRN-K
Lenox Hill Hospital _NEPD, Northwell Health System, New York, NY, USA
Emily Alter, BSN, ONC
Orthopaedics, Lenox Hill Hospital, New York, NY, USA
Linda R. DiCarlo, MS, RN
Department of Nursing, Lenox Hill Hospital-Northwell Health System, New York, NY, USA

Lenox Hill Hospital (a member of the Northwell Health System) is a comprehensive acute care facility located in New York City. It is recognized nationally for its outstanding patient care, as well as its innovative medical/surgical modalities. The market shift from volume to value based care, coupled with Lenox Hill Hospitals’ own mission to provide exceptional patient centered health care with compassion and respect, is the foundation on which nursing leadership develops an environment that engenders staff contribution.

Patients’ perception of their care significantly impacts their response to both Press Ganey and HCHAPS surveys, which directly correlates to incentive payments. Communication with the nurse is paramount in that it optimizes care, increases satisfaction and facilitates safe discharge thus enhancing survey response ratings.

In order to achieve high performance scores in the communication with nurse dimension and patient satisfaction, several best practices must be adopted. These include consistent and purposeful hourly rounding, bedside shift reporting (hand-off), use of scripts and the recruitment of nursing candidates that exhibit strong interpersonal skills. In addition, leadership rounding has proven to sustain quality outcomes.

The Institute of Medicine (IOM) endorses empowering all members of the healthcare team to engage in creating a culture that promotes patient safety. This recommendation is further validated by nursing research involving the effect of empowerment and the importance of consistent workplace strategies to promote staff and patient satisfaction.
The theory of Structural Empowerment has been widely applied in nursing research and practice. This philosophy is defined as the ability to accomplish goals in an organization by having access to information, resources, opportunity and support. Kanter, the founding theorist, acknowledged that management plays a significant role in the provision of these structural factors and postulates that empowered leaders are more effective in endowing their employees. This results in an increased commitment to ensuring that the organizational goals are achieved (DiNapoli, & O'Flaherty 2015;DiNapoli et al., 2016;Boamah & Laschinger, 2014). In espousing this theory, the leadership team has developed strategies that empower the staff, have positively impacted patient and staff satisfaction and increased engagement scores (Clavelle et al., 2013). The nursing leadership team fosters an environment that promotes competence and confidence in our nurses (Purdy et al, 2010;Neville et al., 2016). This has resulted in the delivery of safe and outstanding care as evidenced by the outcomes in our patient satisfaction scores and quality data.