Purposeful Rounding seeks to improve the patient experience through
the use of a structured hourly rounding routine. Staff nurses and
managers from several units reviewed the best practices literature in
this area, examined existing internal practices, and developed the
Purposeful Rounding protocol for Stanford Health Care (SHC). This
initiative, launched in Fall 2012, has been widely proven to improve
patient outcomes and satisfaction.
The concept of Purposeful Rounding is introduced to the patient and
family members upon admission in order to set expectations for the
SHC has identified eight specific behaviors that inform the success
of Purposeful Rounding.
Eight Behaviors of Purposeful Hourly Rounding
Use Opening Key Words (C-I-CARE) with PRESENCE
Reduces anxiety, contributes to efficiency
Accomplish scheduled tasks
Contributes to efficiency
Address 4 P's (pain, toileting, positioning, fall prevention)
Quality Indicators, pain management, decubitus and fall prevention
Address additional personal needs, questions
Nurse sensitive indicators care and respect, listening
Conduct environmental assessment (bed alarms, IV pumps, hats, urinals)
Contributes to efficiency, safety, teamwork and addresses patient satisfaction
Ask "Is there anything else I can do for you before I go? I have time."
Increases efficiency, improves communication and teamwork (respect,
Research on hourly rounding in 14 hospitals revealed impressive improvements:
12% increase in Patient Satisfaction scores.
reduction in patient falls.
37% reduction in light
14% decline in skin breakdowns.
one hospital measured a 20% reduction in the distance walked each
day by the nursing staff.
Leighty, John. "Hourly Rounding Dims Call Lights".
www.Nurse.com, December 4, 2006. Meade, Christine M. et al.
"Effects on Nursing Rounds on Patients' Call Light Use,
Satisfaction, and Safety". American Journal of Nursing,
September 2006. 106 (9): 60.
Press Ganey measured the results of fourteen hospitals that
implemented Purposeful Rounding, comparing them to hospitals with
Hourly rounding substantially increased patient satisfaction
in ALL of the Press Ganey Subscales and the HCAHPS Subscales, every
two hour rounding, and hourly (purposeful) rounding.
"tipping-point" is achieved with hourly rounding in the
patient's perception of the overall experience of care.