Purposeful Rounding
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 hospital stay.
SHC has identified eight specific behaviors that inform the success of Purposeful Rounding.
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Eight Behaviors of Purposeful Hourly Rounding |
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Expected Results |
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Use Opening Key Words (C-I-CARE) with PRESENCE |
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Reduces anxiety, contributes to efficiency |
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Accomplish scheduled tasks |
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Contributes to efficiency |
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Address 4 P's (pain, toileting, positioning, fall prevention) |
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Quality Indicators, pain management, decubitus and fall prevention |
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Address additional personal needs, questions |
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Nurse sensitive indicators care and respect, listening |
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Conduct environmental assessment (bed alarms, IV pumps, hats, urinals) |
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Contributes to efficiency, safety, teamwork and addresses patient satisfaction |
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Ask "Is there anything else I can do for you before I go? I have time." |
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Increases efficiency, improves communication and teamwork (respect, caring, listening) |
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Tell each patient when you will be back |
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Contributes to efficiency, provides reassurance |
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Document the round |
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Quality and accountability |
Research on hourly rounding in 14 hospitals revealed impressive improvements:
- 12% increase in Patient Satisfaction scores.
- 52% reduction in patient falls.
- 37% reduction in light use.
- 14% decline in skin breakdowns.
- In addition, 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 random rounding:
- 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.
- A "tipping-point" is achieved with hourly rounding in the patient's perception of the overall experience of care.
