In this first post, I'll start by making the case for hourly rounding.
Hourly rounding is really the antithesis of the task-based care that came before it. Rather than reacting to patient needs as they arise, hourly rounding encourages a proactive approach that leads to patient-centered care. It is known by many names, each with some unique variations: hourly rounding, purposeful rounding, and patient rounding, to name a few, but they all share some common attributes, as noted by Beverly Ford:
- A member of the nursing staff rounds on each patient hourly (or perhaps every two hours depending on the shift and unit), explaining to patients that the rounding process is meant to enhance their safety and address their needs.
- During the round, the nurse identifies him or herself and performs scheduled tasks (dressing changes, medication, etc.).
- Next, the nurse addresses the four (or more) Ps: Pain, Potty, Positioning, and Placement.
- Before leaving the room, the nurse asks if the patient needs anything else, being certain to demonstrate that he or she has time to take care of any patient needs.
- The patient is reminded that a staff member will round again in one hour (or two).
- Ideally, a mechanism is in place to record that the hourly round has been conducted. Marking the time and the nurse’s initials on the care board or using a rounding log are two examples.
- A 40% or more reduction in call lights, resulting in roughly five minutes of reclaimed nursing time per call avoided (as noted in Marketing Health Services)
- A reduction of $100,000 per month in avoided costs attributable to reduced falls and pressure ulcers and in an increase of $720,000 in emergency department revenue (as noted in Becker's Hospital Review)
- Significant increases in patient satisfaction levels (noted in several sources, including Nursing Spectrum and American Journal of Nursing)
- The ability to capture more of the hospital’s potential CMS VBP HCAHPS payout; for a typical 300-bed hospital this additional revenue capture can reach $1.6MM when fully implemented (as described by ActiveStrategy)
- Improved staff satisfaction levels (as noted in Nursing Spectrum).
I think you'll agree that the case for hourly rounding has been well-made. So why aren't all hospitals doing it? Next time, I'll describe the major reasons there aren't more successful rounding programs (and how to address them).
If you just can't wait, you can download a full white paper on Rounding-Driven Excellence now.