Rounding the floor with front-line nurses and staff is more than just a management practice for leaders to show face — it is a vital tool for connecting with employees and driving meaningful change.
In conversations with hospital leaders, they often echo the sentiment of how routinely spending time with front-line staff uncovers opportunities to address pain points in their daily workflow. With nurses often pointing to lack of resources and support as drivers of job dissatisfaction and burnout, rounding represents a key strategy to positively affect staff engagement and retention, and thus, patient care.
Becker's recently asked four chief nursing officers to share a recent example of a time when rounding sparked a process change or improvement at their hospital. Here are their responses:
John Bowles, PhD, RN. CNO at HonorHealth John C. Lincoln Medical Center (Phoenix): A few months ago, while conducting leadership rounds in critical care, a nursing director requested I speak with one of our direct care nurses who has a passion to address workplace violence, particularly in the critical care setting.
During a subsequent conversation, the nurse explained how she had conducted an evidence-based literature search on best practices for preventing workplace violence, specifically related to patient and family behavioral escalations. Her passion for early recognition and intervention was undeniable.
Recognizing her potential, we connected her with the HonorHealth Workplace Violence Prevention Steering Committee. This collaboration allowed her to bring her advocacy to the decision-making table, leading to the establishment of a hospital-based workplace violence prevention committee that is integrated into our shared governance structure and reports to the network committee.
Additionally, we partnered with external agencies to trial expert-recommended de-escalation techniques. Her advocacy is transforming our approach to creating a safer environment for our team members, patients, families and the community we serve.
Marie Foley-Danecker, DNP, RN. Vice President and CNO at Hackensack Meridian Health Ocean University Medical Center (Brick Township, N.J.): I piloted a virtual nursing model to decrease administrative burden for front-line nurses. The pilot was a success, with noted improvement in length of stay, patient falls and use of premium staffing. Using feedback from the team, the model is being streamlined eliminating non-value-added tasks as we expand to other campuses.
Christy Grabus, BSN, RN. CNO at Sentara Northern Virginia Medical Center (Woodbridge): Rounding is central to Ms. Grabus' leadership style, she told Becker's in an August interview. Being on the ground with nurses routinely leads to changes that improve nurses' workflow and efficiency, she said.
In one recent example, Ms. Grabus was rounding on the hospital's intermediate unit when a nurse asked if it was possible to add windows to the doors of patient rooms. Previously, nurses had been keeping the doors open to have an easy line of sight to patients, which can be a barrier to patient privacy and pose an infection risk during infectious disease outbreaks. Ms. Grabus took the feedback to the hospital's facilities department and got new doors in play.
While such improvements may seem small or mundane, they add up overtime to improve nurses' workflow, she said.
"They're really big to them because when you think about how many times [nurses] do something over and over in a day, it can lead to delays in getting procedures done or time spent with patients, just depending on what the barrier may be," Ms. Grabus said.
Lauren Smith, MSN, RN. CNO at St. Alphonsus Health System (Boise, Idaho): On occasion, Ms. Smith arrives at the hospital around 4 a.m. to round with the night shift staff. In late August, she was chatting with a certified nursing assistant on the general surgery floor in the early morning who presented the idea of training CNAs to draw blood as a way to ease some of the effects of a phlebotomist shortage.
"I loved that idea, and it's definitely in scope for them," Ms. Smith said. "I reached out to my head educator and my director of acute care nursing and asked what it would take for us to get at least get our night shift CNAs up to speed on drawing blood so that they can help offload some of the burden on our phlebotomy team as well as our bedside nurses."
Leaders are now in the process of putting a curriculum together, aiming to start training certified nursing assistants within the next few weeks.