Cheryl Boldt, RN, NHA
It is critical the Leadership Team
Members of any Healthcare Organization develop a “habit” of rounding as a
team to all Units and Departments.
This does not mean a team of
20 walks to all locations at one time. The rounding pattern calendar can
be established by month or by quarter and the Leadership Team members
can “divide up” who goes where, when, and with whom. Rounding patterns
are customarily in sync with organizational goals and improvement
projects. These goals and efforts will naturally guide some of the
“teaming” assignments, determine who we interact with, and define what
we seek feedback on during our rounds.
typically underestimate how much it means to the front line staff on the
units and in the departments to have the leaders present. You may also
underestimate the impression that will be left with any patients you
The rounding calendar should be coordinated throughout the
year to touch all shifts in all departments.The rounding teams will find
a group of 3-4 to be the most manageable. The rounding pattern is even
more meaningful if you make certain you ask star performers on the unit
or in the department, in advance, to join you on rounds.
to effective rounding is to schedule the time on your calendar in
advance and protect the time as you do for any other important
“meeting”.Like any meeting, you need ground rules:
Additional helpful hints:
team members should know in advance, per the calendar of where they are
- The team determines the amount of time to be spent
on the rounds- i.e. 30 minutes.
- A simple, focused agenda will
be prepared in advance of the rounds by the team who will be rounding on
- The team members arrive on time on the unit or in the
department at the designated location and we “start on time and end on
- Appoint a Note Taker and a Time Keeper.
- Greet all
team members and patients who cross your path.
- If you know the
staff, call them by name.
- Smile and make eye contact. Be a good
- If you do not know the staff member, refer to their
name tag so you are calling them by name as you greet them.
staff members are not wearing their name tag, you can politely ask what
their name is and what their role is.
- Compliment the staff you
meet on what you notice is good and what you have been impressed with
i.e. progress on an initiative they are working on.
- If you do
find a problematic area, you can honestly (not in front of customers)
discuss the problem area with the front line and ask for solutions or
ideas on how to make certain the problem is resolved.
things may be placed on a “follow up” for a leadership team member and
front line staff member to update the team on i.e. a week from now and
do not fail to follow through.
- Ask front line team members to
join you spontaneously if they can and it would not interfere
with patient care.
relationship building efforts include:
areas you will round on typically are a mixture of environmental
monitoring, interaction with staff and interaction with the customer.
note of any “scoreboard” on the unit and do not hesitate to involve the
front line in a discussion about what it means.
- Your demeanor
must be friendly, courteous and engaging, not authoritative.
leaders will indicate they do not have the time to do rounds. We
consistently find the opposite to be true. You have to make the time to
do rounds or risk losing touch with those we serve and those we lead.
your weekly leadership team meetings, it is important to share lessons
learned this week on rounds, what is the “buzz” and any action that was
triggered as a result of the rounding effort.
- “Lunch with
Leaders” for front line employees (AKA Tuna with the big Kahuna).
Scoreboard celebrations on units with special appearances by
- Handwritten notes or e-mails giving
positive comments in follow up to rounds, interactions, or upon hitting
targeted goals. This can be to individuals or teams.
- It is more
fun to catch people doing things right, than focusing on what is wrong.
not hesitate to give immediate feedback when you notice something good,
in front of others.
- Do not “walk by” something that is not
right, it will send a message that it is OK.
- If you need to
speak with someone about something negative, do not do it in front of
- Do not forget that it is meaningful to an employee
or customer to have the opportunity to interact positively with someone
who they perceive as “in charge”.
- “Pilot” rounding and debrief
on what worked or did not work until you refine the process.