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Accreditation Statement
Studer Group is accredited by the Accreditation Council for
Continuing Medical Education (ACCME) to provide continuing
medical education for physicians.
Designation of Credit
Studer Group designates this educational event for a
maximum of 1 AMA PRA Category 1 Credits™. Physicians
should only claim credit commensurate with the extent of
their participation in the educational event.
Disclosure Policy
Ann M. Winn and Carol Richter have disclosed that they do not
have any relevant financial relationships with any commercial
interests related to the content of this educational event.
Ann M Winn RN, FACHE,NEA-BC
Chief Nursing Officer
Carol Richter RN, BSN, CPN
Nurse Director
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Provide tactics to drive Quality and accountability
in Nurse Leader Patient Rounding
Discuss data resources to keep leaders on track
with prescriptive patient rounding
Discuss tools and documentation to support staff
recognition and coaching
Discuss ways to improve the perception of
responsiveness while increasing nurse engagement
◦ Perception of the Quality being delivered on the
unit
• Continual assessment
• Evaluate consistency
• Harvest reward and recognition
◦ Customer Loyalty
◦ Competition
“If my boss isn’t watching it
then it is not that important”
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Staff -> Nurse Directors
Nurse Directors -> Chief Nursing Officers
How do we keep the Momentum?
 Weekly Huddles by leadership
 Daily Huddles at the Front Line
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Competing priorities
Lack of By In
Just another Program attitude
◦ It will go away soon
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Staff Push back
Fear of the unknown – what do our families
REALLY think about us
Failure in seeing trends
But We’re Different……
To Begin:
What do you want to know about the care
being delivered on your unit?
 Focus on 3-4 Open Ended Questions
 Directors need to submit questions for
Review
 Observation
 Coaching
 Recognition
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Our goal is to be responsive to your needs, have
you had to use your call light during this
hospitalization? What would you say is the primary
reason you have had to use your call light? Did the
staff educate you about the alarms from the IV’s
you might hear?
Have we managed your pain to your satisfaction A
no answer would lead you to ask what we could do
better. A yes answer would need to lead you to ask
what have we done or what could we do to exceed
your expectations?
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Who is your Nurse today?
How often does she come in to your room?
What is the plan for your day today?
What medications have we given you?
What side effects have you been told about?
What is (Nurse) doing to manage your pain?
What have you had to use your call light for in
the last 24 hours?
MCH/WS: WEEKLY NURSE LEADER ROUNDING LOG
NURSE LEADER: _____________________________ ________________
UNIT/DEPARTMENT: ___________________ ______________________
Week beginning: __________________________ DATE: ____________
#
Patients
Nurse Name
Comments
about Nurse
Plan of Care
Pain
Management
Reason Call Light
Was Pushed
Environmental
Assessment
Clean
Communication board
complete
Clean
Communication board
complete
Clean
Communication board
complete
Clean
Communication board
complete
Clean
Communication board
complete
Clean
Communication board
complete
Clean
Communication board
complete
Clean
Communication board
complete
Clean
Communication board
complete
Follow-Up Notes
6
5
4
7-Oct
14-Oct
21-Oct
28-Oct
5-Nov
12-Nov
6-Dec
Nurse Communication
Plan of Care
Pain Management
Call light
Clean
89
89
100
100
89
100
84
96
96
100
96
89
100
92
100
73
82
95
86
86
100
100
100
90
93
100
96
96
100
96
90
93
95
58
95
Communication Board
89
72
89
82
79
89
Recognition
Opportunity/Coach
Monica
DeeAnn/Yomar
a
Suzanne
Browyn
Alma
Angela
Janet
Rebecca
Violet
Martha
Martha
Diane
Rebecca
Mary C (f)
Jennifer
Cynthia
Christine
Rebecca p
Christina
Nancy
Sue
CPOE issue LD/MB
communication
hot water
new board
hot water
120
100
80
60
40
20
0
Nurse
Communication
Plan of Care
Pain
Management
Call light
Clean
Communication
Board
7-Oct
14-Oct
21-Oct
28-Oct
5-Nov
12-Nov
6-Dec
Nurse Communication
Plan of Care
Pain Management
Call light
Clean
89
89
100
100
89
100
84
96
96
100
96
89
100
92
100
73
82
95
86
86
100
100
100
90
93
100
96
96
100
96
90
93
95
58
95
Communication Board
89
72
89
82
79
89
Recognition
Opportunity/Coach
Monica
DeeAnn/Yomar
a
Suzanne
Browyn
Alma
Angela
Janet
Rebecca
Violet
Martha
Martha
Diane
Rebecca
Mary C (f)
Jennifer
Cynthia
Christine
Rebecca p
Christina
Nancy
Sue
CPOE issue LD/MB
communication
hot water
new board
hot water
Solve an issue before you receive Survey Results
 Missing the 5 P’s (we add Play in Children’s)
 Inconsistency
 New Leadership on Unit
 Needed Validation of Hourly Rounding by
making it
Purposeful Rounding
Ped
Surg
39/41
95%
PIMC
Strengths
Connect to Purpose
Opportunity for Improvement
Reduces anxiety of family and child – AIDET

Connect To Purpose
38/44
86%


Introductions to patients and families
Nurse got down on patient level when speaking
Increases communication and perception of family feeling
safe and secure

Encouraging the family to use the
call light for emergencies, but
verifying that we will be back in the
room for all other needs in about an
hour
Telling the families, “but just call me
if you need anything in the
meantime.”
Responsiveness will decrease if we continue to tell them
to use the call light. We need to develop trust with
hourly rounds and ask them to use the call light for
urgent/emergent matters
WIIFM – unnecessary visits to pt. rooms
Communication is enhanced and trust is built when the family can
look back at the log and see that someone was looking in on them
even while they slept. Also Responsiveness and anticipation of
needs will be addressed with this practice
WIIFM- reduction in additional visits to rooms

Completing the “tasks” (i.e. Picking up trash,
throwing out linen, emptying urinal)
Cleanliness is a perception of infection free. although our
rooms may be “worn” looking, they still can be kept tidy and
free from infection

Asking patient/family if they need anything
before leaving the room
Will reduce call light usage after staff leave.

Explaining the purpose of hourly rounding
Perception of more responsive to the needs of
family/patient

Explaining the rounding log to the families
Telling the family that we do hourly rounding
Builds trust that you will be there for the “little” things and
that you will “be there” if an emergency happens – WIIFM
(reduction of call lights so you can focus on documentation
or other patients) Responsiveness and anticipating of needs

Speaking to the tasks we are completing
Nurse communication will be enhanced and families will feel at
ease.

Explaining the buddy system
Providing the family with a sense that they are
never alone in the hospital and that you or your
buddy will be there for them.
Feeling safe and secure along with
Responsiveness will be increased

Coaching on AIDET, staff not really good at
managing the team up
Responsiveness and Anticipation of Needs will be reflected if we
manage up our team and let families know that there is a team of
staff working together to meet their needs

Discussing medications and side effects
Nurse Communication /Communication of medications.
This will reduce anxiety and allow family/patient to ask
questions in non-threatening environment.

Staff need to get better on talking about the
duration
Nurse Communication will be enhanced because you are providing
families with some idea of what is to occur and when

One nurse introduced herself and said “I am your AIDET – You do not need to tell them how many years you
RN for the day”; felt that sounded better than just have been a nurse but to tell them that you are a registered
saying I am your nurse it distinguished her role
nurse adds more to the introduction. Remember you can
tell them that there is a team of nurses working to care for
their child.

Staff need to explain the why on tasks like
side rails (not just walk in the room and
yank them up)
Anticipation of Needs and communication will be addressed if we
speak to all the great things we are doing. Also this will increase
the families perception of feeling safe and secure

Identifying pain goal and assessing pain level
Staff need to remember the Play of 5 P’s and talk up
the playroom and child life therapist



Pain Management – placing this on the communication
board also improves communication among care givers.
The family knows what med and when it can be given by
looking at the board
Managing the team up will increase the families’ sense of trust and
communication. Anticipation of needs will be increased as well.
Use a Black Marker on the communication boards. The colored markers are hard to read from afar. Remember that this is your tool to communication to the family and for them
to be part of the plan
Ped
Surg
39/41
95%
PIMC
Strengths
Connect to Purpose
Opportunity for Improvement
Reduces anxiety of family and child – AIDET

Connect To Purpose
38/44
86%


Introductions to patients and families
Nurse got down on patient level when speaking
Increases communication and perception of family feeling
safe and secure

Encouraging the family to use the
call light for emergencies, but
verifying that we will be back in the
room for all other needs in about an
hour
Telling the families, “but just call me
if you need anything in the
meantime.”
Responsiveness will decrease if we continue to tell them
to use the call light. We need to develop trust with
hourly rounds and ask them to use the call light for
urgent/emergent matters
WIIFM – unnecessary visits to pt. rooms
Communication is enhanced and trust is built when the family can
look back at the log and see that someone was looking in on them
even while they slept. Also Responsiveness and anticipation of
needs will be addressed with this practice
WIIFM- reduction in additional visits to rooms

Completing the “tasks” (i.e. Picking up trash,
throwing out linen, emptying urinal)
Cleanliness is a perception of infection free. although our
rooms may be “worn” looking, they still can be kept tidy and
free from infection

Asking patient/family if they need anything
before leaving the room
Will reduce call light usage after staff leave.

Explaining the purpose of hourly rounding
Perception of more responsive to the needs of
family/patient

Explaining the rounding log to the families
Telling the family that we do hourly rounding
Builds trust that you will be there for the “little” things and
that you will “be there” if an emergency happens – WIIFM
(reduction of call lights so you can focus on documentation
or other patients) Responsiveness and anticipating of needs

Speaking to the tasks we are completing
Nurse communication will be enhanced and families will feel at
ease.

Explaining the buddy system
Providing the family with a sense that they are
never alone in the hospital and that you or your
buddy will be there for them.
Feeling safe and secure along with
Responsiveness will be increased

Coaching on AIDET, staff not really good at
managing the team up
Responsiveness and Anticipation of Needs will be reflected if we
manage up our team and let families know that there is a team of
staff working together to meet their needs

Discussing medications and side effects
Nurse Communication /Communication of medications.
This will reduce anxiety and allow family/patient to ask
questions in non-threatening environment.

Staff need to get better on talking about the
duration
Nurse Communication will be enhanced because you are providing
families with some idea of what is to occur and when

One nurse introduced herself and said “I am your AIDET – You do not need to tell them how many years you
RN for the day”; felt that sounded better than just have been a nurse but to tell them that you are a registered
saying I am your nurse it distinguished her role
nurse adds more to the introduction. Remember you can
tell them that there is a team of nurses working to care for
their child.

Staff need to explain the why on tasks like
side rails (not just walk in the room and
yank them up)
Anticipation of Needs and communication will be addressed if we
speak to all the great things we are doing. Also this will increase
the families perception of feeling safe and secure

Identifying pain goal and assessing pain level
Staff need to remember the Play of 5 P’s and talk up
the playroom and child life therapist



Pain Management – placing this on the communication
board also improves communication among care givers.
The family knows what med and when it can be given by
looking at the board
Managing the team up will increase the families’ sense of trust and
communication. Anticipation of needs will be increased as well.
Use a Black Marker on the communication boards. The colored markers are hard to read from afar. Remember that this is your tool to communication to the family and for them
to be part of the plan

Consistency
◦ Weekly on the same day
◦ Chaired by CNO

Accountability
◦ Leaders presented logs and are prepared to discuss
analysis of findings

Team Support and sharing of ideas
◦ Frustration and Exhaustion

Sense of Urgency and Action
◦ Plan for the next week
◦ Homework assignments
Our Consistent Opportunity
Recall the HCAHPS Questions asked regarding
Responsiveness.
During this hospital stay did you need help
from nurses or other hospital staff in getting
to the bathroom or in using the bedpan?
During this hospital stay, after you pressed
the call button, how often did you get help as
soon a you wanted it?
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Proven success in
our Emergency
Department
Staff Satisfier
Future
enhancement was
to include EVS and
Respiratory
HCAHPS survey results 4 qtr. 2011 – 2012 1st qtr.
HCAHPS results Qtr. 1&2. Implementation occurred in Qtr. 3
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Set day of week and time (stick to it)
SOTEOT
◦ Start on Time, End on Time
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Nursing Directors bring copy of logs for week
Meeting is driven by the rounding log graphs
◦ What is the trend?
◦ What did the Nurse Director see this week
◦ Keep directors action oriented not excuse oriented
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
All logs collected at end of meeting
If unit is piloting a tactic, place update on
agenda for next meeting
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From Coaching to Counseling
Expanded Nurse Leader Patient Rounding to
Ancillary Directors (RT and PT)
Quality Huddles – Mandatory
◦ Guests from other facilities are attending
◦ Environmental Services and Food/Nutrition
Services are members
◦ Continue to be “Action Oriented”
◦ Conducted from the NL Rounding Graphs
How do we notify
our new moms
who are with their
babies in NICU,
that we sanitized
their room?
Recipient of the
Studer Health Care
Organization of the
month June 2013
Market Share – Pediatrics without Neonates
Market Share - Neonates
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Validating and Verifying Hourly Rounds
◦ Question the quality of these rounds
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Why are some of the departments
consistently in V-tach
Keeping the momentum
Cascading the urgency to staff and
department leadership
Including additional support at huddles
Challenge our Staff Nurse Practice Council
again
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Ann M Winn RN
[email protected]
210-638-2125
Carol Richter RN
[email protected]
210-575-6727
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To take the survey, visit www.studergroup.com/webinar37
To receive CME credit for this webinar you must take
the survey prior to December 31, 2014.
Your certificate will be available for you to print &
complete upon survey submission.
The Studer Group is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical
education for physicians. The Studer Group designates this educational activity for a maximum of 1AMA PRA Category 1
CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.