Incorporating hourly rounding to increase emergency department patient satisfaction
Carmen M. Brosinski, RN, MSN; Lieutenant Commander Autumn J. Riddell, RN, MSN, CEN, ACCNS-AG
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Session H presented Tuesday, October 1, 2:30-3:30 pm
Purpose: Within our healthcare system, our hospital was ranked number 17 out of 35 in patient satisfaction scores. In an effort to meet patient expectations, a process improvement initiative involving hourly rounding was implemented to improve low patient satisfaction scores.
Design: A process improvement project designed to increase patient satisfaction.
Setting: A 49 bed Emergency Department located in a Northeast academic hospital with a monthly census of 5,500 patients.
Participants/Subjects: All nurses and technicians who performed bedside patient care participated in the project. From that group, a team of nine were assembled, with nurse manager oversight to champion the project. Of the nine members, one was selected to supervise project progression and collect data, while the remaining members were divided into nurse and technician team leaders, who were responsible for implementing the project within their respective teams. All patients seen in the ED were eligible to submit customer service evaluation feedback.
Methods: The PI project took place over an 18 month period and consisted of four phases (Baseline, Intervention I, Break, Intervention II). During Intervention I and II phases, self-reported staff rounding data was tracked on a daily basis. Compliance and patient satisfaction results were provided to staff during unit meetings and on a visual tracker board that was displayed outside of the conference room. Customer service training was provided to all nurses and technicians in weekly five minute sessions. Compliance with hourly rounding was monitored daily via the staff self-reporting tool. During the Baseline and Break phases, staff were no longer required to self-report hourly rounding and the visual tracker board was no longer utilized. However, patient satisfaction data was still collected through the Interactive Customer Evaluation (ICE) System. The three variables measured using a five point Likert scale were (1) overall patient satisfaction, (2) patient perception of staff attitude, and (3) the healthcare team answered all patient questions/concerns.
Results/Outcomes: The number of ICE submissions during the Baseline phase was 91, Intervention phase I was 383, Break phase was 269, and Intervention phase II was 303. Hourly rounding compliance during Intervention phase I was 39% and during Intervention phase II was 51%. Overall satisfaction increased from 52% to 73%; perception of staff attitude increased from 70% to 84%; the healthcare team answered all patient questions/concerns increased from 63% to 81%.
Implications: There is a positive correlation between hourly rounding and patient satisfaction scores. Despite low compliance with hourly rounding, there was an increase in patient satisfaction in all three variables measured. In order to achieve a change in culture with hourly rounding compliance, nurse managers must consistently monitor staff compliance with hourly rounding. Frequent customer service training and the development and maintenance of a visual tracking board to display current satisfaction scores may help to increase staff compliance with hourly rounding, which has a positive impact on patient satisfaction scores.
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