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Topics: Nursing, Health care, Medicine Pages: 10 (2724 words) Published: September 16, 2013
Beverly M. Ford

Hourly Rounding: A Strategy to Improve Patient Satisfaction Scores

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atient satisfaction is an important phenomenon in the health care industry. Health care organizations continually seek innovative approaches to boost patient satisfaction scores. Several studies uncovered nursing behaviors essential to patient satisfaction. Patients value the nurse-patient relationship, as well as time spent with them, continuity of care, trust, compassion, respect, safety, understandable instructions, and service quality. They also appreciate reliability, responsiveness, and effective communication (Andaleeb, Siddiqui, & Khandakar, 2007; Cheng, Yang, & Chiang, 2003; Davis, 2005; Fan, Burman, McDonell, & Fihn, 2005). Satisfaction surveys are used to identify, measure, and track key determinants of satisfaction (Pearson Assessments, 2007). The Committee on Quality Health Care in America has worked with the Institute of Medicine (IOM) on the nation’s quality of care since 1996, developing a new paradigm for health care delivery based on logic and evidence of patient needs. The IOM (2001) purported successful care will serve the needs of the patient, keep the patient fully informed, allow the patient to retain control through more active participation, and be mindful of patient values and preferences. Sofaer and Firminger

Beverly M. Ford, MSN, RN, BC, CMSRN, is a Medical-Surgical Charge Nurse, Baltimore Washington Medical Center, Glen Burnie, MD.

(2005) supported these findings in a study based on the aims and rules in previous IOM reports. They noted, “If we are truly to achieve a health care system that is patient-centered, we must continue to search for creative ways to elicit, and heed the voice of the patient” (p. 555). Safety weighs heavily in patient satisfaction. The Joint Commission provides its accredited health care organizations with a list of National Patient Safety Goals and mandates the requirements necessary to improve patient safety (The Joint Commission, 2008). Problematic areas of health care are identified with evidence-based and expertbased solutions designed to protect patients (The Joint Commission, 2009). Examples of safety goals include reducing risk of patient harm related to falls, preventing pressure ulcers, and enhancing medication administration. Nurses directly impact all these areas with routine nursing care delivery. Satisfaction is the perception of the patient. Because nursing services play a major role in patient satisfaction, quality of care, and safety, organizations continually must seek new ways to improve these critical services. One strategy called hourly rounding is a suggested method to address these issues (Studer Group, 2007). Hourly rounding is a new, proactive approach to organizing nursing care that has garnered positive results; its focus on patient-centered care has led to notably improved patient satisfaction scores.

Purpose
The use of a proactive hourly rounding strategy to improve patient satisfaction is described. Inspired by the work of Meade, Bursell, and Ketelsen (2006), staff at Baltimore Washington Medical Center (BWMC) piloted hourly rounding on several units. Although results from this study are not yet available, a brief case study can demonstrate how results at BWMC may compare to the national study. The study’s purpose was to determine if patient satisfaction increases significantly as the new strategy is implemented.

Background
Baltimore Washington Medical Center, a 311-bed facility that is part of the University of Maryland Medical System, is located on the busy Baltimore and Washington, DC, corridor. BWMC’s 2,600 employees cared for more than 200,000 patients in 2009. BWMC was named the only Solucient® Top 100 Hospital in Maryland or the District of Columbia in 2006 (Lanham, 2007). The award, which is now known as Thompson Reuters, benchmarks hospital performance across the nation in specific areas, including quality of care, patient...

References: Agency for Healthcare Research and Quality (AHRQ). (2008). The CAHPS hospital survey (H-CAHPS). (2008). Retrieved from https://www.cahps.ahrq.gov/content/products/HOSP/PROD_HOSP_Intr o.asp Andaleeb, S.S., Siddiqui, N., & Khandakar, S. (2007). Patient satisfaction with health services in Bangladesh. Health Policy and Planning, 22(4), 263-273. Cheng, S.H., Yang, M.C., & Chiang, T.L. (2003). Patient satisfaction with and recommendation of a hospital: Effects of interpersonal and technical aspects of hospital care. International Journal for Quality in Health Care, 15(4), 345-355. Davis, L. (2005). A phenomenological study of patient expectations concerning nursing care. Holistic Nursing Practice, 19(3), 126-133. Fan, V., Burman, M., McDonell, M., & Fihn, S. (2005). Continuity of care and other determinants of patient satisfaction with primary care. Journal of General Internal Medicine, 20(3), 226-233. Institute of Medicine (IOM). (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. Lanham, M. (2007). Baltimore Washington Medical Center (BWMC) named one of the nation’s 100 top hospitals. Retrieved from http:/data.bwmc.umms.org/news/ detail.cfm?ID=1687 Leighty, J. (2006a). Let there be less light. Retrieved from http://www.studergroup. com/dotCMS/knowledgeAssetDetail? inode=323218 Leighty, J. (2006b). Nursing Spectrum Career Fitness Online. Retrieved from http://community.nursingspectrum.com/ MagazineArticles/article.cfm?/AID=250 38 Meade, C.M., Bursell, A.L., & Ketelsen, L. (2006). Effects of nursing rounds: On patients’ call light use, satisfaction, and safety. American Journal of Nursing, 106(9), 58-70.
Pearson Assessments. (2007). Patient satisfaction surveys. Retrieved from http://survey.pearsonassessments.com/ audience/patient.htm Shaner-McRae, H. (2007). Notes on nursing. Retrieved from http://www.fahc.org/ Nursing/nursing_contribution/NON_200 7/02-07_NON.pdf Sigma Theta Tau International. (2006). RNews capsules. Retrieved from http://www2.nursingsociety.org/RNL/4Q _2006/columns/rnews_capsules.html Sofaer, S., & Firminger, K. (2005). Patient perceptions of the quality of health services. Annual Review of Public Health, 26, 513-559. Studer Group. (2005). The magic of rounding: Quint Studer brings a leadership technique from medicine into the world of business. Retrieved from http://www. studergroup.com/dotCMS/knowledge AssetDetail?inode=111088 Studer Group. (2007). Hourly rounding supplement. Retrieved from http://www.mc.vanderbilt.edu/root/pdfs/nursing/hourly_roun ding_supplement-studer_group.pdf The Joint Commission. (2008). 2008 National Patient Safety Goals: Hospital program.
Retrieved from http://www.jointcommission.org/PatientSafety/NationalPatientS afetyGoals/08_hap_npsgs.htm The Joint Commission. (2009). National Patient Safety Goals: Evaluating safety and quality using the national patient safety goals. Retrieved from http://www. jointcommission.org/GeneralPublic/NPS G/gp_npsg.htm?print=yes Thompson Reuters. (2010). New 2009 100 top hospitals: National benchmarks study. Retrieved from http://www.100top hospitals.com/top-national-hospitals/ Wood, D. (2005). Rounding cuts call-light use. Retrieved from http://w3.rn.com/ news_news.asp?articleID=14521&page =RN%5FNews&Profile=RN%5FNews& Headline=Rounding+Cuts+Call%2DLigh t+Use Additional Reading Studer Group. (2006). Improve clinical outcomes with hourly roundingsm. Retrieved from http:/studergroup.com/ newsletter/Vol1_Issue7/fall2006_sec1.h tm
MEDSURG Nursing—May/June 2010—Vol. 19/No. 3
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