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How Digitized Nurse Leader Rounding Can Improve HCAHPS Scores
Date Posted: 02/Apr/2019
At Carroll Hospital, digitized nurse leader rounding improved HCAHPS overall hospital ratings by 15 points. A key aspect of nurse and patient relationships, nurse leader rounding has long been a part of patient care. Emerging nurse rounding technologies have proven effective at streamlining that process, delivering better patient satisfaction scores and improving the patient experience of care.
Most healthcare organizations have a strict organizational structure in place to ensure nurse rounding efficiency. Nursing leaders want to know which nurse has checked in with each patient and ensure nurses have adhered to key patient relationship protocol.
Traditionally, hospitals have used paper and clipboard to keep track of nurse leader rounding. But those methods have proven ineffective in this increasingly digitized healthcare industry. When a nursing team tracks patient rounding with paper and clipboard, they run the risk of mismanaging patients and visiting the same patient twice and another not at all.
Digital nurse rounding tools have helped some healthcare organizations build on their nurse rounding best practices. At Carroll Hospital, a 180-bed acute care clinic based in Maryland, a digital nurse rounding tool has built on what was already a key patient satisfaction procedure.
“Even if you round on paper, it's a great thing because you're asking patients what they need and then working to get it for them, whatever that need is,” said Stephanie Reid, RN, the hospital’s Chief Nursing Officer and vice president for Patient Care. “But taking it to electronic took us to a different level where we could be even more effective with that process.”
READ MORE: What the CMS Hospital Star Ratings Mean for Care Quality, Patients
Before adopting a nurse rounding technology from GetWellNetwork, Reid and her team faced a lot of inefficiencies with their paper systems.
“We've done nurse leader rounding for years, but it was all a manual process,” Reid explained in an interview with “Managing nurse rounding took very long, and there was no standard work involved in that. There was no communication to other departments of issues, any follow-up for customer satisfaction.”
Reid and her team looked for a tool that could help them organize nurse rounding, create a standard protocol for what rounding on a patient means, and track and trend nurse rounding. The technology Reid eventually adopted is device agnostic, meaning she and her team can access it from a desktop computer, a smartphone, or from an iPad, which is the primary tool nurses use at Carroll.
After a slow rollout among the hospital’s nurse managers and directors, Reid and her team began introducing the tool to charge nurses. Earlier adopters served as technology champions, Reid said, setting the tone as the rest of the hospital got used to the new devices.
Having these champions was essential to nurse buy-in, as well as efforts to overcome any adoption glitches the Carroll team faced.
READ MORE: What Is Non-Response Bias in Patient Satisfaction, CAHPS Surveys?
While Reid and her team were certainly satisfied with the technology for delivering on all of their goals, they were especially impressed with the tool’s ability to help nurses prevent poor patient experiences. Through patient surveying tools, nurses can now anticipate patient complaints and address them before they escalate.
For example, a two-question patient survey could reveal which part of the HCAHPS assessment the patient may respond to negatively.
“We could individualize each survey question to a part of a nurse unit’s HCAHPS performance, and prompt nurse leaders to ask patients about those areas,” Reid said.
If a particular unit regularly struggles with responding to nurse call lights, for example, the nurse leader will be in charge of asking patients about response time during their rounds, ideally preventing any issues with that down the road.
“This afforded us the ability to individualize the needs of the patient on the different units to try to drive their outcomes and improvements in HCHAP's and patient satisfaction,” Reid explained.
READ MORE: Assessing CAHPS Surveys, Patient Satisfaction with Machine Learning
The rounding tool also integrates into the EHR, allowing the nurse to understand patient needs in the context of their clinical care. It also ensures that they are adhering to different patient engagement protocol, such as patient education.
When a nurse assigns education to the patient, for example, they can check to ensure the patient has completed their learning portion through an EHR note. When the nurse leader rounds, they can check that note and then conduct any patient teach-back they need.
“Did the patient education help? Did the patient have questions? Would the patient like any additional information?” Reid posited. “Plus, nurses know especially what disease process the education was around. We never had the capability to do that on paper.”
These tools have had an impressive impact on Carroll Hospital’s HCAHPS scores. Both their overall hospital rating and their scores for respectful doctor interactions went up by over 15 points. Additionally, their scores for clinical staff relieving patient pain went up by about 9 points.
While those HCAHPS gains are great for Carroll, the improvements from the nurse rounding tool are about much more.
“Not only do we want to have high HCAHPS performance, because that's how hospitals are reimbursed, it’s just the right thing to do for our patients,” Reid said.
Anecdotal evidence proves that adopting a digital nurse leader rounding tool is in the best interest of the patient, Reid said. Through numerous patient encounters and reports, she and her team have heard that efficient nurse rounding has ensured all patient needs are met.
“We want patients to be involved, that's why we have this engagement with them, and these different efforts to make that happen,” Reid concluded. “That is how we are meeting the needs of our patients, by strictly listening to them.”
Source: patient engagement hit

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