For years, hospital leaders have been hitting the hallways to try to improve patient safety. But despite the prevalence of executive rounding programs, consensus on best practices is hard to come by and studies on their effectiveness are scarce.

Researchers are trying to fill those gaps, and they’ve already identified a few keys to success, including making sure all members of the C-suite participate. Especially critical is closing the feedback loop so clinicians who raise safety concerns are kept informed of how the hospital is addressing those issues. A study of executive rounding programs in 44 neonatal intensive care units found that higher levels of feedback by leaders were associated with stronger safety and teamwork environments, better staff perceptions of safety, and lower burnout among clinicians, according to the analysis published in the May issue of the British Medical Journal of Quality & Safety.

The Joint Commission has worked to perfect the art of executive rounding through its hospital engagement network. It has found that, in addition to providing feedback, celebrating savings and quality improvement, rather than solely focusing on the negatives, is important to any rounding effort, says Deborah Nadzam, R.N., project director of the Joint Commission Resources Partnership for Patients HEN.

Consistency also is critical. All members of the C-suite should participate, she says, and rounds should take place at least once a week for a minimum of one year.

Harrisburg (Ill.) Medical Center, one of the Joint Commission HEN participants, has two types of executive rounds. The first is patient-focused, with one of the four C-suite leaders taking a week each month to visit newly admitted patients to ask them about the quality of their care. In the second approach, leaders gather daily to visit staff at project management white boards scattered throughout the hospital. In eight months of use, the boards already have helped Harrisburg to eliminate about $1 million worth of waste, says President and CEO Rodney Smith.

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