Rounding: A game-changer that builds teams and a sense of belonging

May 10, 2022  //  FOUND IN: Strategy & Leadership, ,
Rounding in the PICU on Purple Friday

The High Reliability Organization (HRO) manual describes rounding as “a method for connecting with front line employees to reinforce our commitment to safety and creating an exceptional experience for patients and employees.”

This is an accurate definition but, if you talk to anyone consistently engaged in rounding — both leaders and staff — they will tell you it goes deeper than that.

It is a game-changer.  

Making intuitive connections

Kelly Baird-Cox, chief nursing officer for C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital, has been rounding for more than 30 years. She believes it “builds trust, promotes contagious energy, boosts productivity and fosters a positive work culture.”

For her, rounding has become a philosophy. 

“Leadership is not about being in ‘charge’ but taking care of and supporting those in my charge,” she said. “Rounding is not a formal task for me. I don’t put pressure on myself to check a box and meet at certain times. Instead, rounding has become a more intuitive way to connect to my team, which is seamlessly part of what I do every day.”

Baird-Cox makes a point of focusing on the positive when rounding, and never sticking to a script. She recommends meeting each person or team where they are at. “Their story or place in time always supersedes my own interest,” she said.

She recommends using these questions to prompt discussion and promote listening during rounding:

  • What is going well? Do you have what you need to do your job?
  • Are there any staff or patient safety concerns?
  • Who is being a great team player today? What are you proud of your team for?
  • How are we doing with teamwork? How can we support you to do better?
  • Do you have learning needs so you can practice more autonomously?
  • How can we support your professional development?

Breaking down ‘power’ barriers

Angela Haley, senior administrative manager for surgery clinics, agrees that a positive tone and a lot of listening can break down any perceived power differential between leaders and team members.

“The best way to be successful is to know your team, and let them get to know you,” Haley said. “If anyone on your team feels they will ‘get into trouble’ for bringing something up, nothing ever gets resolved. But when the staff knows the leaders and realize they care and want to listen, it builds trust.”

Haley said it’s important to be honest about what can be accomplished and always include the entire team in working toward a solution.

“I’m not always able to tackle every issue but I can hear their concerns and let them know I am listening,” she said. “Whenever possible we engage them in the solutons, because they are on the front line. They often know the best approaches for an issue.” 

Brainstorming solutions

Team problem-solving has worked well within Haley’s groups.

“I’ve been surprised by what comes up and how quickly we are able to fix them on the spot,” she said about her diverse group of medical assistants, nurses, schedulers and patient services associates.

For example, based on rounding discussions, her teams have developed a less confusing check out system for patients, reconfigured staffing spaces to reduce the amount of time it takes for MAs to greet patients and changed how the front desk prepares documents for MAs. All of these were win-win solutions that improved both the patient and employee experience.

Malissa Eversole, associate chief operating officer for ambulatory care surgical procedures, and chief department administrator for urology, has also experienced many rounding sessions which have quickly turned into productive brainstorming.

Saving time

“Some worry that rounding takes too much time, but it actually saves time,” Eversole said. “Many times we have turned rounding into a working meeting, where issues are resolved immediately.”

Eversole, who tees up a variety of topics during rounding, including key measurements, current workflow and patient safety and access, also tries to include patients in the rounding experience.  

“I try to ask patients in the lobby to tell us about their experiences,” she said. “We always learn a lot from these interactions. Once, a patient said, ‘I love my doctor and the people here but whenever I come, I don’t know what to do with my purse. I have to put it on the floor or by the trashcan.’ After we heard this, we put low and high shelves and hooks in key patient areas and bathrooms to improve this experience.”

Like everyone we spoke to, Eversole feels connecting to the team is the most critical benefit.

“The people who report to me know me and I know them,” she said. “I’m not just a name on the organizational chart.”

For more information, this Leadership Rounding website shares rounding tools and training and aligns this work with the BASE strategic priorities.