For Mary Lanning Healthcare’s Behavioral Services Unit, hourly rounding is centered around connecting with patient’s and having an active discussion about their current needs.
Unit Director, Kim Kern, says “Every 15 minutes care providers are required to document that they have laid eyes on the patient to keep patients safe”. While this process, typical in mental health settings, keeps patients’ safe; it doesn’t allow the care provider and the patient to have an active conversation.
Beyond the need for nurses to connect with patients, Kim saw that patients frequently had to approach the nurses’ station for common daily living items such as extra clothes or shampoo. While these requests may be simple, they disrupted nurses and unit staff from charting and other patient care tasks.
Implementation
Working with Nobl, Kim Kern and her team created an hourly rounding process to decrease those visits and meet their patients’ needs proactively. Every hour, care providers locate the patient to discuss their schedule and personal needs. During this conversation, they also check that the patient's immediate environment is safe. Each front line staff member has an iPod that they used to document their conversation in Hourly Rounding . The tool makes it easy for their multidisciplinary team to participate in hourly rounds by keeping track of when the next round due and displaying that information for everyone to see.
Before, there use to be a line of patients at the nurses’ station waiting to speak with a nurse — now that’s a rarity.
Outcomes
Less than 3 months after deploying the new rounding process and Hourly, the unit is already seeing a cultural change. “Before, there use to be a line of patients at the nurses’ station waiting to speak with a nurse — now that’s a rarity”, says Kim Kern. The unit has also seen steady improvements in HCAHPS scores related to the nurse courtesy, respect, and listening survey questions. “When I leader round on patients, I ask patients how often nurses are connecting with them” mentions Kim Kern. “Now, I always hear patients say they are checked and cared for every hour”.
