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Proactive nurse rounds ‘boost hospital patient satisfaction’

  • 14 Comments

Simple “low tech” practices, such as ongoing rounds by nurses and senior managers, can improve ratings for patient experience in hospitals, according to US researchers.

An overarching culture that engages all levels of staff who are providing care is also key to higher levels of patient satisfaction, the study found.

The researchers, from Johns Hopkins University in Baltimore, said they had identified a handful of practices most likely to result in patients having a positive experience and feeling they came first.

“All that is required is commitment and a set of principles that any hospital can apply”

Hanan Aboumatar

Their findings are based on responses to surveys and letters sent to chief executives and clinical personnel at more than 50 US hospitals.

The survey, the researchers said, was designed to uncover how high-performing hospitals promoted the idea of “patient-centred care” – a concept also popular with healthcare policy makers in the UK.

They identified US hospitals with a “top ranking” or a “most improved” designation based on their 2012 scores in a national assessment of patient experiences and satisfaction – a similar measure to the annual NHS patient survey programme.

According to the study authors, clinicians and leaders at hospitals that were considered the best by patients shared a “devotion to consistency, personal and focused interactions”.

At an operational level, responsiveness was a key element at the best rated hospitals, said the study authors in the journal Medical Care.

Lead author Dr Hanan Aboumatar said: “Importantly, we found that similar practices were occurring across the spectrum of the hospitals in our study. It did not matter how many beds they had or whether they were an academic hospital.

He added: “Also, these didn’t need any high-tech resources. All that is required is commitment and a set of principles that any hospital can apply.”

A particularly common approach was proactive nurse rounding, where nursing staff visited patients individually at periodic intervals and asked a set of specific questions related to care.

“Importantly, we found that similar practices were occurring across the spectrum of the hospitals in our study”

Hanan Aboumatar

Similarly, leader rounds – during which senior members of the hospital’s management visited patients and staff members to check on concerns or issues – were also common in the top hospitals.

Hospitals that were rated highly by their patients also promoted specific activities or behaviours, such as always making eye contact with patients or sitting at patients’ bedsides, rather than standing or hovering over them, said the study authors.

The study also found a link between good ratings for patient experience and hospitals that had cultures that “demanded involvement of all levels of caregivers”.

Dr Aboumatar said: “It’s not just about getting the physicians or nurses involved. Everyone involved at the hospital, all the way up to top leadership, has to place a high priority on the needs of patients and their families.

“It may seem a simple thing,” she said. “But if leaders and staff members don’t prioritise this commitment and link it to the greater mission, it becomes easier to lose sight of it in the hectic pace of hospital care.”

  • 14 Comments

Readers' comments (14)

  • This does not need researchers to say this is a good idea,of course it is. It ensures that patients are not found dead God forbid,but it happens. I cannot see what the fuss is about as it's common sense and gives confidence to the patients as well as reassuring the staff. It's not every patient who is on half hourly obs and high maintenance,some just need to see a face.

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  • The mere fact that this "research" is "news" speaks of a pervasive sickness in the NHS - a gross over-adoption of "evidence-based" practice. It seems that now you can't even alter how much milk you put in the patient's tea without waiting two years while some bunch of academics produces "robust evidence". What the hell happened to "common sense"?

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  • Pussy

    Anons. Absolutely! It's a sad day isn't it when checking patients on a regular basis has to be researched? So many nurses doing so-called research when they should be by the bedside. A sad time for all concerned.

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  • Again US research is presented without any consideration of environmental and infastructure when applied to the UK NHS setting. US rounding research is cosistently presented in the UK without an analysis of bay v single room or staffing ratios. This is most certainly news and not a considered representation. NT I suggest putting US in your headline would be more fair.

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  • Pussy

    Anon,all excuses eg staff ratio and bay's v single room. What difference does it make? All patients not on half holy obs should be checked hourly. it isn't rocket science it's normal everyday common sense. Not an intensive check but just to see they are OK and havnt died or fallen which as you know DOES happen.

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  • Anonymous | 12-Aug-2015 8:26 am
    You are definitely part of the problem - I feel for any staff and patients that the NHS has erroneously made you responsible for.

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  • Again US research is presented without any consideration of environmental and infastructure when applied to the UK NHS setting. US rounding research is cosistently presented in the UK without an analysis of bay v single room or staffing ratios. This is most certainly news and not a considered representation. NT I suggest putting US in your headline would be more fair.

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  • Anonymous | 12-Aug-2015 8:26 am
    Anonymous | 12-Aug-2015 10:57 am

    ... and we can see you're fully in control of the technology at your disposal.

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  • Pussy, you have presented the important discussion point yourself right there.... "Not an intensive check but just to see they are OK and havnt died or fallen" If the American model was followed as intended we should be asking questions and doing purposeful checks every hour

    What are the key elements of intentional rounding?
    In acute settings key aspects that are usually checked during intentional rounds include the “Four P’s” [2,3]:

    Positioning: Making sure the patient is comfortable and assessing the risk of pressure ulcers
    Personal needs: Scheduling patient trips to the bathroom to avoid risk of falls
    Pain: Asking patients to describe their pain level on a scale of 0 - 10
    Placement: Making sure the items a patient needs are within easy reach (Kings 2012)

    Not just has somebody died or fallen - that goes without saying. Being honest about how hourly rounding truly happens in practice and thinking how we can have meaningful interactions is really important

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  • It agree with Pussy,sorry guys. How come some patients report they never see a nurse from one hour to the next! How often do we hear this? The patients can't all be wrong! I bet all of you have found a pt on the floor or dead and if you havnt you will! The state of nursing is appalling and I should know having just been a patient! The care was sadly lacking-very sad.

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