Leader rounding does it impact outcomes
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Leader Rounding. Does It Impact Outcomes?. Sherry Sweek, RHIA, CPHQ, CPMSM, Director, Quality Improvement Southeast Georgia Health System [email protected] , 912.466.3265 September 26, 2012. Southeast Georgia Health System. Two hospitals: Brunswick-316 beds, Camden-40 beds

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Leader Rounding. Does It Impact Outcomes?

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Leader Rounding. Does It Impact Outcomes?

Sherry Sweek, RHIA, CPHQ, CPMSM,

Director, Quality Improvement

Southeast Georgia Health System

[email protected], 912.466.3265

September 26, 2012


Southeast Georgia Health System

  • Two hospitals: Brunswick-316 beds, Camden-40 beds

  • Two Nursing Homes: Brunswick-232 beds, St. Marys-78 beds

  • Physician Practices: over 79 physicians in primary care and specialty care

  • 2,200 team members

  • Focus today is experience at Camden facility


Session Learning Objectives

  • Discuss how to incorporate Leader Rounding into practice.

  • Outline the steps to implement a successful Leader Rounding program.

  • Identify the outcomes impacted by Leader Rounding.


P D C A (Plan, Do, Check, Act)Quality Improvement Model

  • PLAN-How should the problem be tackled? Address issues surrounding problem.

  • DO-Implementation of the plan.

  • CHECK-How will the team know the plan is working? What data must be collected? Test.

  • ACT-How to best go forward? Redesign? Evaluation Step.


Plan the Improvement

  • HCAHPS scores unfavorably decreased in August 2011 and based on drop negatively impacted 2011 YTD scores

    • Maternity HCAHPS-90th percentile

    • Med/Surg HCAHPS drive overall Camden HCAHPS

  • Approached VP and Assistant Administration at Camden to gain support for addressing solution in September 2011

  • Situation discussed at October 2011 Camden Patient Care & Safety Committee (oversight for quality at operations level) with managers from clinical and non-clinical areas


Do the Improvement

  • Developed standardized process (who, what, where, when) for rounding on Med/Surg floor

  • Presented at next Leadership meeting with forms

  • Folder on shared drive (access by all leaders) with forms and calendar for leaders to self-schedule

  • Leaders agreed to pilot for three months and measure improvement


Who: Patients admitted within last day and

those scheduled for discharge next day

What: Rounding using standard Rounding Form and

follow-up on issues identified & turn in form to

Admin Sec

When: Leader to pick two days in Month (Mon-Fri)

Where: Med/Surg

When: You may round anytime but morning may be

better so if there are concerns you still have

an opportunity to address same day

Leader Rounding Pilot


Leader Rounding Early Wins

  • Supplement to bedside nurse hourly rounding and nurse manager rounding

  • Admin Rounding (VP, Assistant Administrator, Quality Director) discussed Leader Rounding with team members and the early outcomes

  • Pulled HCAHPS based on discharge date to see if scores improved

  • Camden Leaders seen as early adopters and setting the standard for System rounding


Check Leader Rounding Pilot Results


Check Other Results

  • Feedback:

    • Leaders enjoyed rounding and felt they were making a different

    • Patients appreciated someone coming to visit

  • The interventions prevented problems from becoming larger issues

  • Leaders could re-enforce patient safety topics (fall prevention, calling for assistance, isolation precautions)


Act on Results

  • Leaders agreed to continue Leader Rounding

  • Determined measures to track outcomes

  • Set 2012 HCAHPS goals to improve into next quartile rankings

  • HCAHPS indicators (Communication with Nurses, Response of Hospital Staff) shared at Nursing leadership meetings comparing all units throughout System

  • Participate in GHA Hospital Engagement Network to impact patient outcomes


2012 Leader Rounding

  • Service Excellence Coordinator rounds every Wednesday and meets with managers to resolve issues and address concerns

  • Safety huddles to address core measure compliance, patient concerns, infections, issues identified)

  • Leader Rounding expanded to Brunswick Campus in April 2012 based on positive experience at Camden


YTD 2012: No injury falls


Med/Surg: Formal Compliances & Grievances


Core Measures 2012 results

US top quartile based on hospital compare data for time frame Q4/10-Q3/11 on whynotthebest.org


Pneumococcal Vaccination

Jan-12:Pneumo Immunizations expanded to high risk patients


2012 Core Measures Misses

  • Physician Impact: 83%

  • Nurse Impact: 17%


Other 2012 Outcomes

  • Zero hospital acquired conditions

    • Foreign object retained after surgery*

    • Air embolism*

    • Blood incompatibility*

    • Pressure Ulcer stage III or IV*

    • Falls & trauma

    • Vascular catheter-associated infection*

    • Catheter-associated Urinary Tract Infection*

    • Manifestations of poor glycemic control

  • Zero patient safety indicators

    • Death among surgical inpatients with serious treatable complications

    • Latrogenic pneumothorax

    • Post-Op PE or Deep Vein Thrombosis

    • Postop wound dehiscence

    • Accidental puncture or laceration


Questions?

Questions: Sherry Sweek, 466-3265 or [email protected]


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