Stanford Nursing

Purposeful Rounding

Purposeful Rounding seeks to improve the patient experience through the use of a structured hourly rounding routine. Staff nurses and managers from several units reviewed the best practices literature in this area, examined existing internal practices, and developed the Purposeful Rounding protocol for Stanford Hospital & Clinics (SHC). This initiative, launched in Fall 2012, has been widely proven to improve patient outcomes and satisfaction.

The concept of Purposeful Rounding is introduced to the patient and family members upon admission in order to set expectations for the hospital stay.

SHC has identified eight specific behaviors that inform the success of Purposeful Rounding.

Purposeful Rounding Video »

Eight Behaviors of Purposeful Hourly Rounding Expected Results
Use Opening Key Words (C-I-CARE) with PRESENCE Reduces anxiety, contributes to efficiency
Accomplish scheduled tasks Contributes to efficiency
Address 4 Ps (pain, toileting, positioning, fall prevention) Quality Indicators, pain management, decubitus and fall prevention
Address additional personal needs, questions Nurse sensitive indicators care and respect, listening
Conduct environmental assessment (bed alarms, IV pumps, hats, urinals) Contributes to efficiency, safety, teamwork and addresses patient satisfaction
Ask Is there anything else I can do for you before I go? I have time. Increases efficiency, improves communication and teamwork (respect, caring, listening)
Tell each patient when you will be back Contributes to efficiency, provides reassurance
Document the round Quality and accountability

Research on Hourly Rounding in 14 hospitals revealed impressive improvements:

Leighty, John. “Hourly Rounding Dims Call Lights”., December 4, 2006.
Meade, Christine M. et al. “Effects on Nursing Rounds on Patients’ Call Light Use, Satisfaction, and Safety”. American Journal of Nursing, September 2006. 106 (9): 60.

Press Ganey measured the results of fourteen hospitals that implemented Purposeful Rounding, comparing them to hospitals with random rounding:

Source: Press Ganey, 2012

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