Modifying Rounding Practices to Support Caregivers During the COVID-19 Pandemic

Added on May 27, 2020

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By Julie Samuelson, Senior Associate, Strategic Consulting

Many health care organizations are grappling with the prospect of reducing leadership rounds during the COVID-19 pandemic in order to ensure that an adequate supply of personal protective equipment (PPE) remains available for front-line caregiver use.

To address that question, we must remind ourselves as leaders why we round:

  • To observe the current reality and associated challenges firsthand, while collecting concerns and ideas to address these challenges from those on the front line
  • To connect compassionately with our teams and convey both information and empathy
  • To inspire and influence our workforce’s ability to provide safe, high-quality, patient-centered care

As we navigate our own organizational circumstances, we must ground our leadership teams in these fundamental aims for rounding and make safety-based decisions.

The question, then, becomes how we can modify our rounding methods during this pandemic while continuing to ensure the highest level of patient care and workforce engagement. Through our extensive, ongoing outreach with leaders from organizations on the front lines of the COVID pandemic, we have assembled some “best practice” examples of how some organizations are adapting their rounding, along with the safety and communication principles that guided their decisions.

Rounding to Inspect and Ideate: An important part of leadership rounding is to observe care and work environments for operational and safety risks or issues. COVID-19 presents new opportunities for leaders to inspect and identify potential concerns before issues arise.

  • Select leaders in a large health system conducted focused rounding in COVID care areas (the ED and designated ICUs) and observed the current patient volumes and pace of the unit’s workforce. Working with the broader leadership team, they reviewed predictive volume metrics for COVID patients requiring intubation, noting the number of staff needed to care for these patients and to perform important interventions such as twice-daily patient repositioning. They proactively compared current staff availability with the volume of anticipated need and developed a plan for therapy staff to assist in patient repositioning during set times each day. Guiding Principle: Be preoccupied with potential and actual failures and risks. Ensure timely and easy access to the resources necessary to ensure the level of safe, high-quality care that’s needed by this high-risk patient population.
  • In a virtual meeting, leaders vetted ICU staff concerns regarding PPE use. Staff suggested and received approval to extend IV tubing so that IV pumps could be placed just outside patient rooms in order to decrease the need for frequent room reentry and the accompanying change of PPE. Guiding Principle: Defer to expertise by capturing, testing, and deploying effective solutions suggested by subject matter experts (i.e., front-line staff). 


Rounding to Inform and Ideate:
There are varied and creative ways for leaders to connect with their workforces while also ensuring two-way communication.

  • Many health care leaders are prioritizing daily communication to keep their workforces informed of important metrics (e.g., infected/suspected patient volumes, discharges, deaths), policy and procedure updates, and internal and community resources. Messaging occurs via email, live and recorded Web conferences or teleconferences, and intermittent direct conversations when possible. Guiding Principle: Communicate early, often, accurately, and transparently to build trust and confidence.
 
  • Leaders are ensuring that their workforces feel heard by providing immediate or subsequent acknowledgment of a question that was raised or a suggestion that was offered. They are also validating and summarizing what’s been said and responding with both what they know and what they will do. Guiding Principle: Practice active listening to assure staff that their concerns and questions are being heard and will be addressed.


Rounding to Inspire and Influence:
For leaders to inspire and impart hope, they must first believe in it themselves. Leaders must stay informed, be transparent, and actively demonstrate authentic concern and caring to influence the resilience of their teams.

  • To increase their visibility to the workforce, leaders of one organization greeted employees as they came to work, helped take employees’ temperatures, and vetted any safety concerns. At the end of each workday, leaders also thanked employees for their dedication and service, either in person or via Web conference/video. Powerful messages of support, gratitude, and empathy can positively influence workforce resilience. Guiding Principle: Communicate through words and actions that “we’re all in this together,” and acknowledge and express gratitude for every workforce member’s contribution to delivering safe, high-quality care.
  • Some organizations are assigning chaplains, therapists, or social workers at easily accessible locations for staff to voice their anxieties or ask for support. Guiding Principle: Demonstrate that staff well-being is a leadership priority by providing the resources and support staff members that need to weather the storm.

In the era of COVID-19, leaders must courageously stay connected to their employees. Consistent leadership rounds provide this opportunity, allowing leaders to intentionally connect with their workforces and positively influence the collective ability to provide safe, high-quality, patient-centered care.

To learn more about this topic, please reach out to the Press Ganey Strategic Consulting team at info@pressganey.com.

Visit our dedicated COVID-19 webpage for additional resources.