The Centers for Medicare and Medicaid Services (CMS) correlates patient satisfaction to quality of care. The organization’s commitment to optimal quality and patient experience requires the involvement of nurse leaders to improve patient outcomes. Nursing leadership regularly round and speak to patients about the environment of care and hospital experience. The traditional pen-and-paper method of leader rounding was an inefficient approach to provide real-time data, quick issue resolution, and flexible reporting.

The organization’s digital solutions team and nursing informatics collaborated on a project request from nursing leadership to design a mobile-responsive web application to capture patient feedback and resolve concerns in real time. The digital rounding solution has a custom-built data collection interface designed to record daily rounding results. Click-to-call and click-to-email functions can be used to report issues to other departments for resolution. Reports can be downloaded in Excel or PDF format and can be sorted and filtered by a broad range of variables. Reports can be used to analyze current usage and bring underlying issues to the surface.

In spring 2018, the quality improvement project was rolled out to a small group of beta users at one hospital location. Over the duration of a year, the nurse managers contributed feedback to improve the application’s functionality and user experience. Data collection and reporting were enhanced based on beta user feedback. The application was deployed enterprise-wide in summer 2019. Nursing informatics provided onsite support which included hands on training.

By allowing nurse leaders to utilize a digital application, the initiative enabled the leaders to prioritize response and identify improvement opportunities. Upon examination of three months of data, comparing rounding results and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores at two hospital locations comparatively equal in size, a correlation is seen between consistency of daily rounding and improvement of HCAHPS scores. Similarly, a correlation is seen between greater executive involvement in the review of weekly rounding results and higher HCAHPS scores. In one observed hospital location, HCAHPS domain responsiveness of staff increased by 5% with 85% utilization and high leadership involvement. Comparatively, this measure increased by only 0.6% in a location with 20% utilization and less reported leadership involvement.

The highest level of improvement in HCAHPS scores have been seen in locations where the availability of a mobile technology for daily rounding data collection has been accompanied by a high level of executive engagement in a reporting model that encourages and reinforces adoption. Ongoing data collection and performance will be monitored and analyzed to continually improve patient experience and quality of care. Digital rounding application is an innovative tool that empowers nurse leaders to use transformational qualities and lead positive and sustaining change.

Vanesa Flaviano MSN, RN-BC

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