Quality Conversations

Employee rounding improves communication, job satisfaction and patient care

HCA Healthcare’s annual employee engagement survey collects insights from employees about how they are feeling on a variety of issues. One area in particular the survey helps to measure is whether employees believe that their suggestions are being heard and acted upon.

Because this input is so important, HCA Healthcare is continually striving to implement improvements in the line of communication between employees and their supervisors. The latest example is a new employee rounding framework that will be deployed across the company in the coming months.

“In the same way nurse leader rounding provides a listening post for nurse leaders to hear directly from patients and their families what issues are important to them, employee rounding provides the same listening post between employees and their manager,” explains Lyn Ketelsen, chief patient experience officer. “What it boils down to is that we are creating the opportunity for people to have a one-on-one conversation with their department head or director. It’s an evidence-based best practice that really engages employees, and has been shown to improve satisfaction and employee retention.”

“A lot of times people can become frustrated when they see an issue that gets in the way of providing great patient care or service, and so this will help make sure they have a regular avenue to voice those concerns or ideas and a framework to know when the leader has addressed them.”

Enhancing personal connections 

Employee rounding works so well in part because it provides an opportunity for leaders and employees to step outside their roles and strengthen their relationships with each other. Rather than focus on an employee’s performance, he or she will be asked if they have the basic tools, equipment and information necessary to do their job, as well as what processes or systems might not be working as efficiently as they should and are in need of attention.

“They’ll also be asked who’s doing a good job, so that good works and good deeds can be called out and recognized,” Ketelsen says. “So in addition to identifying issues and taking corrective action, employee rounding also works for team building and support.”

In-person aspect is key

“It’s a great way to stimulate dialogue with employees, because they feel like they are being communicated with, and that their leaders are working on solutions to issues they have,” adds Sylvia Young, president of HCA Healthcare’s Continental Division.

Young visits hospitals monthly or quarterly depending on location, and says one of the “joys of my job” is connecting with employees and patients in this manner.

“I am headed out to four hospitals this week,” she says. “Last time I was on nursing units, and this time I’ll be in the outpatient testing and surgery areas. I meet with employees and ask them what’s going well, which starts the conversation in a positive way, and then I ask them to take me to see a couple of patients. I always sit down with those people, rather than stand, because I don’t want them to think I’m in a hurry. And I do the same thing with the patient: ask them what is going well, and then turn the conversation to areas where they think we could improve.”

Frequent touchpoints

In general, most employees will take part in a rounding session once per month. Some may occur more frequently, some less so, depending on the size of the department. After the session, the leader creates a “stoplight” report. The stoplight phrase refers to green, where the manager has a resolution in place; yellow, to show some action has been taken; and red areas, where a suggestion can’t be acted upon.

“That kind of feedback is going to keep our employees well informed about everything that’s going on around them,” Ketelsen says. “People are willing to give suggestions in a survey, or in a performance review. But that’s just once a year. This creates a much more effective way to engage people more frequently, and to put positive changes into place much more quickly.”

The regular contact also will mean more in-depth conversations, notes Young.

“In the past, we’ve been guilty of ‘drive-by’ rounding, where it’s just been too fast to be effective,” she says. “It can’t be just ‘How are you?’ Now leaders will sit down and have a meaningful conversation with the people delivering incredible service and compassionate care to our patients.”

In the annual employee engagement survey, HCA Healthcare employees usually say that they would like more interaction with their managers, as well as overall hospital management.

Rounding programs do that and more, say both Ketelsen and Young, who have seen the benefits firsthand.

“When there is a regular avenue for feedback, the employee feels much more a part of the decision-making process,” Ketelsen says. “But what’s more, he or she can point out problems in their early stages, so that corrective action can be taken right away. Everyone wins, from staff to patients, thanks to better communication.” 