BLG: Rounding Observation Checklist - Final

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Department / Clinic Name:

• Patient Population:

• Department / Clinic Leader:

Rounding Questions

• 1. What are some initiatives you have deployed to improve the patient experience?

  Select Hourly Rounding Discharge Calls Team Nursing Bedside Shift Report White Boards Patient-Centered Communication (RELATE, WTW, AIDET)

  • Hourly Rounding
  • Discharge Calls
  • Team Nursing
  • Bedside Shift Report
  • White Boards
  • Patient-Centered Communication (RELATE, WTW, AIDET)

• 1a. What have you tried in the past without success?

• 2. What tools and/or tactics have you used to improve patient satisfaction?

  Select Hourly Rounding Discharge Calls Team Nursing Bedside Shift Report White Boards Patient-Centered Communication (RELATE, WTW, AIDET)

  • Hourly Rounding
  • Discharge Calls
  • Team Nursing
  • Bedside Shift Report
  • White Boards
  • Patient-Centered Communication (RELATE, WTW, AIDET)

• Additional Notes

• 3. How do you work with patients and their families to ensure their needs are being met?

  Select Hourly Rounding Discharge Calls Team Nursing Bedside Shift Report White Boards Patient-Centered Communication (RELATE, WTW, AIDET)

  • Hourly Rounding
  • Discharge Calls
  • Team Nursing
  • Bedside Shift Report
  • White Boards
  • Patient-Centered Communication (RELATE, WTW, AIDET)

• Additional Notes

• 4. How do you engage employees to improve the patient experience? (Look for accountability and reward/recognition)

  Select Staff Meetings Department Awards Huddles Discuss Results Action Plans

  • Staff Meetings
  • Department Awards
  • Huddles
  • Discuss Results
  • Action Plans

• Additional Notes

• 5. How does your front line staff know what to focus on in their efforts to put the patient at the center of their work?

  Select Action Plans Focus of the Month Key Drivers / Priorities Patient Comments

  • Action Plans
  • Focus of the Month
  • Key Drivers / Priorities
  • Patient Comments

• Additional Notes

• 6. What do you do to encourage loyalty and employee engagement on your unit/department?

  Select Thank You Notes Patient Letters Unit Awards Parties

  • Thank You Notes
  • Patient Letters
  • Unit Awards
  • Parties

• Additional Notes

• 7. Tell me the number one challenge that is keeping your department from achieving (or sustaining) excellence.

  Select Time Competing Priorities Technology (EMR, CPOE) Staffing Throughput Wait Times

  • Time
  • Competing Priorities
  • Technology (EMR, CPOE)
  • Staffing
  • Throughput
  • Wait Times

• Additional Notes

• 8. What is the one thing that you are most proud of in this department?

  Select Staff Teamwork Results Commitment Aesthetics Quality of Care

  • Staff
  • Teamwork
  • Results
  • Commitment
  • Aesthetics
  • Quality of Care

• Additional Notes

Observation Criteria and Notes (use photo to validate information when possible)

• Department Communication Board

  Not Present

  Present But Needs Improvement

  Present and Effective

• Additional Notes

• Is a Patient Experience Report Tool (e.g. PSAT) being used?

  Not Present

  Present But Needs Improvement

  Present and Effective

• Is there a documented action plan in "things we will focus on?" Please explain the plan or lack thereof.

  Not Present

  Present But Needs Improvement

  Present and Effective

• Additional Notes

• Are Hourly Rounding Logs present?

  Not Present

  Present But Needs Improvement

  Present and Effective

• Is the log incorporated into daily care?

  N/A

  No

  Yes

• Additional Notes

• Patient White Boards

  Not Present

  Present But Needs Improvement

  Present and Effective

• Is the plan of care written with patient-centered language?

  N/A

  No

  Yes

• Additional Notes

• Bedside Shift Report

  N/A

  No

  Yes

• Additional Notes

Patient Interview Guides

• 1. Our goal is to always provide patients with very good care. Can you tell me about your experience during your stay/visit?

• 2. Can you tell me about what has gone well during your stay at here?

• 3. What could have been done to better serve you during your stay?

• 4. Have the staff been responsive to your needs?

• 5. Have there been any staff members that we can recognize for providing you with outstanding care?

• 6. If we could change one thing to improve the patient experience here, what would it be?