Leadership Rounding Tool

• Document No.

• Leadership Rounding Tool

• BayState Wing Hospital

• Conducted on

  Date

• Prepared by

• BayState Wing Inpatient
  Address

• Personnel

Leadership Rounding Questionaire

• How has your stay been so far?

  Excellent

  Very Good

  Good

  Fair

  Poor

• Did someone explain the admission informational book to you?

  Yes

  No

  N/A

• Were all of your questions regarding the admission information book answered?

  Yes

  No

  N/A

• Has the staff here introduced themselves and explained their role?

  Yes

  No

  N/A

• How well do you think your caregivers are listening to you?

  Excellent

  Very Good

  Good

  Fair

  Poor

• How is the housekeeping?

  Excellent

  Very Good

  Good

  Fair

  Poor

• How was our ability to give help as soon as wanted?

  Excellent

  Very Good

  Good

  Fair

  Poor

• How has the noise level been during your stay so far?

  Excellent

  Very Good

  Good

  Fair

  Poor

• Has the staff checked on you frequently?

  Yes

  No

  N/A

• Did you have any pain during your stay?

  Yes

  No

  N/A

• If you did, did we take care of it for you?

  Yes

  No

  N/A

• Did you start on any new medication while you were here?

  Yes

  No

  N/A

• If you did, did we teach you about it?

  Yes

  No

  N/A

• Has the staff started to educate you to care for yourself when you go home?

  Yes

  No

  N/A

Employee Recognition

• We like to reward our staff? Who as done an excellent job?