Leadership rounds can encourage conversation with frontline staff on crucial issues and, a new study suggests, could lead to better infection control.
Researchers led by a team at the University of Wisconsin conducted leadership rounds on a unit basis over a period of seven months at UW Health, University Hospital and the American Family Children's Hospital, according to a study published in the American Journal of Infection Control.
The rounds identified 350 instances across 22 rounds where staff disclosed issues with hospital-acquired infections and discussed potential solutions with executives, according to the study. Leadership rounding, according to the researchers, can create a sense of "psychologic safety," which makes frontline staff and clinicians more comfortable revealing potential problems to hospital leaders.
"By fostering an open culture, health leaders are able to problem solve with frontline staff to determine barriers to implementation," Mary Jo Knobloch, Ph.D., an infectious disease researcher at UW and the study's lead author, said in an announcement. "This presents an opportunity to move evidence to practice and better protect patients from harm."
The researchers conducted interviews of participants across the 19 units in the study to gather opinions from both executives and frontline staff on the interactions. Staffers said leaders listened attentively, and that having discussions on patient safety in the actual units better illustrated the "business" of the day-to-day work.
However, they were uncomfortable when executives on rounds compared performance between units, according to the study. Comparing the units directly, according to the frontline staff, was unfair, as each has a different set of work circumstances and a varying patient population.
Staff also said that the expectations for the rounds were unclear, according to the study, and wanted better guidance from executives on where the conversations were leading and the impact.
Even so, they said they felt having these conversations was crucial to a culture change around infection control.
Engaging with frontline staff—including nonclinical employees—is a crucial step to improving safety and care quality, experts say. Hospital leaders looking to adopt University of Wisconsin Health's rounding approach could start in the emergency department, which may be neglected in infection control programs, experts say.