WHEN ROUNDING IS HARDWIRED:

Delnor Community Hospital

"When we first started rounding in 1999, we didn't see results," explains Linda Deering, Vice President and CNO at Delnor-Community Hospital, Geneva, IL. "But we were rounding on patients, instead of employees. Five years ago, we didn't understand that rounding on employees is Job One. You have to address employee needs first to raise patient satisfaction."

"We find that when nurses round with physicians, it strengthens their relationship and mutual respect. What we thought would be good for patients also turned out to be good for doctors and nurses."
Linda Deering, RN, MSN, Vice President and CNO Delnor Community Hospital

CEO Craig Livermore correlates Delnor's high patient satisfaction to thank you notes and leadership training which were implemented in response to results of a 1999 employee satisfaction climate survey where employees cited concerns about trust and communication issues between staff and leaders. He also credits the implementation of a leadership evaluation tool to turning the flywheel faster. "Results aren't really going to move until behaviors are aligned with evaluations," he says. "You can beg, encourage and control, but if there's no incentive for accountability, we can always rationalize that's the thing we don't have time to do."

Today, service and operational excellence is hardwired at Delnor-Community Hospital. Seventy-five percent of every leader's merit increase is based on the results of his unit/team and 25% is based on how well the organization achieved its results.

Delnor has achieved what Studer Group calls "Five Pillar" results under people (employee satisfaction and retention), service (patient and physician satisfaction), quality (measured by medication error rate, inpatient fall rate, mortality rate, Medicare LOS, and other indicators); growth (market share, physician volume) and financials (net patient revenue, cost per discharge, and DCH operating margin.)

Delnor's Results are Hardwired

Quarterly Inpatient Satisfaction Trends Up
MD Satisfaction with Nurses Best in Nation
Annual Percentage Turnover Registered Nurses
Operating Margin Results

⁸ Results reported in percentile rankings compared to all hospitals in Press-Ganey database (versus raw percentages.)

High Employee Turnover Correlated to Higher Cost Per Discharge

High turnover is also associated with higher costs per discharge.⁹ According to a 2002 VHA report, organizations with turnover rates 21% or higher (high turnover organizations) had a 36% higher cost per discharge rate than hospitals with a turnover rate 12% or below (low turnover organizations). Low turnover leads to higher profitability. In fact, low turnover organizations averaged a 23% return on assets compared to a 17% return for high turnover organizations.

⁹ “The Business Case for Workforce Stability,” Voluntary Hospitals of America (VHA), April 2002.

Rounding Works Everywhere

Memorial Regional Hospital in Hollywood, FL is a large regional tertiary care hospital (684 beds, 4,000 employees, Level 1 trauma center). It’s also the flagship facility of Memorial Health System, a four hospital health care system and the seventh largest public health care system in the nation. As the busiest hospital in Broward County, Memorial Regional treats over 93,000 ED patients and 35,000 inpatients annually. The inpatient payor mix is 21% Medicare, 14% Medicaid, 49% managed care, and 16% charity/self pay.

And yet, Memorial Regional has also been consistently ranked (Press-Ganey) in the top 5th percentile nationwide among hospitals with 600 beds or more based on inpatient satisfaction results for the last 12 consecutive months.

“Effective rounding happens when staff understands that the purpose of your visit is to illicit information and feedback that will result in specific actions to improve the efficiency and quality of the workplace,” explains Jay Piriz, Administrator at Memorial Regional.

Hardwired Results: Issue 01

WHEN ROUNDING IS HARDWIRED:

Delnor Community Hospital

Delnor's Results are Hardwired