Posted October 02, 2014

Using Leader Rounding on Patients in the Emergency Department to Coach Staff

By Karen Smith, MSN, RN, CEN, NE-BC

We rarely encounter organizations that aren’t doing some sort of rounding. What we find, however, is that some leaders are simply “checking off” rounding on their to-do list, rather than completing rounding with passion and purpose. When done accurately and consistently, rounding is proven to be the best way to collect vital information, build relationships, engage staff and improve performance. It’s also a great way to validate key behaviors are taking place.

Leaders who are skilled in rounding know how to take this one step further. Rounding on Patients is the best way to gather direct information from the patient, in real time, versus waiting for patient experience or satisfaction surveys to provide feedback. Leaders can then leverage the information to provide real-time coaching to individual staff members, reward and recognize behaviors and train their entire team.

When rounding on patients in the Emergency Department, leaders can tailor their rounding questions to focus on the three key drivers for patient experience: 

  • How well was I cared for as a person?
  • How well was I kept informed?
  • How well was my pain managed? 

Leaders can address all three of these elements by asking questions, such as “Has your nurse, Mary, been keeping you informed of your wait time?” or “Do you know what will be happening in the next 30-60 minutes?”  Leaders can then share the responses directly with Mary and either reward and recognize her behavior (if she adequately addressed wait time), or provide coaching to Mary on opportunities for improving her performance (if the patient identified she had not kept them informed).

Rounding on Patients also provides leaders with the opportunity to ask focused questions on areas that the organization is working to improve. Maybe you’ve implemented the use of communication or white boards and you want to validate that Mary has updated the board with accurate information, and also explained to the patient why she is updating the board.

The leader can say “I see that Mary has updated your communication board with your care givers names and that managing your pain is your goal for today. Did she explain to you why we use communication boards? How is your pain now?” The feedback provided allows the leader to immediately address pain management, provide service recovery if the board is not updated properly and ease any patient anxieties by answering questions.

Leaders gather a great deal of information through rounding that can be used to coach all staff. Try dedicating part of your daily huddles or staff meetings to sharing best practices that you’ve learned through your rounding. This is a great place to manage up staff that have hardwired the right behaviors and share success stories that will reignite the entire team. It’s also a way to give specific examples of where the team could have improved their communication to the patient and reinforce why the behaviors are necessary to provide safe, quality care. 

Additional resources:

  • Download a sample Leader Rounding on Patients Rounding Log to record and track the results of rounding on patients.
  • ED CAHPS is coming soon. Access the ED CAHPS At-A-Glance to see what the patient experience survey will mean for your organization.
  • Get emergency department results more efficiently, effectively and collaboratively by attending the Emergency Department Excellence tracks offered at Studer Conferences


  • Karen Smith

    Karen Smith, MSN, RN, CEN, NE-BC

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