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Posted February 01, 2012

The Single Most Powerful Tactic for Creating Physician Engagement

By Julie Kennedy-Oehlert, RN, BSN

Rounding for outcomes has become the gold standard for engaging our healthcare workforce and creating a "feedback conduit" for those who provide patient care. When leaders take the time to connect with those who report to them—asking meaningful questions and obtaining actionable information in the process—it goes a long way toward raising employee engagement and attracting and retaining high performers.

In this time of healthcare upheaval, any tactic that guarantees improved workforce engagement and better patient care becomes the most important tool in a leader's toolbox.

Now, it's time to apply the principle of rounding for outcomes to one of the most important care providers in a patient's world: physicians. When physician leaders regularly round on physicians and follow up on the feedback they receive, they can engage and reinvigorate these vital drivers of healthcare quality. It's a five- to ten-minute investment of time that yields powerful results.

It has long been established that physicians want input into patient care. They want efficient systems in which to care for their patients. They want quality outcomes and the necessary tools and equipment to provide those outcomes. And they want appreciation for the work they do. Rounding on physicians by their leaders provides all of those things!

Rounding enables busy physicians to give input to their leaders in a time-efficient way. It gives them a voice in how the organization cares for patients. And it creates a channel to harvest wins and recognition for other healthcare providers.

The University of Alabama at Birmingham (UAB) Health System, a Studer Group partner, implemented rounding for outcomes on physicians. Here is what one physician leader said after rounding for one quarter in his clinic:

Just a note to let you know how rewarding I found my rounding experience this past quarter. I plan to have my stoplight available in the next week and have already generated 1/2 dozen thank-you notes. I have heard several common themes amongst the medical directors...mainly that they are seeing improvement and hard work being done by clinic coordinators and their acknowledgment of feeling that actions are taking place to improve processes and patient care.  

Richard S. Rosenthal, MD
Associate Chief of Staff, The Kirklin Clinic
Associate Professor, Endocrinology, Diabetes and Metabolism

Three tools were instrumental in this large academic center's successful hardwiring of physician rounding:

1) They customized a physician rounding standard to make all expectations consistent and clear. For example, the medical director commits to rounding on all faculty and/or providers (nurse practitioners, physician assistants, and so forth) at least four times a year. The standard explains that rounding is hardwired when "90 percent of leaders are rounding with prescribed frequency, utilizing good skills, and eliciting actionable reward and recognition and process improvements that are documented and addressed." Click here to see the physician rounding standard in its entirety.

2) They created pocket rounding logs printed on 3x5 cards. (Click here to see a sample rounding log.) UAB understood that it was essential to document the results of physician leader rounding. They also wanted to make it easy for physician leaders to build this behavior into their routines. That's why they designed the rounding logs to easily fit in breast pockets or lab coats. It's convenient for leaders to slip several of the cards into their pocket, along with a pen, so they can easily document feedback and respond to it in a timely fashion.

3) They created a modified stoplight report. This tool is designed to help leaders "close the loop" with physicians by reporting back to them the status of issues raised during rounding. Basically, when a physician asks for a particular action to be taken, the physician leader can rate it one of three colors:

  • Green = Completed. These are items that were able to be addressed immediately.
  • Yellow = Works in Progress. These are opportunities we are working on.
  • Red = We Can't Do Right Now. (Along with the reason why)

UAB created an electronic version of this Studer Group tool so physician leaders can place reports on their intranet for easy access and use. Making the report electronic prompts leaders to share the reports in other venues such as medical executive meetings and staff meetings. Because the reports include a space to document how many physicians were rounded on during the quarter, they serve as a great accountability tool. Click here to see a sample.

Rodney Tucker, MD, MMM, Medical Director, UAB Inpatient Palliative Care programs, and Associate Quality Officer for Patient Experience for UAB Health System, reports: "Rounding on colleagues is becoming more natural after the initial successes. It leads to clearer engagement from the physician staff and gives them a voice that may not otherwise be heard in other settings such as staff meetings or even performance evaluation meetings.

"Clearly, rounding for purpose and specificity gets physician colleagues engaged in many ways, but particularly gives them a way to recall certain positive behaviors that they have noted from others and just simply forgot to acknowledge in the course of a busy week," he adds. "Being rounded on by a leader brings those behaviors to the forefront for recognition of other team members."

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