Hourly Visits to Patients Result in Higher Satisfaction

A couple of months ago my hospital initiated a new process to improve patient satisfaction and care.  It’s called “hourly rounding” and essentially requires a nurse or other caregiver (such as a CNA or PCT) to visit every patient once an hour in order to inquire about their needs.  Specifically the caregiver addresses the 5 P’s: pain, potty, position, periphery, and parting.  By inquiring about pain control, the nurse is able to give medicine to provide comfort before the pain becomes unbearable.  This is one the major concerns of patients in hospitals.  By asking about the need to visit the toilet, the caregiver may avoid a fall by a weak and unstable patient.  The position of the patient, especially someone who is immobile, must be altered routinely to prevent pressure sores; even a more ambulatory patient may need their pillow adjusted or their bed raised.  By assessing the patient’s periphery (the condition of their room, cleanliness, tidiness, accessibility to remotes and call buttons) they add another level of comfort.  The parting comments of the nurse always include a question about any other needs the patient may have, such as, “Is there anything else I can do for you?” 

It’s remarkable how this hourly rounding has impacted the HCAHPS scores of our patients in such a short time.  They have jumped up dramatically in all of the domains (example: pain control, quietness, nurse communication, etc.)  Even the scores for doctor communication increased even though the doctors do not participate in hourly rounding.  The increased score for doctors may be due to a perception of overall communication about physician instructions based on conversations with the nurses. 

Hourly rounding is promoted by the Studer Group and our hospital required training for all nurses.  The class included information about other hospitals’ results that use it as well as effective patient communication methods.  There’s been strong support for the program and our patients love it. 

Working in the lab, I have little patient contact.  Regardless, every employee in our hospital has a vested interest in making sure that our patient satisfaction scores are high.  In the past I have felt frustrated that I could not influence patient satisfaction directly.  Now that we are shown the effects of hourly rounding on the HCAHPS scores, I am thrilled that we have a program that really has tangible effects on our scores.  I’m so excited to see progress and grateful that our administrators put in the effort to bring the program to our hospital.

I’ve heard that the nurses like hourly rounding because they feel more connected to their patients, they have fewer patient falls, and less interruptions due to patient call bells.  I’ve seen patient interviews that show a patient explaining their gratefulness for the nurse who visited frequently to relieve her fears and provide comfort.  This is a new program at my hospital, but I think it will continue and will remain a vital part of our patient satisfaction responsiveness.  It’s a good thing for everyone.