WalkRounds program enhances the patient safety climate in hospitals
Research Activities, June 2009, No. 346
Hospital WalkRounds were introduced in 1999 to improve hospital safety. WalkRounds are weekly visits by hospital executives and frontline medical staff to different hospital units. Their purpose is to provide a forum to ask about adverse events and near misses and identify factors that led to these patient safety problems. The information is then put into a database to use to improve safety. Implementing WalkRounds improves how caregivers assess patient safety and provides a structured forum for them to discuss safety concerns, according to a new study.
For nearly 3 years, seven hospitals agreed to participate in the prospective study by starting a WalkRounds program in all patient care areas. Rounds were conducted weekly using a seven-step program guide. Researchers gathered information on safety attitudes from caregivers at the start of the program and then again at 18 months. At baseline, 10 of 21 care areas had safety climate scores below 60 percent. After implementing WalkRounds, only three care areas had scores below this level. All other care areas increased their scores by 10 points or more. WalkRounds resulted in significant improvement when it came to discussing patient safety concerns. Caregivers felt more encouraged to discuss and learn from errors, as well as to report concerns in an effective manner. They also felt empowered with a stronger sense of responsibility for patient safety and more connected around safety issues with staff in other care areas.
When bringing up patient safety problems, nurses were more inclined to talk about operational difficulties. Physicians, on the other hand, focused on clinical decisionmaking issues. Since the WalkRounds program was so intensive, only two of the seven participating hospitals were able to successfully sustain their implementation on a broad level. The researchers identified three factors necessary for success: leadership commitment, a champion trained in quality and safety, and adequate time and resources for data management and feedback. The study was supported in part by the Agency for Healthcare Research and Quality (HS55401).
See "Revealing and resolving patient safety defects: The impact of leadership WalkRounds on frontline caregiver assessments of patient safety," by Allan Frankel, Ph.D., Sarah Pratt Grillo, M.H.A., Mary Pittman, Dr.P.H., and others, in the December 2008 HSR: Health Services Research 43(6), pp. 2050-2066.