rounding

“Dexter” Janet Borrowman is an operational excellence coach for performance improvement in the Southern California Region. She recently spoke with LMP Communications manager Sherry Crosby about the importance of rounding conversations for managers and frontline workers. Building a workplace culture where everyone’s voice matters is key to our Labor Management Partnership.

What is rounding?

Rounding is an evidence-based practice that relies on purposeful conversation and observation to drive workplace engagement and insights. Direct report rounding involves conversations between a team member and that person’s supervisor, manager or leader.

How does rounding benefit managers and frontline workers?

When done well, rounding helps managers build trust with staff, gain insights into workplace challenges and recognize employees, which fosters joy in work. Frontline workers benefit by having a chance to connect individually with their managers, share ideas, express concerns and find deeper purpose in their everyday work.

What evidence shows rounding is an effective practice?

Rounding is one of the most effective ways for managers to spend their time. And the more they consistently round, the greater the impact. According to People Pulse, departments where rounding is routinely practiced achieve more meaningful levels of engagement, better patient care outcomes, fewer workplace injuries and improved attendance.

How can frontline workers get the most out of rounding conversations?

Sometimes employees don’t see the benefit of direct report rounding; they just see it as helping the boss complete their checklist. It’s totally missing the point! Rounding is your chance to discuss what you need to be successful and the support you need. This is all about you!

How can managers get the most out of rounding conversations?

Rounding is one of the best tools that managers have for proactively surfacing and addressing issues which can create safer, more efficient and productive teams and environments. Use rounding to connect with your team members. People need to feel that their life and work has meaning, and that they are personally supported and cared for as a complete person. People need a personal touch, especially during difficult times, and rounding can help with that.

How can managers use rounding to build trusting relationships?

Your direct reports need to feel that what they’re saying is important and that you’re following up with action. Circle back to that person who brought up the issue with you. Go to the huddle and follow up with the whole team. We build trust by following up after a rounding conversation. We break trust by not following up.

What advice do you have for those who want to enhance their rounding practice?

If we are doing rounding the right way, if we’re doing it consistently, if we’re doing it authentically, then we will discover what matters most to our people and we’ll be able to better support them and the work they do.

Alaine Lounsbury, RN, is proud of her nursing team at Downey Medical Center in Southern California. 4 West team members have worked together for decades, forming bonds that have led to high patient satisfaction rates and region-wide recognition.

Lounsbury, nursing assistant clinical director, attributes the team's success to rounding — the practice of engaging frontline workers in face-to-face conversations on the floor and listening to their concerns. Managers who round say it helps build a culture of engagement and dialogue, a key goal of the Labor Management Partnership between Kaiser Permanente and the Partnership unions. 

“It’s about making a connection,” explains Lounsbury, who rounds quarterly on 90-plus staff members using Kaiser Permanente’s Rounding Plus online tool [KP Intranet]. “You want to hear the good with the bad.”

Removing roadblocks

With the tool, managers can use their mobile device to identify, track and escalate issues surfaced during rounding conversations. Program-wide, nearly 10,000 leaders and managers use the program.

At Downey, nurses used rounding conversations to speak up about a workflow issue. Because 4 West is the only unit with nurses qualified to give chemotherapy to adults, it meant staff members sometimes had to leave their department to administer drugs to patients. Their frequent absences meant more work for others.

“I heard them in rounding say, ‘You need to figure this out,’” recalls Lounsbury. She and her team developed new protocols to enable others outside the unit to give the medication. “That was a big satisfier.”

Getting visual

To help her systematically follow up and act on her team’s questions and concerns, Lounsbury uses a colorful poster, called the Stoplight Report, that assigns green, yellow and red colors to track the status of issues.

The poster was conceived by Downey Quality Coordinator Suxian Hu, RN, based on the color-coded reports managers receive through the Rounding Plus program. Last year, all of Downey’s inpatient nursing units began using it.

In 4 West, the poster hangs prominently in the conference room, where everyone can see it.

“Staff members know something is being done,” says Donielle Tresvant, RN, a staff nurse and member of UNAC/UHCP, one of the unions in the Alliance of Health Care Unions. “They know they’re being heard.”

Nurses say the information shared on the poster also fosters team communication and collaboration. “It keeps us updated about things at work and it helps us improve our care by being focused,” says Brianna Schneider, RN, a member of UNAC/UHCP. “It makes for a cohesive atmosphere.”