Objectives
1. Define the vision of executive and
administrative off-shift rounding.
2. Identify logistics of off-shift leader
rounding.
3. List examples of how leaders may
react to difficult situations they may
encounter while rounding.
4. Describe how to educate hospital
executives and leadership on the
rounding process and how to
onboard new leaders when hired or
promoted.
5. Discuss ways to track outcomes,
recognition, and opportunities
attained while rounding.
Nuts and Bolts of Executive
and Administrative
Off-Shift Leadership Rounding
Julie Lichtenberg, MA, RN
Presence Saint Joseph Hospital, Elgin, IL
Presence Saint Joseph Hospital | Elgin, IL
Founded in
1902
184 Licensed
Beds
375 Physicians
Goal:
Increase visibility and engagement with
quality interactions through
leadership rounding
Direct Outcomes
Increased Employee
Satisfaction
Enhanced Quality of
Care
Indirect Outcomes
Increased Patient
Satisfaction
Increased Physician
Satisfaction
How will we achieve this?
• Develop a schedule for all leaders (clinical
and non-clinical) to sign up for off-shift
rounding
• Rounding will include coverage for weekday
evenings (B) and weekend (A, B & C) shifts
• Conduct rounding training for current leaders
and ongoing with new leaders hired
• The information gathered from the rounds will
be tracked in Midas (an electronic data base)
What is the process?
• The intent is not to have leaders work additional hours,
but to manage their time appropriately during the week
they are rounding
• For night shift rounding (3 hours)
• Leaders should be rounding the entire shift
• For rounding shifts that are at least 6 hours
• Leaders need to round for a few hours, then may do some
work in their office, round again
• There is a list of departments (zones) that leaders must
visit each rounding shift
What is the process?
• A Rounding Log has been developed to serve as a guide
to record the off-shift rounding
• Leaders must also contact the Administrative
Coordinator (x5421) and on-duty to let them know you
are in the building to round in the event they need your
assistance; they may also round with you; you should
ask them what current issues are occurring on that shift
as well
• After the Rounding shift, the leader will send the
rounding action items to the appropriate leaders based
upon the feedback received
Rounding Log Expectations:
•
•
•
Rounding action items must be sent to the
appropriate leader within 48 hours of the Rounding
Shift
Expectations are that the department leaders
respond to the rounding log action items identified
in their department within 48 hours of notification
Rounding log must be entered into Midas within 48
hours of the rounding shift
Rounding Specifics
• Leaders must be dressed in Business/Casual attire (no jeans)
• All leaders must sign up for TWO rounding shifts in a 6 month
timeframe.
• Shifts will be Monday/Wednesday one week and
Tuesday/Thursday the following week. Every weekend will
require rounding during the day and night shift
• Leaders with night shift staff must sign up for at least 1 night
shift rounding
• Holidays and Holiday weekends will not be included in the
rounding schedule
• If a leader is unable to round on their shift, they must find
another leader to take their rounding shift and must notify the
CEO’s Executive Assistant to adjust the master schedule
How leaders sign up?
• Each leader is provided a
specific 24-hour timeframe
in which they can sign up
for shifts
• Leaders go to
Administration to sign up
for the shifts; a master
copy of the rounding
schedule is made
available on the shared Y
drive.
Process for signing up to round
• Each leader was given a date to sign up for shifts. The
first 6 leaders picked in the raffle will sign up for shifts,
then the next 6 leaders, etc. Executives will sign up for
their shifts first.
Example:
Leaders 1 – 6
Can sign up on Dec. 10
Leaders 7 – 11
Can sign up on Dec. 11
Leaders 12 – 16
Can sign up on Dec. 12
Rounding Schedule Example
Zone A
Zone A
Zone B
Zone B
Mon
Wed
Sat
Sat
10/3
10/5
10/8
10/8
5p-11p
5p-11p
Leader #1
Zone A
Sun
10/9
10/9
1am-4am 11am-5p 1am-4am 11am-5p
x
Leader #2
x
x
x
Zone B
Zone B
Tues
Th
10/11
10/13
5p-11p
5p-11p
x
x
Leader #3
Leader #4
Zone A
x
Rounding Zones
Zone A
•
•
•
•
•
•
•
•
Comprehensive Rehab
Behavioral Health
Inpatient Units
Perioperative Services
Sterile Processing
ICU/CVICU
Telemetry Center
Cath Lab
Rounding Zones
Zone B
•
•
•
•
Respiratory
Gift Shop
Switchboard
Security
• Central/Sterile
Processing
• Food and Nutrition
•
•
•
•
•
•
•
•
Laboratory
Admitting
Medical Imaging
Emergency
Department
Maintenance
Engineering
Housekeeping
Pharmacy
New Leaders
• New Leaders will be provided with the rounding training
during leadership orientation within their first 30 days.
They will be expected to sign up for shifts within their first
30 days.
• New leaders will not begin rounding until after they have
been here for 90 days.
• HR will send the CEO’s Executive Assistant the new
leader’s name and the Exec Asst AND Immediate
Supervisor of the new leader will ensure they sign up
for rounding.
Rounding Training
It’s all about Building
Relationships
• Schedule your time to round – then add the
dates/time into your outlook calendar
• Educate yourself as to what is going on in the
departments you will be rounding in
• Make personal connections while you are rounding
(use sample questions provided)
• Be accessible/approachable to staff – feedback
from staff says leaders are sometimes not
approachable
• If someone asks you a difficult question ask them,
“Have you brought this up with your Manager?”
It’s all about Building
Relationships
• Recognize employees right away via
employee recognition program or with a
meaningful Thank You Note
• Ask staff for feedback they want to provide
• Record opportunities and wins on the
Rounding Log as you round!
• Log your rounding outcomes into Midas right
away
• Discuss leader rounding directly with your
leader
“This Isn’t Going Too Well… HELP”
Situation
Instead of…
•Stopping the
conversation
Employee isn’t focused
on conversation; seems
distracted
•Attempting to proceed
through the distraction
•Immediately moving to
the next topic
Other issues enter the
conversation
Try Saying/Doing…
•“I notice that you seem
distracted. Is there a better time
for us to have this conversation.”
•Completely dismissing
new issue
•“I notice that you seem
preoccupied, is there something I
can help you with? We can finish
this conversation when it’s more
convenient.”
•“You bring up an interesting
point. Would you be okay with us
finishing this discussion and
coming back to the concern you
just raised?”
“This Isn’t Going Too Well… HELP”
Situation
Instead of…
•Getting angry
Employee demonstrates
behavior contrary to our
standards (i.e. eye rolling,
inappropriate comments,
managing down of
others)
•Returning the kind
gesture 
Try Saying/Doing…
•“I’m a little concerned with
how you just < XYZ>. If I’ve done
something to offend you please
let me know. The manner you
just addressed me is
inappropriate. Can we try this
conversation again?”
Note: If employee continues with
behavior, notify their supervisor
•Letting conversation
linger
Conversation doesn’t end
•Stop conversation
abruptly
•“I really want to be respectful of
your time. We have spent our time
well. If it is okay with you I will note
your concerns and share them with
the appropriate person. If I may, I
would like to take 2 minutes to
summarize what we discussed to
ensure what I have is accurate. Is that
okay with you?”
Presence Saint Joseph Hospital: Leader Rounding Issue/Recognition Documentation and Follow-up Log
Shift Rounded
On:
Date:
Dept
Name
Employee
Name
(if
available)
Issue/Concern
Suggestion
Rounding Leader Name:
Person/Dept
Responsible
to
Follow up
Date
Completed
Recognition &
Successes
People to
Recognize & Why
Date
Completed
“Closing the Loop”
Date Employee and/or Dept Contacted
Suggested Rounding Questions
Clinical Leader rounding
• What is going well?
• Is there anything to prevent
you from providing safe
care?
• What are your unit’s key
drivers and what are you
focusing on to address
them?
• Do you have the tools to do
your job?
All Leader rounding
• What could my department
do more or less of?
• What is the best service we
provide and why?
• Has someone in my
department been especially
helpful and why?
• When you have a problem
do you know who to call?
• What
employee/patient/physician
satisfaction issue can my
department assist with?
Midas Rounding Report
QUESTIONS?