Solution: Employee Rounding
What Is Employee Rounding?
 Dedicated time that a leader takes to talk (usually 1:1; but could be in a
small group) with employees (in their department or other departments) or
physicians. It is relationship building versus conveying information.
 Rounding takes “management by wandering around” or “leader visibility” to
a new level. The format of rounding leads to purposeful conversation that
focuses on positives as well as important aspects of work and patient care.
Why Should Leaders Round?
 You want to make your organization a better place to work.
 Leaders who understand the importance of employee engagement work to
create a positive connection with each member of their team.
 Leaders can promote engagement through rounding by teaching their team
how to shift the challenges they experience into positive outcomes.
 Rounding can be a continual method to assess employee engagement.
You don’t have to wait for the annual survey to measure for you – you can
assess it daily.
 Your employees want a relationship with you that is professional and
personal. Rounding on your employees regularly and consistently will
increase your approachability.
 The communication/documentation of rounding (up the chain of command
to the CEO) allows for the senior leaders to be more knowledgeable and intouch with front-lines of patient care and operations which aids in decision
making and resource allocation.
 When a leader follows up to the input they receive in rounding, this allows
leaders to build trust with their employees and physicians that they are
being heard and that their ideas are important to the organization.
 Roundingis a proactive leadership activity (vs. reacting to when there are
issues & problems). It takes a dedicated period of time of rounding, and
diligent follow up, for you to start noticing that your leadership activities
become more proactive. Once you’ve been rounding for a period of time,
you will notice how different (and great) this feels.
1|Solution:
Employee Rounding
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Solution: Employee Rounding
Why Else Should Leaders Round?
 Employees want efficient systems. They do not want to do re-work and
face barriers every day at work. Rounding assists in finding creative
solutions to breaking down barriers and roadblocks. If you don’t know about
it you cannot fix it.
 To harvest recognition opportunities that help keep the 3:1 ratio happening.
 Employees need tools and equipment, training and education. Often,
employees will assume you know what training and education they need.
They assume you know what is broken and needs to be fixed. Asking them
directly brings that information to the surface where it can easily be
discussed.
 Rounding provides leaders with an opportunity to be a transparent and
open communicator. Transparency reduces stress and negativity in your
employees -- no matter what the message is.
ROUNDING IS THE SINGLE MOST EFFECTIVE TOOL YOU HAVE
TO MAKE EMPLOYEES FEEL APPRECIATED AND HEARD
2|Solution:
Employee Rounding
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Solution: Employee Rounding
The “Why” Behind Suggested Employee Rounding Questions
 Relationship building question.
o Relationships are key to employee engagement – rounding is all
about building a relationship with your employees.
 Begin the conversation on a positive note.
o As healthcare employees we are trained to focus to look at what’s
wrong. We need to be intentional about bringing out the positives.
 Incorporate Leadership Safety Rounds.
o Your employees are your eyes and ears. Don’t just rely on
documented occurrence reports.
 Ask if there are any issues with tools or equipment.
o Be proactive about supplies and equipment needs – not just at
budget time.
 Ask about training and education needs.
o Employees rarely offer this information to you. You must ask.
 Custom question(s) focused on your current improvements.
o This keeps your rounding fresh for you and your employees. And,
allows you to validate the progress on new initiatives.
 Ask about your leadership.
o You may never get enough feedback from your supervisor about how
you are doing as a leader. This feedback is very helpful when it
comes directly from those you are leading.
 Do you have any “burning questions” for senior leadership?
o If one employee has a question, likely others have the same
question.
 Open ended question.
o This allows the employee an opportunity to ask questions or inform
you of things important to them that may not have come up in the
rounding yet.
 Harvest opportunities for recognition.
o Ends rounding on a positive note.
3|Solution:
Employee Rounding
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Solution: Employee Rounding
Suggested Employee Rounding Questions
 How is your…..?
 “What is going well today?”; “What is happening that is positive today?”;
“What is working well for you?”
 “Are you aware of anything that may pose a safety risk to our patients,
employees or visitors?”; “Have you recognized or reported any good
catches recently?”; “What keeps you awake at night regarding patient
safety?”; “What is one way we can improve patient safety?”
 “Is there any equipment broken or missing?”; “What equipment or supplies
would help you do a better job?”; “Do you have the tools and equipment to
do your job?”
 “What training could we offer that would assist you in caring for your
patients?”; “What educational pursuits do you have?”; “Do you have plans
for BSN completion?”; “Do you have a goal for specialty certification?”, “Do
you have your next job in mind?”
 “How are you finding the new medication reconciliation process to be
working?”; “What outcomes are you seeing with the implementation of
Hourly Rounding? Do you find call lights are ringing less?”
 “Is there anything I can be doing differently to support you?”; “What
opportunities do you see for me to improve my leadership of the unit?”; “I
want to always be improving my leadership. Can you tell me one thing I
could do differently?”
 “Is there something going on in the organization that you don’t fully
understand or would like to know more about?”
 Is there anything else I should know or any questions I can answer for you?
 “Who may I thank for doing a great job?”; “What employee, physician or
department has gone above and beyond to serve a patient well?”; “Tell me
about a co-worker or physician who has done something you would define
as excellent.”
4|Solution:
Employee Rounding
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Solution: Employee Rounding
Frequency of Employee Rounding
Large Departments – each employee once a quarter
Small Departments – each employee once a month
Make it a habit – Round each day you work.
When to Round
Scheduled Rounding
 Ask employees/physicians to coordinate a date/time; get it on your
calendar.
 Schedule employees/physicians for a specific date/time.
 Schedule blocks of time (preferably not in your office) and have
employees sign up and/or show up during the designated time.
 Be flexible – it may be early mornings, evenings, other off hours.
 If it’s scheduled, send a copy of the rounding questions in advance so
they can be more prepared with their responses.
Unscheduled Rounding
 Ask permission – “Is this a good time?” Be cautious not to interrupt their
work – you won’t have their undivided attention and they may have a
bad perception regarding rounding versus the positive one you are trying
to create.
 During down-time in the unit.
 Right after shift change for employees leaving their shift.
 Before or after a scheduled department meeting.
5|Solution:
Employee Rounding
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Solution: Employee Rounding
Follow Up (and Follow Through) from Rounding Builds Trust
 Communicate/Document Rounding up to senior leader(s) & CEO.
 Make documentation simple…no more than 5 minutes to document.
 “Burning Questions” forwarded through rounding should be answered in an
organization-wide communication (Note: We suggest that they are
answered in the senior leadership team meetings and recorded in the
minutes that are posted throughout the organization on the Pillar
Communication Boards).
 Bring your rounding log (See Page 11) with you to your Monthly
Accountability Meeting with your supervisor.
 Communicate with an employee during your next rounding (or before) with
any results of your follow up actions to their rounding input.
 Provide recognition (e.g., Thank You Notes to Home, etc.).
 Acquire suggested tools and equipment. Communicate the purchase to
your employees. Publicly thank the employee who gave you the
suggestion.
 Coordinate suggested training/education. Communicate to employees that
the training is in follow up to a suggestion received through rounding.
 Implement action steps for fixing reported system issues.
 Find a way to report back to your department what things are being
improved based on employee input received in rounding (see Stop Light
Report Example on Page 7).
6|Solution:
Employee Rounding
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Solution: Employee Rounding
Department/Unit: _______________________________________________
Update
Date
Employee Rounding
Recommendation
Update
Date
Employee Rounding
Recommendation
Why is it Tabled?
FUTURE
IN PROCESS
ACCOMPLISHED
Date
Employee Rounding
Recommendation
7|Solution:
Employee Rounding
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Solution: Employee Rounding
The Basics of Physician Rounding
Physician Rounding is very similar to employee rounding. Many of the
questions may be the same. Often, however, it is difficult to round with
physicians without having a scheduled time. It is suggested the nursing
leaders round with one physician per week if possible. This may actually
require setting a meeting time with them before they start their day, during
their lunch or after their office hours. If you are going to round on them
without a scheduled appointment time, you would definitely want to ask if they
have the time. Many administrative/senior leadership teams scheduled a
group rounding (entire leadership team with an individual physician or a group
of physicians).
Suggested Physician Rounding Questions:
Thank them for the work that they do to care for patients.
 What is working well?
 Any Safety Issues/Concerns? Do physicians feel safe knowing patients
are in the care of employees when they leave at night?
 Two or three things can we do to improve the quality of care to your
patients?
 Does the admission (referral, scheduling, etc.) process go well?
 Any Supplies, Equipment, Space and/or Training Needs?
 Any Burning Question(s) for Senior Leadership? Anything that
leadership can do to improve communication to physicians?
 Responsiveness of Leaders/Supervisors?
 Is there an employee and/or physician you would like to recognize and
why?
 Anything else I should know or any further questions?
8|Solution:
Employee Rounding
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Solution: Employee Rounding
Senior Leader Rounding
 Senior Leaders round less frequently than front line leaders. A minimum
of once a week is recommended. Senior leaders should be reading their
leader(s) rounding notes every day.
 If your organization has a standard rounding time established, this is a
great time for senior leaders to be in departments validating that
rounding is happening.
 Request that your front-line leaders “invite” the CEO into a department
to round on employees with a very specific agenda in mind (e.g.,
recognition regarding a specific goal accomplishment, to learn about an
improved patient care process, etc.).
 Senior leaders should “harvest and deliver wins for the leader of the
department”…..the senior leader should not play “the hero” at the
expense of the department director.
 We suggest that each senior leader rounds in a different department
weekly and schedules it with the leader of that department so
preparation can take place (e.g., You may not want your CEO to round
on an employee you have just disciplined without the CEO knowing
about it). A brief standardized report format may help prepare the senior
leader for rounding in your department. This brief report could include:
Recent accomplishments
New Equipment
Employees to Recognize
Employees to Coach/Mentor
Tough Questions/Issues
Physician Activities/Issues
Current Patient Satisfaction Results
Other goal results (employee sat, quality, etc.)
Other “heads up” issues
9|Solution:
Employee Rounding
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Solution: Employee Rounding
Support Department Leader Rounding
 Support Department Leaders have a unique ability to break down silos
in an organization by rounding with the front line employees providing
patient care. It is great to ask: “how can our department help you to
serve our patients better?”
 Support Department Leaders should round daily with their own
employees or employees in departments that are served by their
department.
 Support Department Leaders who round daily and harvest wins can
create a bond between employees in other departments. For example if an RN tells you to thank one of your support department employees
for a job well done, you now have an opportunity through recognition to
create positive feelings between your employee and the RN.
Training Leaders and Holding them Accountable for Rounding
 Rounding (with purpose) is a new leadership skill for most leaders. The
“whys and how” should be taught and practiced.
 Many organizations develop a “competency assessment” in which
leaders are observed and their skills validated.
 Having leaders post a “stop light” report is a visible sign that rounding is
happening and is gaining results.
 Having leaders document and “communicate up” their rounding reports
is also validation that rounding is being done.
 Some organizations track documented roundings and report them, by
leader, monthly at a leadership meeting.
 For organizations that adopt Monthly Accountability Meetings, rounding
logs and documentation are a key standing agenda topic. This is also a
time in which senior leaders can assist leaders with any barriers to
consistent rounding and/or improving rounding techniques.
 Be the change you want to see in others – ROUND, even if no one else
is. You can make a difference.
10 | S o l u t i o n :
Employee Rounding
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Solution: Employee Rounding
Sample Rounding Tracking Form
Week
M
T
W
R
F
Use Codes or Name or Other Identifiers in Spaces Above
Codes:
P = Patient
D = Doctor
E = Employee
P = Patient
11 | S o l u t i o n :
Employee Rounding
V = Visitor
S = Support Department
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