Rhonda Ward, Littleton Adventist Hospital's Chief Nursing Officer and Joanne Carlson, director of patient experience are two champions of the hospital's commitment to hourly rounding.

At Littleton Adventist Hospital our goal is to be the best hospital. We want our patients to have the best experience possible.  To ensure this we take a proactive approach to patient care, checking in on our patients hourly.

“Instead of waiting for a patient to ask for help, we try to anticipate their needs,” says Joanne Carlson, patient experience director at Littleton Adventist Hospital.

Making sure the patient is comfortable and assessing the risk of pressure ulcers, scheduling patient trips to the bathroom and asking patients to describe their pain level are all addressed in these hourly visits.

Staff also checks for environmental concerns that could lead to a patient using the call light such as tissues, the telephone, or a glass of water, Carlson says.

A recent research study sponsored by the Studer Group, a health care leadership and service excellence consulting firm, revealed that regular nursing rounds every one to two hours were associated with a significant reduction in call light use, fewer patient falls, and greater patient satisfaction.

The hospital implemented hourly rounding in September 2008. In the six months since implementation, patient satisfaction is on an upward trend and has risen nearly 10 percent.

“We aim to have our patient satisfaction scores in the 90th percentile,” said Carlson. “When we reach that goal, we know we're doing everything we can to provide our patients the best healing experience possible.” As of February 2009, patient satisfaction scores at the hospital were in the 83rd percentile.

Not only does hourly rounding help to improve patient care, but it can save nurses valuable time, Carlson adds. If patients use their call lights less frequently, nurses are less likely to run back and forth answering calls. In the Studer Group study, hourly rounding reduced call light use by 38 percent.

After a one-month stay at Littleton Hospital one patient remarked, “I wait if I need something, because I know the nurse is returning soon... I'll only use the call light if they just left the room and something came up.”

“Hourly rounding creates a sense of trust and confidence between nursing staff and patients, which ultimately leads to better care” Carlson says.

Hourly rounding has also impacted patient safety. While doing her hourly rounds, one nurse walked in to find a patient looking in her purse for medications that could have had an adverse effect with her treatment plan. Luckily, the nurse was able to stop the patient before she had time to take any of the medications.

Currently, managers, directors and hospital administrators round on patients as a way of assessing and acknowledging implementation and effectiveness of hourly rounding throughout the hospital. According to Carlson, the staff enjoys receiving immediate feedback from patients especially when an administrator is acknowledging their efforts.

“Implementing hourly rounds throughout an entire hospital takes a lot of hard work,” says Carlson. “But what we've done, thus far, has received rave reviews. Satisfied patients make the whole process worth it.”