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Focusing on the Goals of a Best Practice to Better Meet Patient Needs: Rounding with Behavioral Health Patients

by Deirdre Mylod, PhD, Executive Director, Institute for Innovation | Aug 18, 2015

When transforming the strategic objective of patient experience efforts from service behaviors to truly reducing patient suffering, it’s imperative that we keep the goals and purpose of the work front and center. Often a service behaviors approach seeks to satisfy patients and earn high scores. A holistic patient experience approach, on the other hand, strives to meet patient needs and reduce suffering. Both approaches can improve patient evaluations of care, but when the goal is focused on the patient outcome, and not the scores, it is framed in a way that encourages more compassionate, connected care.

The process of hourly rounding in the inpatient setting can be viewed through both of these lenses. When considered as a service behavior, rounding can feel like yet another task required from staff to help patients feel more positive about their experience. But hourly rounding is actually a redesign of care. It is a different method of proactively meeting patient needs so  pain is better controlled, toileting needs are assisted more quickly (reducing likelihood to fall), questions are answered more readily, and patients feel more assured that they are being monitored and develop deeper trust in their care team. Hourly rounding seeks to proactively meet patient needs and reduce anxiety. As a result, patient experiences are better—and their subsequent evaluations of care reflect the enhancement.

Starting with the goals of a practice is particularly important when we need to modify a practice. To modify a practice while retaining the desired benefits, we must be mindful of the intended outcomes. A great example of modifying a process through focus on the goals occurred when NewYork-Presbyterian (NYP) Westchester Division worked to adapt hourly rounding to the Inpatient Behavioral Health setting. They began by understanding the goals of rounding: to proactively meet patient needs and build trust. They acknowledged from the beginning that the process would need to be very different than rounding in an acute care inpatient setting. They evolved the process with their own patient population in mind to bring a new and innovative process to behavioral health care. They sought feedback from patients and staff to stay true to their intentions. As a result, their new process meets the goals of hourly rounding, even though the steps look very different than the typical practice within a medical setting. You can read more in the NYP Westchester Division rounding story.