The Effect of Intentional Rounding on Patent Satisfaction in Ambulatory Care Clinics

Learning objective: Evaluate whether the inclusion of intentional rounding by nursing staff affects the satisfaction of patients attending a clinic appointment.
Description: Intentional rounding (IR) is purposeful therapeutic communication between nurses and patients during regular checks with patients using standardized protocols. Evidence suggests that IR may reduce the incidence of patient falls and medication errors, and may improve pain management, earlier detection of patient deterioration, and patient satisfaction. Further, IR is associated with better communication between staff and patients. We were unable to find a study or QI project of IR that involved nurses of ambulatory care patients.
Our health care system has an ambulatory care rooming protocol that states nursing staff members should intentionally round on patients every 15 minutes. However, this policy is inconsistently implemented across ambulatory care clinics. Patients in some clinics were not being updated properly as they waited during their appointments. Other patients were told they could leave appointments before the provider was done with the visit, causing confusion, miscommunication, potential errors, and patient dissatisfaction during appointments.
Evaluation/outcome: Our intervention used AIDET (acknowledge, introduce, duration, explanation, thank you) as a rounding communication strategy to keep patients informed during clinic appointments. Clinic nursing staff kept track of patients every 15 minutes in one of two options to time their IR: 1) whiteboards placed outside patients' doors on which rounding time was tracked or 2) timers in EPIC to monitor rounding times.
The nursing staff of three clinics participated in this project. The Press-Ganey Medical Practice Survey item “degree to which you were informed about any delays” was the project outcome measure. This item was measured on a 5-point Likert scale and provided as part of a de-identified monthly report to clinic managers. Data was collected in November 2023 (pre-intervention) and monthly from February to May 2024 (post-intervention) and analyzed by frequencies.
Conclusions: This project has assisted the nursing staff in improving patient satisfaction and communication with patients as they move through their clinic visits. We plan to continue and expand intentional patient rounding within our clinics.