Jun 15 2021

How Digital Rounding Helped One Hospital Improve Its Patient Experience Scores

Northwell Health’s Lenox Hill Hospital in New York enhanced nurse-patient communication and responsiveness by implementing a digital rounding tool.

Since 2018, Northwell Health’s Lenox Hill Hospital in New York has steadily improved patient satisfaction, raising its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores for responsiveness, nurse-patient communication and likelihood to recommend by using a digital rounding platform.

Using a bottom-up approach to implementation, Lenox Hill built consensus among cross-functional teams. Joe Leggio, associate director and vice president of experience services at Lenox Hill, says the hospital designed a rounding process using technology from CipherHealth that reflected institutional priorities as well as preferences of the on-the-ground employees who would be carrying out patient rounds.

Improving Patient Experience Requires Communication and Structure

“There’s so much literature out there in the world of patient experience that supports that nurse leader rounding and visiting patients every day is one of the strategies you can use to drive success, improve HCAHPS scores and improve experiences,” says Leggio. “Without technology, we say we’re doing that, and we hope we’re doing that, but the information we gather is circumstantial, singular and only as good as someone’s memory. That’s problematic in nature when trying to have a process improvement approach and trying to quantify and analyze data to find out what our patients are actually telling us.”

Leadership at Lenox Hill knew the process of visiting people would stay the same, but they needed a tool to help capture data and structure those visits while keeping interactions unique. Staff members wanted to know what they didn’t know, says Leggio. It can be weeks before hospital staff see results from an HCAHPS survey, and by then there’s not much the hospital can do to rectify a bad experience. Digital rounding technology allows Lenox Hill to address problems in real time.

READ MORE: How mobile devices are meeting the soaring need for care.

“We can understand what the patient is saying and start to anticipate their needs, allowing us to be proactive rather than reactive,” says Leggio.

Leggio says the hospital created separate rounding scripts for nurse leaders, key surface facilitators, the experience team, the food and nutrition team, and environmental services team. The app can filter patients by name or room number, but Leggio says staff members prefer to filter by the last time someone rounded on a patient.

“We’re all using the same tool, so everyone can see who rounded on a patient previously and what was discussed. It looks like we’re talking to each other, and that’s because we are,” he says. “Nurses’ shifts overlap by half an hour, so they can transfer vitals and medication information. That’s the clinical safety protocol, but we needed a version of that for the person protocol, which includes making sure patients are comfortable.”

Including Users Early On Is Key to Successful Tech Implementation

Leggio’s team began the rounding platform implementation by speaking with nurses about why they round, what they do while rounding, what would make that process easier and what would make it more difficult.

“The most important thing isn’t the technology itself but what it enables you to do,” he says.

Nurses gave their input on how to build the script, the questions that would be asked during rounding and how the escalation process would work.

Joe Leggio
The most important thing isn’t the technology itself but what it enables you to do.”

Joe Leggio Associate Director and Vice President of Experience Services, Northwell Health’s Lenox Hill Hospital

“They built it with us, which is so important. If you don’t do it that way you won’t be successful,” says Leggio. “Failure isn’t the technology’s fault, but often the fault of a policy approach.”

The hospital started a pilot program for the technology in four or five of its units. The goal was for clinicians to get comfortable using the iPad device and digital rounding tool, and to learn how to work the questions into conversations in an authentic way without the device pulling their focus away from the patient.

Implementation of the technology takes time, says Leggio — more time than hospital leadership would prefer. He suggests that healthcare organizations looking to implement digital rounding or similar technologies create a pilot program to work out any issues before scaling it systemwide. While there may be growing pains or user experience hurdles, Leggio says healthcare organizations need to be patient and resilient to succeed and create a better experience for employees and patients.

LEARN MORE: Virtual rounding supports communication during a pandemic.

And, he adds, the improvement in HCAHPS scores isn’t about the number, but about the people behind the number and whether they had a good experience. For one quarter during the COVID-19 pandemic, Lenox Hill reallocated some of the tablets used for digital rounding to allow patients to connect with families using FaceTime. Leadership was able to compare the HCAHPS surveys of people who experienced digital rounding to those of patients who didn’t.

“There was a statistically significant improvement in almost every domain, from 3 to 20 percentage points, just from digital rounding,” says Leggio. 

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