One of the most important activities of a hospital CEO is Rounding.
In the last issue I wrote about being fair, honest and open. This issue we will look at Leader Rounding.
In my years as a hospital leader, coaching CEOs and managers, there is one thing I have observed in the C-suite of most hospitals. That is hospital leaders sitting in their office. For long periods of time. How do I know this? Whenever I go to a new hospital to work with a CEO, I ask them to give me a tour of the building. It is very easy to tell if a CEO is not a “Rounder.” On the tour you hear comments from the staff, “Hey, what are you doing here?” or “Man, we haven’t seen you in a long time.” Or “When did they let you out of your cage?” An informal estimate on my part is that probably 20% of CEOs and COOs round, while the other 80% hole up waiting for the next attack. Rounding won’t necessarily make you a great leader, but I promise you cannot be a great hospital leader without rounding.
When I first started in healthcare, I did not know what leadership rounding was. I thought only doctors and nurses made “rounds” during the work day. But, what I was doing was MBWA, management by walking around. That’s what it was called in the old days. After I read Quint Studer’s, excellent book, Hardwiring Excellence, I began “rounding.”
Rounding, especially for a CEO is not difficult. Especially in a rural hospital. You can usually walk the whole hospital in less than an hour. Those leaders who round in a larger hospital need to divide it up, visiting different departments each day. And, before I forget, you need to make sure all of your reports are rounding too. It varies by position, but they can figure it out. Below are suggestions on rounding.
Rounding by Department
Arrive early. After you finish your coffee, get out of your office. Devise a department order that will be good for you. Start with clinical departments, but don’t forget the business office and other financial departments. Some CEOs do the tour the same every time. Others vary to keep things fresh. It doesn’t matter, just do it. At least two days per week come in between 6:00am and 6:30am so you can visit with those who are finishing their shift. They will appreciate it. Be friendly. If you are new, introduce yourself and ask people about their family. Tell them something about yourself, ask them what they do. Finally, ask them if they have all the tools to do their jobs. The tool I’ve been asked the most about over the years is the coffee maker. This may not seem very important, but when you’ve been working a twelve-hour shift and it’s 3:00am coffee is a lifeline. It is amazing how much mojo you get when you (personally) bring in a new coffee maker to the department. While I’m on coffee, never make employees kick in for coffee. Hopefully this is not a problem for you at your hospital. But, coming in new to one hospital, I found a money jar by the coffee machine. I immediately put an end to that and provided good coffee for staff to drink all day. Finally, don’t forget to round on physicians early. It may be the only time you can see them in the day. Ask them two questions. “Do you have everything you need?” and “Do you think clinical staff has everything they need?”
As you round you may find people have ideas for improvement, if they do, and it’s OK with their supervisor, put that person on the assignment to see the project through. Do not, under any circumstances, ignore their idea. All ideas from staff are important.
Rounding on Patients & Families
It’s important from time to time to round on patients and families. Do this in conjunction with the Chief Nursing Officer. Patients and families feel like they have received a special visit when hospital leadership stops by. It’s not difficult. Always knock first, go in and you only have to ask one question, “How are we treating you?” The conversation will develop from there. If the answer is positive, ask why and was there anyone who was extra good. If they mention a nurse, physician, tech or housekeeper, ask them for the employee’s name and later write them a nice note. It’s also a great time to build up the talent and attributes of your staff. “I see your nurse is Katy. She is one of our best. She’s been here for over 5 years and people just love the care she provides.” It’s especially good if you can do it in front of Katie.
If the patient or family responds negatively, it is your job to make sure the Chief Nursing Officer got this so that it can be remedied as soon as possible.
Some people think a CEO is over-stepping his/her bounds by rounding on patients. However, if everyone is hitting on all cylinders, and we all care about the safety and comfort of our patients (and their families) and we don’t use it as an excuse to beat up on our people for not doing everything perfect, it helps us find and fix problems before they snowball.
Today we have talked about one of the important traits of a hospital leader, Rounding. It’s important for your staff—they need to see you being involved in the hospital; and it’s important for you because you become involved and find out how your staff is really taking care of the patients. After just a few weeks, you will feel more confident about what is going on. You will have a better handle on your hospital. If you’re not yet rounding, start today. If you already round, maybe you have some ideas that can help. If so, please let me know and I’ll pass them along. Share any ideas you have on rounding. Again, if you have any questions please email them to me and we can talk about it.
My email is: firstname.lastname@example.org. Or call me at 251-610-7661.