Revealing and Resolving Patient Safety Defects

The Impact of Leadership WalkRounds on Frontline Caregiver Assessments of Patient Safety

WalkRounds is a program instituted by hospital leadership staff to enhance patient safety through direct interaction with front-line caregivers. However, little research has been done showing whether or not such interventions are effective in increasing patient safety, or which interventions are most effective. One issue identified by the authors of this paper is that hospital leadership does not necessarily differentiate between rounds done to evaluate patient satisfaction or to assess compliance with policies from rounds conducted specifically to assess patient safety.

In order to more rigorously evaluate the efficacy of WalkRounds programs, seven acute care hospitals and one ambulatory center in Massachusetts were invited to participate in a study to examine the impact of Patient Safety Leadership WalkRounds on the safety climate. The study lasted from August 2002 to April 2005 and used the Safety Attitudes Questionnaire (SAQ). The SAQ contains statements such as "Medical errors are handled appropriately in this clinical area" and "I would feel safe being treated here as a patient" and respondents rate them on five-point scale of agreement. This paper presents results from only two hospitals, mainly because the other hospitals were not able to produce enough meaningful data to be included in the analysis.

Results showed that WalkRounds provided a structure and mechanisms for caregivers to address safety issues. Improvements were particularly notable through agreement with the statement "I am encouraged by my colleagues to report any patient safety concerns…" indicating that WalkRounds increased a sense of shared responsibility for patient safety. The authors concluded that WalkRounds, when used in conjunction with tools such as the SAQ, can be very useful at diagnosing strengths and weaknesses in patient safety, while also being a relatively low-cost intervention. An important finding of this study is that only two of seven hospitals were successful at maintaining WalkRounds programs. The successful institutions had commitment from leadership, a champion trained in safety, and resources to manage data produced by the study.