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Walkrounds in practice: corrupting or enhancing a quality improvement intervention? A qualitative study
Joint Commission Journal on Quality and Patient Safety
|August 19, 2014
Summary
Local adaptations to leadership walkrounds can change their purpose, potentially undermining patient safety culture improvements. Executives must ensure these adjustments align with original goals to avoid surveillance and staff alienation.
Area of Science:
- Healthcare Management
- Patient Safety Research
- Organizational Behavior
Background:
- Leadership WalkRounds are promoted to enhance leadership engagement in patient safety and improve safety culture.
- Evidence for the effectiveness of walkrounds is mixed.
- Hospitals in the English National Health Service (NHS) were encouraged to adopt walkrounds.
Purpose of the Study:
- To explore the practical implementation of walkrounds in the English NHS.
- To identify variations in walkrounds' implementation that may affect their impact on safety and culture.
Main Methods:
- Utilized data from 82 semistructured interviews within the English NHS.
- Employed the constant comparative method for data analysis.
Main Results:
- Local, pragmatic adjustments to walkrounds can significantly alter their nature and reception by frontline staff.
- Modifying walkrounds may increase executive value but risks shifting focus from actionable safety insights to surveillance.
- Such modifications can alienate frontline staff and lead to inaccurate conclusions.
Conclusions:
- Findings offer explanations for the mixed evidence on walkrounds' effectiveness in fostering a safety culture.
- Executives must critically evaluate adaptations to ensure they support, rather than conflict with, the intended change model of walkrounds.
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