Nurse-Leader Collaborative Improvement Project: Improving Patient Experience in the Emergency Department

Studies show that nurse rounding is an effective means to increase patient satisfaction and quality of care and decrease patient-safety events. There is evidence to support that daily leader rounding improves patients' hospital experience as well. Patients' experience increased confidence in their care providers, and leaders are able to address service concerns proactively. Furthermore, recent studies have addressed patient satisfaction in the ED setting as having an impact on patients' perceptions of the health care institution as a whole. Our objective was to demonstrate the effect of hourly nursing rounds and daily leader rounds on the ED patient experience.

We used a pre- and postintervention evaluation of Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) survey scores. Two groups of stakeholders developed standard work for rounding. The leader group and the bedside nursing care groups used the evidence cited in this article to create their standard processes.

During the 2-month pilot period, patient experience scores-as measured by 5 survey questions-all improved. Results will continue to be tracked monthly and reported to all stakeholders in real time to help hardwire the process change.

Through collaboration and a participative approach, nurses and leaders used the current evidence from scholarly nursing literature as well as Lewin's theory of change to guide a successful approach to rounding and improving patients' experiences when receiving emergency care.