Abstract: Organizations that have embraced safety as a core value have a strong commitment to actions, behaviors, and choices intended at preventing harm (Chassin & Loeb, 2013). Eliminating preventable patient harm is a goal of the Reaching for Zero journey. Creating a culture of safety based on trust, reducing adverse events, and focusing on process improvement is crucial. Leadership practices will impact human performance and increase consistency in outcomes. Leadership rounding is an important tool utilized by high reliability organizations to create superior levels of predictable, repeatable processes, share feedback, and learning. Rounding provided an opportunity for leaders to connect with frontline staff and patients, directly observe what affected daily operations, and identify any issues needing to be addressed. Leader rounding is valuable as an ongoing part of an organizational-wide initiative to improve safety, quality, and customer service. Rounding is a leadership practice that can be used to strengthen the Reaching for Zero journey. The orthopedic unit embraced focused safety work applying Reaching for Zero leader rounding to support change, learning, and transparency concentrating on identifying potential safety issues (Chassin & Loeb, 2013). Roger’s Diffusion of Innovation (DOI) model guided the leader rounding implementation.A cross-sectional study methodology was utilized for the project. The 2017 Agency for Healthcare Research and Quality (AHRQ) Culture of Safety survey and Advisory Board Employee Engagement survey results prior to implementation of leader rounding served as the baseline of the safety culture and employee engagement. Post-implementation of leader rounding, the AHRQ Culture of Safety Survey and Advisory Board Employee Engagement survey was repeated. Overlapping the culture of safety and employee engagement surveys was the key in determining a change in the culture on the orthopedic unit. Patient harm events were also measured prior to implementation of leader rounding and post-implementation of leader rounding.The outcome of this project was an improvement in the AHRQ Culture of Safety Survey and the Advisory Board Employee Engagement Survey results post-implementation of leader rounding methods. The outcome measurement of the number of patient safety reports decreased by 10% from 2017 to 2018. Patient harm events decrease by 16% from 2017 to 2018. The results demonstrated a decrease in harm events as the safety culture improved as the unit embraced high reliability principles. The orthopedic unit’s employee turnover decreased from 22.7% in 2017 to 12.9% in 2018.
Keywords: Culture of safety,Employee engagement, Leader rounding