CenTrak

RTLS Enabled Nurse Rounding Increases Patient Satisfaction

The article discusses how implementing RTLS-enabled nurse rounding programs, which ensure timely and well-documented rounds focusing on key patient needs like pain, toileting, and positioning, can significantly improve nurse-patient communication, enhance HCAHPS scores—particularly in nurse communication and staff responsiveness—and thereby increase patient satisfaction and hospital reimbursement under CMS's Value Based Purchasing program.

Improving Nurse Rounding Programs with RTLS Enabled Solutions

"Trust, but verify" is a Russian proverb made famous by Ronald Reagan during the late days of the Cold War. This expression is relevant when considering HCAHPS scores and how a well-executed nurse rounding program can positively impact patient satisfaction. Despite the proven benefits, many hospitals continue to perform poorly in this area.

The negative financial effect of poor HCAHPS scores on hospital reimbursement is widely recognized in the healthcare community. For larger hospitals, millions of dollars in reimbursement incentives from the Centers for Medicare and Medicaid Services (CMS) are contingent upon the Value Based Purchasing (VBP) program. A hospital's Total Performance Score (TPS), with HCAHPS results as a significant contributor, forms the basis for each hospital's reimbursement incentive adjustment.

The HCAHPS survey dimension with the highest correlation to its "Overall Hospital Ranking" is "Communication with Nurses." Press Ganey's research found that five HCAHPS dimensions—nurse communication, staff responsiveness, pain management, communication about medicine, and total score—tend to cluster together. This cluster impacts 15% of a hospital's VBP score. High performance in these dimensions is therefore very important.

Nurse rounding can help in all these areas. Most nurse rounding protocols use some variation of the "3P's" (or 4 or 5): pain, potty, and position, as part of their purposeful hourly rounding programs. As one hospital executive put it, "Every time a patient rings the call bell it is a chance for us to fail." While this may seem cynical, data shows that regular staff presence in patient rooms reduces the demand for patient calls.

Every hospital visited in the last three years has implemented a nurse rounding program. However, the quality of execution varies. Key questions include:

  • How is rounding documented?
  • Are rounds performed on time every hour or two?
  • Is historical data compiled and analyzed?
  • How is real-time compliance monitored?

An industry has developed around supporting hospital rounding programs, including consulting firms, paper-based rounding logs, IT-based solutions (apps for smartphones and tablets), and wall-mounted touch screens for acknowledging rounding events. These tools can be used alone or in combination.

Despite these resources, many hospitals still see declining VBP scores. The challenge is that each tool requires caregivers to take action—writing something down or touching a screen. The system can break down when staff must manually acknowledge or initiate rounding cycles.

Linda Groah, CEO/executive director of AORN, noted, "No one can sabotage a healthcare technology deployment faster than a staff nurse."

The Missing Ingredient: Real-Time Locating System (RTLS) Technology

RTLS technology eliminates the need for staff to interact with the rounding compliance system. CenTrak's Clinical Grade™ locating technology operates in the background. Caregivers wear CenTrak's RTLS staff badge behind their ID badges, and the system automatically detects when a caregiver enters a room and tracks the time spent with each patient. Only CenTrak RTLS offers the certainty-based accuracy required for effective monitoring.

A unique RTLS-enabled feature is its proactive nature. A visual floor plan of the nursing unit is displayed on a large screen at the nurse's station (or another strategic location) to remind nurses when rounding is due or overdue for a particular room. Customizable reports allow managers and executives to review compliance and historical performance. Integrations with wireless devices and software applications from CenTrak's partners provide additional options for proactive rounding reminders.

The benefit of nurse rounding is clear, but effective execution is critical. Nurses need to focus on providing excellent care, which is why CenTrak's proactive RTLS technology does not require staff interaction with the system.

Additionally, investing in CenTrak's RTLS-enabled nurse rounding solution can also support:

  • Hand hygiene compliance
  • Asset tracking and management
  • Patient workflow improvement
  • Temperature and environmental monitoring
  • Infant security
  • Other uses that improve patient care and hospital operations

Trust, but verify.