Patient Safety Leadership WalkRounds.
BACKGROUND
In the WalkRounds concept, a core group, which includes the senior executives and/or vice presidents, conducts weekly visits to different areas of the hospital. The group, joined by one or two nurses in the area and other available staff, asks specific questions about adverse events or near misses and about the factors or systems issues that led to these events. ANALYSIS OF EVENTS: Events in the Walkrounds are entered into a database and classified according to the contributing factors. The data are aggregated by contributing factors and priority scores to highlight the root issues. The priority scores are used to determine QI pilots and make best use of limited resources. Executives are surveyed quarterly about actions they have taken as a direct result of WalkRounds and are asked what they have learned from the rounds.


RESULTS
As of September 2002, 47 Patient Safety Leadership WalkRounds visited a total of 48 different areas of the hospital, with 432 individual comments.


CONCLUSIONS
The WalkRounds require not only knowledgeable and invested senior leadership but also a well-organized support structure. Quality and safety personnel are needed to collect data and maintain a database of confidential information, evaluate the data from a systems approach, and delineate systems-based actions to improve care delivery. Comments of frontline clinicians and executives suggested that WalkRounds helps educate leadership and frontline staff in patient safety concepts and will lead to cultural changes, as manifested in more open discussion of adverse events and an improved rate of safety-based changes.
Frankel
Allan
A
Partners HealthCare System, Boston, USA. afrankel@partners.org
Graydon-Baker
Erin
E
Neppl
Camilla
C
Simmonds
Terri
T
Gustafson
Michael
M
Gandhi
Tejal K
TK
D001900:Boston; D003142:Communication; D003628:Database Management Systems; D019033:Delivery of Health Care, Integrated / Q000592:standards; D006740:Hospital Administrators / Q000193:education; D006751:Hospital Information Systems; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D007324:Institutional Management Teams; D007857:Leadership; D019300:Medical Errors / Q000517:prevention & control; D009096:Multi-Institutional Systems / Q000592:standards; D012308:Risk Management / Q000379:methods; D017751:Safety Management / Q000379:methods* / Q000458:organization & administration; D013597:Systems Analysis; D017749:Total Quality Management / Q000379:methods* / Q000458:organization & administration