title: Anesthesiology leadership rounding: identifying opportunities for improvement.
abstract: BACKGROUND
  Rounding that includes participation of individuals with authority to implement changes has been advocated as important to the transformation of an institution into a high-quality and safe organization. We describe a Department of Anesthesiology's experience with leadership rounding.
  
  
  METHODS
  The Department Chair or other senior faculty designate, a quality coordinator, up to four residents, the ward charge nurse, and patient nurses participated in rounds at bedsides.
  
  
  RESULTS
  During a 23-month period, 14 significant opportunities to improve care were identified. Nurses identified 5 of these opportunities, primary team physicians 2, the rounding team 4, and patients or their family members another 3. The anesthesiology service had sole or shared responsibility for 10 improvements.
  
  
  CONCLUSIONS
  A variety of organizations track specific measures across all phases of the patient experience to gauge quality of care. Chart auditing tools for detecting threats to safety are often used. These measures and tools missed opportunities for improvement that were discovered only through rounding. We conclude that the introduction of leadership rounding by an anesthesiology service can identify opportunities for improving quality that are not captured by conventional efforts.
authors.affiliation: Anesthesiology at the University of Florida College of Medicine in Gainesville, FL,USA. dgravenstein@anest.ufl.edu
authors.forename: Dietrich
authors.initials: D
authors.lastname: Gravenstein
authors.forename: Susan
authors.initials: S
authors.lastname: Ford
authors.forename: F Kayser
authors.initials: FK
authors.lastname: Enneking
mesh_terms: D000776:Anesthesiology / Q000592:standards*; D003695:Delivery of Health Care / Q000592:standards*; D017598:Efficiency, Organizational; D006801:Humans; D007857:Leadership; D008505:Medical Staff, Hospital; D011182:Postoperative Care / Q000592:standards; D017064:Process Assessment, Health Care; D058996:Quality Improvement; D056164:Teaching Rounds / Q000592:standards*