title: Hourly rounding in the pediatric emergency department: patient and family safety and satisfaction rounds.
abstract: BACKGROUND
  Methods of increasing patient and family involvement in and understanding of their medical care are plentiful, and hourly rounding specifically has shown benefit in several clinical settings. Although the approach has shown a variety of advantages in other areas, its use in urgent care pediatric settings is not well described.
  
  
  OBJECTIVE
  This study evaluates the institution of patient satisfaction and safety rounding ("hourly rounding") in the pediatric emergency department (ED) setting.
  
  
  METHODS
  Hourly rounding was instituted in a tertiary care, urban pediatric ED using a formal mnemonic, after staff education, training, and observation to ensure standardization of approach. Pre- and postintervention data were collected, including frequency and type of nursing call bell usage, family discharge opinion survey, and vendor-collected survey results.
  
  
  RESULTS
  Two weeks of nursing call bell activation data and 200 pre- and postintervention family discharge opinion surveys were collected, evenly divided between pre- and postimplementation data. Call bell activations prior to and after hourly rounding institution were 102 and 150 respectively, with accidental activations comprising the majority. Additionally, vendor-collected patient satisfaction data were analyzed. There were no changes in patient scoring when pre- and postimplementation data were compared.
  
  
  CONCLUSIONS
  This model of hourly rounding shows no measurable improvement in patient satisfaction or provider-patient communication using call bell data, family discharge opinion surveys, or vendor-collected patient satisfaction data. Further studies may be indicated to identify different methods of analyzing the effects of this method, and to examine alternative methods of improving these outcomes in the pediatric ED setting.
authors.affiliation: Department of Pediatric Emergency Medicine, Yale-New Haven Children's Hospital, New Haven, Connecticut.
authors.forename: Beth L
authors.initials: BL
authors.lastname: Emerson
authors.affiliation: Department of Pediatric Emergency Medicine, Yale-New Haven Children's Hospital, New Haven, Connecticut.
authors.forename: Kendra B
authors.initials: KB
authors.lastname: Chmura
authors.affiliation: Department of Pediatric Emergency Medicine, Elmhurst Hospital Center, Elmhurst, New York.
authors.forename: David
authors.initials: D
authors.lastname: Walker
mesh_terms: D003142:Communication; D016529:Emergency Nursing / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D024802:Nurse's Role; D017060:Patient Satisfaction; D010372:Pediatrics; D011446:Prospective Studies; D012449:Safety; D013997:Time Factors
keywords: AIDET; call bell use; hourly rounding; patient satisfaction; pediatric emergency medicine