Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout.
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2018-04
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BACKGROUND:There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance. METHODS:This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings. RESULTS:16 797 of 23 853 administered surveys were returned (70.4%). 5497 (32.7% of total) reported that they had participated in WR, and 4074 (24.3%) reported that they participated in WR with feedback. Work settings reporting more WR with feedback had substantially higher safety culture domain scores (first vs fourth quartile Cohen's d range: 0.34-0.84; % increase range: 15-27) and significantly higher engagement scores for four of its six domains (first vs fourth quartile Cohen's d range: 0.02-0.76; % increase range: 0.48-0.70). CONCLUSION:This WR study of patient safety and organisational outcomes tested relationships with a comprehensive set of safety culture and engagement metrics in the largest sample of hospitals and respondents to date. Beyond measuring simply whether WRs occur, we examine WR with feedback, as WR being done well. We suggest that when WRs are conducted, acted on, and the results are fed back to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making and the emotional exhaustion component of burnout. Whether WR with feedback is a manifestation of better norms, or a cause of these norms, is unknown, but the link is demonstrably potent.
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Sexton, J Bryan, Kathryn C Adair, Michael W Leonard, Terri Christensen Frankel, Joshua Proulx, Sam R Watson, Brooke Magnus, Brittany Bogan, et al. (2018). Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout. BMJ quality & safety, 27(4). pp. 261–270. 10.1136/bmjqs-2016-006399 Retrieved from https://hdl.handle.net/10161/19119.
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John Bryan Sexton
Bryan is the Director of the Duke Center for the Advancement of Well-being Science. He leads the efforts around research, training and coaching, guiding quality improvement and well-being activities.
A psychologist member of the Department of Psychiatry, Bryan is a psychometrician and spends time developing methods of assessing and improving safety culture, teamwork, leadership and especially work-force well-being. Currently, he is disseminating the results from a successful NIH R01 grant that used RCTs to show that we can cause enduring improvements in healthcare worker well-being.
A perpetually recovering father of four, he enjoys running, using hand tools on wood, books on Audible, and hearing particularly good explanations of extremely complicated topics.
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