Purposeful hourly rounding: How Providence CARES

Bonnie Thompson, RN, MSN
Project lead and chief operating/nursing officer, Providence Seaside Hospital

Sept. 18, 2013

As 7W develops its Accountable Care Unit, the rest of Providence St. Vincent Medical Center also is undergoing changes in care practices. It's the first hospital in the region to launch a new nursing program that enhances something we do every day: check on our patients. As other Providence hospitals prepare to follow suit, here’s a look at the new program.

Improving the patient experience
The project started with direction from Providence’s system office for all hospitals to develop a purposeful hourly inpatient rounding program. Research from 14 hospitals shows that consistent and purposeful hourly rounds result in fewer patient falls and pressure ulcers, less use of call lights and an increase in overall patient satisfaction.

By adding intent and structure to every encounter with our patients, we aim to improve their experience and safety while increasing the efficiency of our caregivers. Patient experience, fall rates and pressure ulcer rates will be monitored closely as we roll out this program over the coming months.

Developing a common practice
Oregon has not had a region-wide standard for purposeful hourly patient rounding. Some ministries have had a formal rounding program for years, resulting in impressive safety outcomes for their patients. Others will be implementing this standard for the first time.

In Oregon, the new practice – dubbed Providence CARES – was developed by frontline nurses and nurse leaders from each hospital, using evidenced-based best practices for patient safety and patient experience.

Implementing a new program
The standard developed by the Providence CARES steering team is simple. At each hour during the day, and every other hour through the night, a nurse caregiver is checking with patients to ensure:

C: They are comfortable.
A: Their needs (food, drink, call bell, reading material) are anticipated.
R: They are repositioned for comfort and skin care.
E: Their elimination needs are attended to.
S: Their safety and concerns are addressed.

Over the next several months, other hospitals will be training nursing teams and launching the Providence CARES model. This framework is another step along our journey toward excellence in patient experience, patient safety and clinical transformation. To learn more, talk with your nurse leader.