Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout

Abstract

BackgroundThere is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance.MethodsThis 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.Results16 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).ConclusionThis 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.

Patient safety culture in a university hospital

“…This construct reflects intangible aspects of health care, influenced exceedingly by the leadership, supervision and feedback to professionals 2 . Caregivers recognize to be inserted into an institution in which to follow the procedures is important.…”

Quality & safety in the literature: May 2019

“…Unfortunately, this intervention has not led to significant decreases in burnout 43 44. Health system leaders may consider addressing organisational change by conducting leadership walk rounds with feedback,45 setting up a time-banking system for home-related or personal services,46 or providing employees flexibility with work hours 47. The second level involves improving the fit between organisation and individual physician through professional development.…”

Reporting adverse events—Swedish Registered Nurses experience in a municipal home care context

“…Managers gain a trust through their presence that motivates the staff in their work. Sexton et al () also emphasize the presence of the manager and conclude that the culture of patient safety and staff satisfaction increase when the manager is present in the daily work. RNs in this study expressed a distrust for their managers that were absent in their daily work.…”