Enhancing Quality & Safety Through Reflection Rounds: A Case Study at Our Lady of Lourdes Hospital
Developed based on the Schwartz Round model, Reflection Rounds at Our Lady of Lourdes Hospital have significantly reduced Dignity & Respect themed complaints, improving patient-centered care. The rounds, led by local leads, provide a platform for frontline staff to reflect on patient experiences, leading to improved staff engagement and satisfaction. The initiative has shown positive outcomes with high staff attendance rates and plans for continued implementation across specialties.
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Reflection Rounds It s Time To Listen Name: Emily Maguire/Breffnie Carroll Department: Quality & Safety Department Our Lady of Lourdes Hospital, Drogheda
Background: Dignity & Respect (D&R) thematic Level 2 complaints in OLOL are consistently the largest proportion of complaints received (~38% per month 2020). Thematic elements include end of life care, delivery of care or alleged inappropriate behaviour. Appropriate management of themed complaints will contribute significantly to improved patient centered care. Reflection Rounds Its Time To Listen were developed based on the proven Schwartz Round model. A distinctive logo was developed and used during all sessions and correspondence. OLOL Reflection Rounds led by local lead allowing conversations and open discussion around one complaint. Clinical workshop sessions were also developed, clinically led discussion around three complaints. Aim: To develop local KPI: Proportion of D&R themed complaints received ( 27% per month). To identify key learnings from the initiative and thereby inform clinical staff and others of the effectiveness of this model. Change initiative: Improving staff engagement improves patient centred care. Refection Rounds brought together small cohort of front line staff to listen and learn from a recent patient correspondence, thereby providing a valuable opportunity for staff to reflect on their work through conversations facilitated by a local lead.
PDSA Quality Cycle: Methodology: Excellent 36% Plan: Analysis of complaint trends in OLOL 2019-2021. D&R themed complaints were further analysed (~38% per month). Aim to reduce D&R complaints to under 27%. Suitable complaints were identified to share with staff. Exceptional 61% Good 3% Figure 1: Reflection Round Satisfaction Distribution Do: Workshops (Clinical Staff) and Reflection Rounds (all staff) were developed and convened with Medical and Surgical staff. A patient family engagement round was also facilitated. Study: Benefits of the Reflection Rounds were indicated in a participant survey which showed an exceptionally positive satisfaction rate of 61% (Fig. 1). Continual monitoring of D&R themed complaints to access effectiveness. Cycle 2 - extended the reflection rounds to include surgical wards and family engagement. Cycle 3 - continual roll out of the current model to other areas i.e. bed management/phlebotomy Act: Cycle 1 - removed Reflection Rounds from lecture theatre and brought it back to local ward level.
Complaint Theme Dignity & Respect 100 RESULTS: % 0 MONTH 2021 2020 KPI (below 27%) Following the concurrent introduction of interventions, the number of D&R complaints decreased to within our local KPI ( 27%) (figure 2) Figure 2: Intervention Results Reflection Rounds are a positively evaluated initiative and an invaluable tool to improve staff engagement. 88% of staff plan to attend in the future. Areas highlighted by respondents include gaining greater insight into self and others, insight into family dynamics, communication failures and the levelling of hierarchical structures. Next Steps for OLOL 2022 Continue regular Reflection Rounds for all specialties, identify facilitators/local leads thereby ensuring sustainability of the initiative. Possible expansion of the model to include learning from case reviews. Reflection Rounds It s Time to Listen is a proven powerful method of bringing the patient experience to the front line allowing them to stop, listen and reflect.
