Leadership Rounding App
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Share PrintOur mission is to cultivate trust and foster engagement by revolutionizing communication between employees and leadership through our digital rounding app. By streamlining issue tracking and accelerating resolutions, we demonstrate that leadership is actively listening, which boosts employee satisfaction and enhances Veteran care. This innovative approach not only improves workplace culture but also reinforces our commitment to providing the best possible care to Veterans.
Origin:
January 2021, Augusta VA Medical Center-Uptown (Augusta Uptown), Richard L. Roudebush Veterans' Administration Medical Center (Indianapolis, Indiana)
Adoptions:
29 successful, 4 in-progress
Awards and Recognition:
Recognized by Under Secretary of VA and Coined, VEO best practice adoption for rounding, FY24 Shark Tank Semi-Finalist
Partners:
Patient Care Services
Recent Updates
Overview
The problem
Context: Vital feedback and data were scattered across multiple, disconnected channels—such as safety inspections, committee reports, suggestion boxes, and paper-based surveys—creating a fragmented system that hindered timely responses to employee concerns. The absence of a centralized, efficient method for tracking these concerns made it nearly impossible for leadership to act swiftly, further eroding trust and compromising the facility's ability to function as a High Reliability Organization (HRO).
Initial Goals:
Develop a Streamlined Digital Solution:
Create a dedicated application to centralize the tracking of employee concerns raised during WeCare and HRO leadership rounds.
Enhance Responsiveness:
Enable leadership to quickly acknowledge and address employee concerns, demonstrating active listening and commitment to resolution.
Recognize Achievements:
Provide a platform to promptly acknowledge and celebrate employee accomplishments, boosting morale.
Improve Issue Tracking and Resolution:
Implement consistent tracking mechanisms to ensure no concern is lost, leading to faster resolution times.
Boost Satisfaction and Safety:
Increase both employee and Veteran satisfaction by addressing problems early, thereby enhancing overall safety and quality of care.
Rebuild Trust:
Foster a culture of transparency and reliability to strengthen trust between employees and leadership.
By achieving these goals, our innovation seeks to enhance communication pathways, promote a culture of safety, and align with VHA's mission to accelerate its journey toward becoming a High Reliability Organization. See more
- VISN 7 HRO presentation VISN 7 HRO presentation
Files
The solution
Key Features of the Solu ... To address the communication gap between employees and leadership, we developed a Digital Application for Leadership/WeCARE Rounding. This innovative app serves as a centralized platform that streamlines the process of leadership rounding, enabling real-time logging, tracking, and resolution of employee concerns and commendations.
Key Features of the Solution:
Unified Rounding Platform:
Integration of WeCare and HRO Rounds: The app merges WeCare and High Reliability Organization (HRO) leadership rounding practices into a single, cohesive platform. This ensures consistency in data collection and facilitates a holistic approach to employee engagement.
Real-Time Issue Logging and Tracking:
Instant Reporting: Leaders can use their VA-issued mobile devices to immediately log issues, concerns, or employee accolades during rounds.
Automated Routing: Logged entries are automatically directed to the appropriate departments or personnel responsible for resolution, expediting the response process.
Enhanced Communication Channels:
Two-Way Feedback: The app enables continuous dialogue between staff and leadership, ensuring concerns are acknowledged and addressed promptly.
Notification System: Built-in alerts keep both employees and leaders informed about the status of reported issues.
Data Centralization and Analytics:
SharePoint and Power BI Integration: The app utilizes SharePoint lists connected to Microsoft Power BI, creating dynamic dashboards that visualize rounding data, issue trends, and resolution times.
Sentiment Analysis: Employing Power BI's AI capabilities, the app analyzes employee feedback to gauge overall sentiment, helping leadership understand and address underlying morale issues.
Customization and Scalability:
Adaptable Design: The app is designed to be easily customizable to fit the specific needs of different facilities, with editable graphics and adjustable settings.
Ease of Implementation: With step-by-step video tutorials and minimal technical requirements, the app can be deployed in other facilities within 1-3 months.
Privacy and Confidentiality:
Anonymization Options: Employee identities can be concealed within the app to protect confidentiality while still allowing issues to be tracked and resolved.
Impact of the Solution:
Increased Engagement:
The average number of monthly rounds increased from 28 to 77—a 175% increase—indicating higher engagement levels between staff and leadership.
Faster Issue Resolution:
The average time to resolve reported issues decreased from 22 days to less than 7 days for half of all concerns, significantly improving responsiveness.
Improved Trust and Morale:
By demonstrating a commitment to promptly addressing concerns, the app has helped rebuild trust in leadership and improve overall employee satisfaction.
Enhanced Safety and Care Quality:
Early identification and resolution of problems contribute to a safer environment for both employees and Veterans, aligning with the VHA's mission to provide exceptional care.
Implementation Process:
Development of the App:
Created using Microsoft Power Apps, integrating seamlessly with existing VA IT infrastructure.
Resource Provisioning:
Provided facilities with access to a OneDrive folder containing all necessary files, including Power Automate workflows, app packages for PC and iPhone, and instructional videos.
Step-by-Step Deployment:
Users follow guided instructions to set up SharePoint lists, import the app, and configure connections and notifications.
Training and Support:
Offered training sessions via Microsoft Teams and comprehensive documentation to ensure smooth adoption.
Customization:
Facilities can customize the app's interface and questions to suit their specific rounding practices and branding.
Conclusion:
The implementation of the Digital Application for Leadership/WeCARE Rounding has effectively addressed the problem of fragmented communication and lack of trust between employees and leadership. By centralizing and streamlining the rounding process, the app has enhanced transparency, increased engagement, and expedited the resolution of concerns, ultimately contributing to improved employee satisfaction and better care for Veterans. See more
The results
1. Increased Leadership Engagement
Rounding Frequency:
Before Implementation: Averaged 28 leadership rounds per m ... The implementation of the Digital Application for Leadership/WeCARE Rounding at our originating healthcare facility led to significant improvements in communication, trust, and operational efficiency. The following key impacts were observed:
1. Increased Leadership Engagement
Rounding Frequency:
Before Implementation: Averaged 28 leadership rounds per month.
After Implementation: Increased to an average of 77 rounds per month.
Impact: This represents a 175% increase in rounding activities, indicating heightened engagement between leadership and staff. The increased presence of leadership fostered stronger relationships and more frequent opportunities for open dialogue.
2. Enhanced Issue Resolution Efficiency
Faster Resolution Times:
Before Implementation: Average issue resolution time was 22 days.
After Implementation: Half of all issues were resolved within 7 days.
Impact: The app streamlined the reporting and tracking process, leading to a 68% reduction in average resolution time for many issues. This efficiency demonstrated to employees that their concerns were being taken seriously and addressed promptly.
3. Improved Employee Trust and Satisfaction
Positive Shift in Employee Sentiment:
Feedback Analysis: Using Power BI's AI capabilities, employee comments were analyzed for sentiment.
Results: There was a noticeable increase in positive feedback and a decrease in negative comments.
AES Data Improvement: A year after implementing the app, trust and engagement scores improved according to the All Employee Survey (AES).
Impact: Employees felt more heard and valued, leading to increased morale and a stronger sense of trust in leadership.
4. Strengthened Safety Culture
Early Issue Detection:
Process: Immediate logging of concerns allowed for quicker identification of potential safety issues.
Impact: By addressing problems promptly, the facility enhanced both employee and Veteran safety, aligning with the principle of "do no harm."
Alignment with HRO Principles:
Inclusion of HRO-Focused Questions: The app integrated High Reliability Organization (HRO) concepts into rounding questions.
Impact: This promoted a culture of safety and continuous improvement, essential for high-quality Veteran care.
5. Recognition of Employee Achievements
Immediate Acknowledgment:
Functionality: Leaders could instantly log and share employee accomplishments during rounds.
Impact: Prompt recognition boosted employee morale and reinforced positive behaviors, contributing to a more supportive work environment.
6. Data-Driven Decision Making
Real-Time Insights:
Tools Used: SharePoint lists connected to Microsoft Power BI provided dynamic visuals.
Data Tracked:
Areas Rounded: Identification of departments visited.
Round Participants: Tracking of leadership and staff engagement.
Employee Sentiment: Analysis of feedback positivity or negativity.
Impact: Leadership could make informed decisions based on current data, allowing for targeted interventions where needed.
7. Operational Efficiency
Streamlined Processes:
Elimination of Paper-Based Systems: Transitioned from fragmented, paper-based feedback to a centralized digital platform.
Impact: Reduced administrative burden, minimized lost or overlooked concerns, and saved time for both leadership and staff.
Resource Optimization:
Cost: Utilized existing VA technology infrastructure with no significant additional costs.
Impact: Demonstrated a cost-effective solution that could be sustained and scaled without straining resources.
Qualitative Feedback and Testimonials
Employee Perspectives:
"I feel that my voice is finally being heard. Issues I brought up were addressed within days, not weeks."
"The leadership's increased presence has made a real difference in our department's morale."
Leadership Feedback:
"The app has made it much easier to keep track of employee concerns and ensures we follow up in a timely manner."
"Having real-time data helps us prioritize issues that impact Veteran care the most."
Conclusion
The introduction of the Digital Application for Leadership/WeCARE Rounding profoundly impacted the originating healthcare facility by:
Bridging Communication Gaps: Enhanced two-way communication between staff and leadership.
Building Trust: Demonstrated leadership's commitment to addressing concerns promptly, strengthening trust.
Improving Care Quality: Contributed to a safer environment and higher quality of care for Veterans through early issue detection and resolution.
Fostering Engagement: Increased leadership rounds and employee participation, fostering a more engaged workforce.
Supporting Strategic Goals: Aligned with the VHA's mission to accelerate its journey toward becoming a High Reliability Organization.
The significant improvements in rounding frequency, issue resolution times, employee satisfaction, and safety culture underscore the effectiveness of the innovation. The facility's success serves as a model for other VHA facilities seeking to enhance communication, trust, and operational efficiency. See more
Metrics
- Before Implementation: Average Rounds per Month: 28 After Implementation: Average Rounds per Month: 77 175% Increase in monthly rounding activities
- Before Implementation: Average Resolution Time: 22 days After Implementation: Average Resolution Time: Half of all issues resolved within 7 days Goal Achievement: Aiming for resolutions within one week, depending on complexity Percentage Reduction: Up to 68% Reduction in average resolution time for many issues
- After One Year of Implementation: Improved Trust Scores: Notable increase in employees' trust in leadership Enhanced Engagement Scores: Higher levels of employee engagement reported
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
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5-10 min
Create lists using directions from video on install site -
5-10 min
Install Power App file using directions from video on install site -
30min-2hr
Add organization mapping to SharePoint Locations, ELT Services lists. using directions from video on install site and examples from demo lists.
Departments
- Veteran experience
- Quality Management
- Medical Informatics
- Administration
- Information technology
- Information management
Core Resources
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PROCESSES |
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TOOLS |
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Links
- Site for instructions and resources as well as live demo application Rounding Install Site
Support Resources
Resource type | Resource description |
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PEOPLE |
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PROCESSES |
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TOOLS |
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Links
- Office hours helps facilitate multiple of same type questions also offers repository of common questions and answers. Learning Together Office hours
Risks and mitigations
Risk | Mitigation |
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The application relies on Microsoft Power Apps, SharePoint, Power Automate, and Power BI. Users may encounter difficulties with system compatibility or lack the necessary permissions to create or modify SharePoint sites and lists. |
Early IT Involvement: Engage the facility's IT department early to ensure all technical requirements are met. Permission Audits: Conduct audits to verify that users have the necessary permissions on SharePoint and related platforms. Support Resources: Utilize the provided detailed instructional videos and offer technical support sessions. |
Staff may lack familiarity with Microsoft Power Platform tools such as Power Apps and Power Automate. |
Comprehensive Training: Offer training workshops and step-by-step guides to build user proficiency. Technical Support: Provide access to experts who can assist with troubleshooting and questions. Pilot Testing: Run a pilot program to identify and address technical issues before full-scale deployment. |
Employees and leadership may resist adopting new technologies or altering established routines. |
Stakeholder Engagement: Involve employees and leadership in the planning process to gain buy-in. Communication Plan: Clearly articulate the benefits and address concerns through regular communications. Champions and Advocates: Identify and empower early adopters to promote the application. |
The application's processes may not align seamlessly with existing workflows or organizational structures. |
Customization: Adjust the application settings and features to fit the facility's specific needs. Workflow Mapping: Analyze current processes and plan how the application will integrate. Training on Integration: Provide guidance on how to incorporate the application into existing workflows. |
: Employees may hesitate to share concerns if they fear retribution or doubt confidentiality protections. |
Transparent Policies: Clearly communicate how data will be used and protected. Anonymous Reporting: Allow for anonymous submissions to encourage openness. Culture of Safety: Foster an environment where feedback is valued and employees feel safe to speak up. |
As the facility grows or processes evolve, the application may need adjustments. |
Flexible Design: Utilize the app's customizable features to adapt to changing needs. Future Planning: Anticipate growth and consider scalability during the initial implementation. Continuous Improvement: Regularly assess the app's performance and make necessary adjustments. |
The application generates extensive data that may be overwhelming to manage and analyze. |
Data Management Plan: Develop strategies for data organization and prioritization. Training on Analytics: Educate staff on using Power BI tools for effective data interpretation. Key Performance Indicators (KPIs): Establish clear KPIs to focus analysis on critical metrics. |
Stakeholders may require evidence of the application's effectiveness to continue support. |
Baseline Measurements: Collect data on key metrics before implementation for comparison. Regular Reporting: Provide stakeholders with updates on progress and impact. Success Stories: Highlight qualitative benefits, such as improved morale or patient care examples. |
Ensuring that leadership and staff consistently use the application as intended. |
Accountability Measures: Set expectations for use and incorporate into performance evaluations. Incentives: Recognize and reward consistent use and engagement. User Engagement: Solicit feedback to improve the application's usability and relevance. |
Contact
Comment
Comments and replies are disabled for retired innovations and non-VA users.
Email gary.crull@va.gov with questions about this innovation.
About
Origin story
Original team
Gary Crull
Management and Program Analyst -
Dr. Christie Artuso
ASSOCIATE DIRECTOR PATIENT CARE SERVICES • OFFICE OF ASSOCIATE DIRECTOR PATIENT CARE
Hello - I will reach out by email re: the app.
Look forward to it!
Hello, I'm a new Nurse Manger to the VA system. I've used rounding apps before in other organizations with much success. I saw this innovation being shared here and I'd like to start trialing it here, focusing on my department which is the float pool and NOD team. I don't see my department on the service area for documentation.
Feel free to reach out there is a link on this page for the install site to get all the details to install it and implement really only takes about 20 mins.