Exposure to Leadership WalkRounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout

Abstract

Background: Leadership WalkRounds (WR) are widely used in healthcare organisations to improve patient safety. The relationship between WR and caregiver assessments of patient safety culture, and healthcare worker burnout is unknown.

Methods: This cross-sectional survey study evaluated the association between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture and burnout across 44 neonatal intensive care units (NICUs) actively participating in a structured delivery room management quality improvement initiative.

Results: Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. More WR feedback was associated with better safety culture results and lower burnout rates in the NICUs. Participation in WR and receiving feedback about WR were less common in NICUs than in a benchmarking comparison of adult clinical areas.

Conclusions: WR are linked to patient safety and burnout. In NICUs, where they occurred more often, the workplace appears to be a better place to deliver and to receive care.

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Figures

Figure 1

Three panels of WalkRounds exposure and one for safety climate. Each bar=1 clinical area, hash marks indicate a neonatal intensive care unit (NICU). There are 44 NICUs and 706 adult clinical areas from: Schwendimann R, Milne J, Frush K, Ausserhofer D, Frankel A, and Sexton JB. American Journal Of Medical Quality: 28 January 2013. The mean (SD) number of respondents per adult clinical area was 27.0, 46% of which were RNs (by comparison, the NICU mean was 47.1, 71% of which were RNs). RN, registered nurse.

Figure 2

Burnout and safety culture domains displayed by WR feedback quartiles. Comparison of the first and fourth WR feedback quartiles with domains of safety culture and burnout. SAQ, Safety Attitudes Questionnaire; AHRQ HSOPSC, Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture; Safe Clim, safety climate; TW Clim, teamwork climate; OPS, overall perceptions of safety; TW w/in units, teamwork within units; Comm Open, communication openness; Error FB/Comm, error feedback and communication; WR, WalkRounds.