Standardizing Nurse Leader Safety Rounds to Promote Highly Reliable Care

Priya Meyer, Cindy Hill, Deborah Baker

Research output: Contribution to journalArticlepeer-review


Background: Despite decades of intensive resource allocation to eliminate preventable harm and increase high reliability in the hospital, the prevalence of serious harm remains consistent. Local Problem: A hospital reduced targeted preventable harms using audit and feedback (A&F) but failed to globally reduce harm or increase proactive awareness. Nurse leaders lacked a defined process for identifying errors, mitigating risk, and teaching systems thinking to influence resiliency among teams. Methods: Nurse leaders underwent A&F of daily safety rounds. Adherence data on frequency, high-quality, and high-reliability organizational (HRO) leader practice standards and precursor incident reporting rates were trended. Results: Rounding practice adherence increased for the following defined standards: frequency (63%-79%); high quality (50%-90%); and HRO leadership (0%-67%). Precursor incident reporting rates increased 25%. Conclusions: A&F reinforced quality and accountability for daily safety rounds. HRO theory-guided feedback offered an innovative way to translate HRO influence into nurse leader practice.

Original languageEnglish (US)
Pages (from-to)252-257
Number of pages6
JournalJournal of nursing care quality
Issue number3
StatePublished - Jul 1 2020


  • audit
  • feedback
  • high reliability
  • high-reliability organization (HRO)
  • nurse leader
  • safety rounds

ASJC Scopus subject areas

  • Nursing(all)


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