NRC Health (NRC) Status update summary

Research findings on rounding and patient loyalty

• Analysis of 37,000 patients across 11 organizations showed those who recalled being rounded on were about 20 percentage points more likely to give top likelihood to recommend scores.

• Rounding impacts both environmental (quietness, cleanliness) and interpersonal (trust, communication) domains, with larger gaps in operational areas.

• Key driver analysis revealed trust and communication are the strongest predictors of loyalty, with rounding indirectly influencing these factors.

• Decomposition analysis found trust and communication explain about 40% of rounding’s effect on loyalty, suggesting multiple pathways for impact.

• Trust emerges from behaviors like listening, clear explanations, and respect, positioning rounding as a mechanism for better patient experiences.

Practical implications and technology integration

• Emphasis should shift from the frequency of rounding to the quality of interactions, focusing on building trust and connection.

• Ambient listening technology reduces device distraction by 15 points and increases leaders’ confidence in capturing meaningful insights.

• Technology enables leaders to focus on patient interaction rather than documentation, improving communication and trust.

• High-performing organizations consistently execute behaviors that matter most to patients, such as listening, explaining, and building trust.

• Effective rounds resolve issues, connect with patients, and build trust through open-ended questions and clear explanations.

Recommendations for measurement and improvement

• Measurement should focus on outcomes of rounding, such as whether patients feel heard and trust is built, rather than just the act of rounding.

• Skills labs and buddy systems are recommended for developing high-performing rounders and enhancing interpersonal skills.

• Data signals for high-quality rounds include the depth of documentation, engagement with patients, and identification of areas for process improvement.

• Moving patients from good to great experiences is more feasible than converting detractors, emphasizing the importance of targeted engagement.

• Future research will explore additional factors influencing loyalty beyond communication and trust.