Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout

• Published in: BMJ quality & safety Vol. 27; no. 4; pp. 261 - 270
• Main Authors: Sexton, J Bryan, Adair, Kathryn C, Leonard, Michael W, Frankel, Terri Christensen, Proulx, Joshua, Watson, Sam R, Magnus, Brooke, Bogan, Brittany, Jamal, Maleek, Schwendimann, Rene, Frankel, Allan S
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2018; BMJ Publishing Group
• Subjects: Attitudes; Burnout; Burnout, Psychological - prevention & control; Cross-Sectional Studies; Employee involvement; Feedback; Formative Feedback; Health care; Humans; Leadership; Occupational health; Occupational safety; Original Research; Patient Safety; Quality; Quantitative psychology; Questionnaires; Safety Management; Surveys and Questionnaires; Teamwork; Work life balance; feedback; score; engagement; safety culture; walkrounds; burnout; resilience
• ISSN: 2044-5415; 2044-5423
• DOI: 10.1136/bmjqs-2016-006399

BackgroundThere is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance.MethodsThis cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings.Results16 797 of 23 853 administered surveys were returned (70.4%). 5497 (32.7% of total) reported that they had participated in WR, and 4074 (24.3%) reported that they participated in WR with feedback. Work settings reporting more WR with feedback had substantially higher safety culture domain scores (first vs fourth quartile Cohen’s d range: 0.34–0.84; % increase range: 15–27) and significantly higher engagement scores for four of its six domains (first vs fourth quartile Cohen’s d range: 0.02–0.76; % increase range: 0.48–0.70).ConclusionThis WR study of patient safety and organisational outcomes tested relationships with a comprehensive set of safety culture and engagement metrics in the largest sample of hospitals and respondents to date. Beyond measuring simply whether WRs occur, we examine WR with feedback, as WR being done well. We suggest that when WRs are conducted, acted on, and the results are fed back to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making and the emotional exhaustion component of burnout. Whether WR with feedback is a manifestation of better norms, or a cause of these norms, is unknown, but the link is demonstrably potent.