In our conversations with healthcare leaders, we’re seeing a shift in how organizations approach rounding. The emphasis is on moving from volume to connection and from routine to consistency. Too often, rounds are treated as a routine task rather than meaningful interactions with each patient that improve safety, quality and experience.
In this article, we’ll highlight seven common challenges that limit the impact of leader rounding with strategies to address them.
#1 Lack of ownership
When it comes to leader rounding, consistency matters. Without clear ownership, standard processes and aligned reporting, even the best efforts can get fragmented and create more unwanted complexity.
Here’s the fix: Be sure to define workflows, assign accountability and tie leader interactions directly to safety, quality and experience goals. And most importantly, make engagement part of the day-to-day, not an extra task. That’s how it becomes a true driver of outcomes instead of a routine exercise.
#2 Overloaded scripts and workflows
Having the right tools in place matters, especially because scripts and workflows shape every patient visit. Clunky or generic scripts can blur purpose, making it hard to capture the right information or act on feedback. The same goes for reporting. Too much data without focus creates confusion instead of insight.
Here’s the fix: Streamline scripts so each has a clear purpose, whether it’s patient experience or device safety. Put owners in place to keep content up to date and create reporting packages that highlight only what leaders need to see. Specific, actionable workflows make it easier to align visits with goals and sustain results over time.
#3 Lack of patient trust
Without clear structure, leader visits can feel transactional or inconsistent, leaving patients unsure of what to expect. That uncertainty can erode trust and make it harder to resolve issues before discharge.
Here’s the fix: Break each visit into phases that follow the patient journey. Use admission to set expectations, treatment to verify them and discharge to close the loop. This shifts the focus from checking a box to building connection and makes it easier for leaders to catch and resolve concerns in real time.
#4 Limited visibility into real-time data
When committees and leaders rely on outdated or overly complex data, they miss key opportunities to spot patterns and make improvements. Real-time data visibility offers a bird’s eye view of performance across departments, locations, and patient populations, highlighting both strengths and gaps.
Here’s the fix: Use dashboards that show the right metrics, including script usage, patient counts, flagged opportunities, that reflect real time data. Focus committees on interpreting trends and collaborating with leaders on targeted action plans. When data is simple, current and actionable, it becomes an important tool for improvement.
#5 Language that limits connection
Reframing rounds as visits instead can signal that the goal is connection, rather than just checking the box. We’ve seen two of our customers make this change in language.
At Providence Central Division, leaders opted for this new word because, “We’re not just coming in to recover service or put out a fire,” said Renee Miller, Principal Program Manager of Human Experience. “We’re coming in to connect with the patient and to learn more about them as a person, not just their diagnosis.”
Similarly, at Carilion Clinic, leaders also shifted from the term rounds to visits to emphasize purpose over process.
As Brandon Jones, MSN, RN, CPXP, NEA-BC, Director of Patient Experience, explained, “When you think about the word round, for us, it referred to checklists that need to be done. It’s very surface level. But when you think about the word visit, and the last time you went and visited with a friend or family member, there was a conversation occurring, and most importantly, there was human connection. So, shifting our language helped to shift the mindset from a round to a visit.”
Here’s the fix: Take another look at the language you’re using. A seemingly simple change in terminology can impact culture, clarify intent and lead to more meaningful touchpoints with patients.
#6 Lack of training for nurse leaders
Being a strong clinical leader doesn’t automatically mean being prepared to engage with patients. It’s often the case that leaders are expected to walk into sensitive conversations without the skills or practice to make those interactions as effective or solution-oriented as they can be.
Here’s the fix: Invest in training. Simulation-based education, for example, gives leaders the chance to practice real scenarios, like handling tough questions or addressing patient concerns, in a safe environment. Studies show that this type of training can significantly strengthen communication and empathy skills, equipping leaders to respond with confidence when challenging situations arise.
#7 Relying on anecdotes, not data
Without reliable systems in place to track outcomes, it’s hard to know whether visits are actually improving safety, quality or experience. And sometimes patient feedback is left unresolved or concerns surface only after discharge, when there’s no longer an opportunity to take timely action.
Here’s the fix: Measure both the process and the results. Track how many patients recall a leader visit, monitor complaint volume and connect visit frequency with key outcomes like safety events or HCAHPS scores.
The way forward
Nurse leader engagement is evolving. The more health systems continue to treat it as a routine task, the less likely they will see positive results in safety, quality and experience. By taking a cue from these strategies and implementing clear and intuitive rounding tools, organizations can transform leader interactions into purposeful visits that build trust, resolve concerns in real time and drive measurable improvements across the patient and staff experience.
