Providence Central Division is rethinking how nurse leaders engage with patients—shifting the focus from volume to meaningful connection.
“We’re not just coming in to recover service or put out a fire,” said Renee Miller, Principal Program Manager of Human Experience at Providence Central Division. “We’re coming in to connect with the patient and to learn more about them as a person, not just their diagnosis.”
In a recent webinar, Miller shared how Providence is investing in purposeful Nurse Leader Visits to improve HCAHPS scores, caregiver engagement, and overall patient experience.
Why Move from Quantity to Quality?
Nurse Leader Visits have long been a best practice, but as Miller explained, they weren’t consistently improving patient experience scores by the expected 5% at the unit level.
Rather than aiming to visit 90% of patients, the team shifted focus toward meaningful interactions tied to performance drivers like “nurses treat with courtesy and respect” and “staff work together to care for you.”
Miller noted that the team moved away from a volume-based goal to one centered on the impact of each visit.
To support this shift, Providence’s Central Division CNO Council launched a targeted improvement effort. Units where Nurse Leader Visits weren’t making a measurable impact were selected for a 90-day investment period focused on coaching, consistency, and data-driven change.
90 Days Later
Ten out of 11 units improved the quality of their Nurse Leader Visits during that 90-day period.
Seven also saw an increase in their HCAHPS “Rate Hospital” top box scores, and six met the 5% improvement goal, earning recognition certificates.
Encouraged by those results, the team launched a second round later in the year. Eight of nine units improved, including several that had continued from the initial group.
In total, 13 of the 14 participating units made measurable progress in 2024.
Tactics That Worked
Miller emphasized that the most successful strategies were also the simplest:
- Schedule visit time: Nurse leaders were encouraged to block time on their calendars for visits. Even if not every block is used, scheduling helps reinforce the habit.
- Introduce yourself as a nurse leader: Patients may be more open when speaking with someone who isn’t part of their immediate care team, so making that distinction helps build trust and encourages honest feedback.
- Leave a reminder: Writing their name on the whiteboard or leaving a business card helps patients remember the visit and provides a point of contact if they want to share feedback later.
- Prioritize the right patients: Many units didn’t have a clear method for deciding which patients to visit, so establishing a consistent process—such as focusing on new admissions or longer stays—was an important improvement.
- Ask consistent questions: Standardizing what leaders ask during visits makes it easier to identify trends in feedback and improve the overall experience.
- Celebrate caregiver recognition: Sharing positive patient comments with staff—through huddles, boards, or newsletters—boosted morale and reinforced the value of these visits.
“Recognition was a great place to start,” Miller noted. “Patients had incredible things to say about their caregivers—our job was to make sure that feedback made it back to the team.”
Coaching, Consistency, and Culture Change
To support nurse managers and ensure consistency, Miller’s team developed preparation guides, coaching templates, and standardized scripting. They also held biweekly check-ins to maintain momentum.
“We really wanted our patient experience champions to understand the ‘why’ of the investment,” Miller said. “We’re moving from the quantity to the quality of our visits, but it’s not punitive in nature.”
She also encouraged teams to move away from the term rounding in favor of Nurse Leader Visit; language that reinforces connection and purpose, rather than a task to complete.
In one case, a hospital initially resisted asking patients any questions out of fear of hearing negative feedback. But things changed. “They’ve made a great turnaround… and they are now in a much better place when it comes to engaging patients.”
Scaling the Work in 2025
To build on early success, Providence extended the support period for each unit from 90 to 120 days and added a follow-up “watch period” to help track lasting change.
This extra time helps teams turn new behaviors into lasting habits—and reach the 5% quality improvement goal.
The team also strengthened reporting processes and expanded the use of CipherRounds to consistently gather patient feedback.
One of their key goals is to make nurse leader visits memorable. If a patient clearly remembers who visited them, it’s a strong sign the interaction had meaning. That’s why they track not only performance data, but also how many patients recall being visited by a nurse leader.
Building a Strong Foundation
Patients who remembered a nurse leader visit were far more likely to rate their hospital highly. In fact, their satisfaction scores were nearly twice as high as those who didn’t recall a visit, highlighting the powerful connection between meaningful interactions and better patient experience.
In the end, it comes down to presence, connection, and accountability.
“It’s hard to get a lot of momentum really, really quickly,” said Miller. “It’s definitely a long game… building that strong foundation is really what’s going to lead to long-term sustainable results.”
To see the full recording of the presentation, click here.
