50 - Enhancing Surgical Safety and Quality Through Nurse Leader Rounding

Description: Description of team

This multidisciplinary Perioperative Services Leadership team includes the OR Administrative Director and Director, Manager, Educator, and Quality Manager, working collaboratively to enhance surgical care.

Preparation and planning

To address variability in perioperative safety practices and limited leadership presence, the team developed a structured nurse leader rounding tool designed to promote accountability, real-time coaching, and consistent evaluation of critical safety processes. Created with clinical stakeholder input and aligned with institutional safety priorities, the tool focuses on key areas including:

-Sterility Verification
-Infection Prevention
-Skin Integrity
-Specimen Management
-Time-Out Compliance
-Medication Safety
-Laser Safety
-Count Policy Compliance
-Hand-Off Communication

Assessment

An internal evaluation revealed challenges, including inconsistent adherence to protocols, high numbers of novice staff orienting peers without adequate oversight, and insufficient leadership visibility in clinical areas. These issues contributed to safety risks and variability in care delivery. Recognizing these gaps, the leadership team aimed to develop a rounding process that would reinforce standards, engage staff in real time, and support sustained improvements in surgical safety and quality.

Implementation

The implementation of the leadership rounding tool followed a collaborative and iterative process to ensure alignment with patient safety goals and staff engagement. Key steps included:

1. Initial Planning Meeting -The Perioperative Leadership Team convened to discuss key safety initiatives and the need for a structured rounding approach.
2. Tool Development and Pilot -A draft of the rounding tool was created, incorporating priority safety elements. The tool was then piloted in the clinical environment to assess usability and relevance.
3. Weekly Leadership Review -The leadership team met weekly to review findings from rounding. Each section of the tool was evaluated, and observed issues were analyzed to identify trends and improvement opportunities.
4. Real-Time Interventions -When issues were identified during rounding, new strategies and resource adjustments were implemented in real time to address them effectively and prevent recurrence.
5. Ongoing Focus Areas -At the end of each week, the team identified a primary focus area for the following week to determine whether the issue was a one-time occurrence or a persistent challenge requiring further action.
6. Supportive, Non-Punitive Approach - Rounding served as an opportunity for immediate education, open dialogue, and real-time clarification, encouraging staff engagement and promoting a culture of learning.
This structured yet flexible approach ensured that leadership remained visible and actively involved in sustaining high standards for patient safety and quality of care in the operating room.

Outcome

Following implementation, measurable improvements were observed:
-Time-out compliance increased to 100%
-Medication labeling variation was eliminated
-Sterility verification adherence increased to 100%
- Hand-off communication completeness increased by 25%

Beyond metrics, staff reported increased perception of leadership support and enhanced teamwork. The initiative fostered a culture of openness, accountability, and collaboration, empowering staff through mentorship and shared goals.