5 Questions To Ask When Leadership Rounding On The Front Lines

15 May 2015

Sarah Thomsen

Leadership Rounding


To make good decisions, you need good information. But too often, executives and managers become isolated in what’s known as an information silo within their own organization. When that happens, information is filtered as it slowly travels up the chain to the executive offices; and sometimes, negative or unpleasant facts never reach the very people who could resolve a problem. The best way for leadership to avoid such information-deficits is to get out there and collect information directly from front line staff. How? Institute a regular leadership rounding with staff routine.


Leadership rounding helps executives and administrators verify that their organization is providing the best possible care, by interacting with patients, staff and physicians. Leadership rounding helps improve front line performance and morale by facilitating positive two-way communication between leadership and staff, as well as leaders and customers, i.e. the patients you serve. It creates a culture of open and transparent communication and helps engage nurses and other front line staff. This kind of rounding provides an invaluable opportunity to monitor the daily activity of front line staff and patient satisfaction, identify issues in the delivery of care and improve processes. When leaders directly observe the front line of patient care, they’re more apt to spot problems earlier and hear ideas for improvements that might not filter up to them otherwise. The best way to learn how to improve patient satisfaction is to ask the patients themselves.


If you’re considering a leadership rounding program, here’s an important fact. The frequency of your rounding is less important than the consistency of the effort. You can do rounding daily, weekly, or even monthly as a facility leader, though at the front lines, greater frequency is more desirable. It’s critical for leadership rounding to happen on a regularly scheduled basis so all stakeholders involved come to trust the process and view it as a serious initiative.


When leadership rounding, we don’t think you need to ask too many questions, and we suggest asking open-ended questions (unless you’re gathering data on a very specific organization initiative). What should you ask when you’re leadership rounding on front lines?

Here are five that we like:

  1. What’s working well? (It’s good to start rounding on a positive note.)
    This provides front line staff with the chance to talk about how their hard work and commitment are paying off in better outcomes. For nurses, who are reported to often feel overworked and underappreciated, this question lets them advocate for themselves and other staff who work tirelessly on behalf of patients.
  2. What’s not going well; what keeps you up at night concerning our patient care or safety? It’s imperative to find out if there are safety risks to patients, staff or even visitors. Or, maybe there’s a new initiative that your hospital has begun recently, and it’s been harder for front line staff to implement than you realized. This question gives your employees the chance to talk about problems and challenges they face and offer ideas to improve and enhance patient outcomes, safety and satisfaction.
  3. Do you have all the resources/tools you need to do an excellent job; if not, what would help you provide better patient care? Ask this question of both your clinical and non-clinical front line employees.  We realize that budgetary constraints can come into play here, and you’re not always going to be able to give staff everything they ask for; but the information you gather with this question can help to prioritize future investments in equipment, staffing or services.
  4. How can I (or my department) help you to better perform/succeed in your job so we always provide outstanding patient care? The first time you ask this question of front line staff, you just might see some very surprised faces; and eventually increased levels of employee satisfaction and engagement. When the front line sees that their executives and managers are engaged, aware of what’s going on, and anxious for them to succeed, they become better employees and are less likely to disengage from their job.
  5. Before we finish up here, is there anything else that would be helpful for me to know? Building a team and a community of people dedicated to excellent patient care requires true two-way communication. By asking this question, you let your front line know that you’re genuinely interested in their thoughts and you finish rounding on a positive note.

What are some effective leadership rounding questions you’ve used with your staff?

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