Why Rounding Should Be Prioritized in Ambulatory Clinics

Ambulatory care

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The Basics of Rounding

Infection prevention (IP) rounding is a primary task that assesses adherence to specific guidelines that reduce and prevent health care-associated infections. Wherever IP rounding occurs, a special set of circumstances may impact how rounding is performed, but the importance surrounding IP rounding should remain consistent regardless of location. Building a workflow allowing IP rounding in ambulatory clinics requires ingenuity, as this task may take less precedence over hospital or inpatient IP rounding. Also, resources may be limited to performing IP rounds daily in many outpatient clinics by a trained infection preventionist. Still, there is value in consistent primary IP rounds in the ambulatory world.

Develop Relationships

IP rounding is more than just an inspection or a visit from the “hand hygiene police”; this is an opportunity to build mutually beneficial relationships that garner a more collaborative environment with the clinic staff. Consistent IP rounds in which the infection preventionist emphasizes inobtrusive observation and respectful exploration allow staff to feel more comfortable discussing challenges and concerns. Knowing that the infection preventionist is there to learn and liaise rather than catch moments of divergent practices is more conducive to a collaborative environment.

There is a common misconception that clinics act in silo and lack the dedication to certain practices; however, ambulatory clinic staff are immensely committed to figuring out adversities inhouse, largely because of financial and physical constraints. Consistent IP rounding also allows the infection preventionist to provide positive feedback when protocols are being followed appropriately and when staff proactively address improvement opportunities. Reprimanding clinic staff for inconsistencies during IP rounds, especially when the infection preventionists' presence is rare, cannot be used to foster a team that is engaged and excited to work together and prevent infections.

Just-In-Time Education

IP rounding is the perfect opportunity for infection preventionists to speak directly to the staff who do the work. The frontline staff performs the desired practices and should be the most prominent voice in the decision-making process of implementing or improving infection prevention efforts. Simply observing the frontline staff can also initiate lightbulb moments for the clinic staff worker and the infection preventionist. This metaphorical lightbulb represents when something once dim and obscure becomes illuminated and clear. This is evident when the infection preventionist can observe a task and impart knowledge to the clinic employee, which may aid in making better and more consistent decisions in their practices. In turn, the infection preventionist can better understand how a protocol is performed and collaborate with the clinic staff with a greater perspective of the work it takes to implement a guideline.

Summary

Consistent IP rounds in ambulatory care clinics may seem daunting because of their location or the sheer number of locations. Still, an infection preventionist has the most significant influence when there are direct interactions where mutual trust and respect can be built with the frontline staff. Building and nurturing these relationships through consistent IP rounds makes staff and clinic leaders more open to collaborating on process improvements. These relationships also make celebrating wins and providing positive feedback much more rewarding. Consistent IP rounds help the infection preventionist and the clinic staff know more about processes, guidelines, requirements, and each other’s challenges and concerns. You don’t know what you don’t know until someone lets you know—and you can only make informed decisions when you know more.