Rounding for Outcomes

Undercover Boss is a television show that originated in the U.K. in 2009 and has now had versions in several other countries.  It is very appealing because it features CEO's disguising themselves as front line employees and spending time learning the jobs that connect directly with their customers.  On the episodes that I have watched they have learned a great deal about what really goes on at the front line of their company.  They have seen how hard it is for employees making minimum wage to pay their bills, seen the tools needed to do the work, and have heard how the employees feel about top management.



Some of these bosses are hopelessly disconnected from the workers on the front lines.  Although it may be sobering for them to put on a set of coveralls and go clean port-a-potties for a day, the best way to stay connected to the front lines is to be intentional about Rounding for Outcomes.  I was orienting a young lady today who I am now precepting about how to round.  She found the experience, even as a role play, invigorating.  Just spending 5-7 minutes with an employee can inform the leader of needs at the front line, opportunities for reward and recognition, important intelligence about what is going well and what is not going well, and create an open path of communication.  What was a little disconcerting was that this role play was the first time that this nurse had been rounded upon.  Her manager is an undercover boss of a different kind.  Undercover as in undercover police officer.  One you don't see!  Maybe on a stake out, around a corner, hidden away in an office.  You can't manage today's workplace without interacting with your employees.

I'm a bit of an introvert, believe it or not, so I have to have a formula for my rounding.  I'm going to share it with you.  When I started out, I had a form that I used for rounding.  If you want a copy, download it under pages.  Rounding for Outcomes is not the same as Managing by Walking Around.  This is not about you being seen, this is about you being effective, so there is work and followup involved.  Here is what you do:

1. Approach your employee and ask for a few minutes of their time.
2. What is going well today? Start with a positive question or all you get will be negative stuff.
3. What is not going well today?
4. What can we improve on?
5. Is there someone I should recognize for doing great work?
6. Do you have the equipment to do your job?
7. Are there any systems that need improvement?
8. Take an opportunity to coach.  This is the outcomes part.  You have been gathering intelligence up to this point.  Now it's time to help achieve some goals.  Talk about something important to the organization.  Example:

           "You know, Mary, we have really been working on patient satisfaction.  What are you doing to
             assure that our patients are having an excellent experience."

LEVERAGE:  A great idea is to have your entire management team rounding on the same initiative  each week.  If the employees are hearing from all managers about patient satisfaction during week 1, handwashing during week 2, legibility during week 3, and HIPAA during week 4 they will all be on the same page as to what initiative is under focus.

      9.  Is there anything I can help you with right now?



This whole encounter should take only 5-7 minutes.  If you are consistent with this, you will get a lot of information.  Warning:  You must follow up on this information or people will not share with you.

After the rounding session, take the time to followup and to send thank you notes to the people mentioned that should be recognized.  You will be on your way to a new level of connection with your team.

OMG, #9, what if they ask me to help them with something?

Well, on the Undercover Boss TV Show, the CEO's did whatever they were told to do.  Some of them had poor performance and were told that they were not working out!  The question for you is this.  What is it that you are asking your employees to do that you are not willing to do?  Unless you don't have the appropriate licensure or competency to do something, it would speak volumes if you would pitch in.  Most of the time, my staff does not have any request of me.  They are flabergasted that I spent a few minutes one on one with them.

What if they just start complaining?

If they are complaining, you need to hear about it.  Unhappy employees will not provide their very best work or provide the best service to your patients.  If it looks like their issues are going to take longer than 5 minutes, schedule a follow up meeting.  Remember to ask them "What's going well?" as the first question.

What kind of records should I keep?

I keep a rounding log so that I don't forget to followup on issues.  Some people keep a logbook to assure that they round on each person every month.

What if I want to round on patients?

Great idea, different questions, download the form from pages.

You Tube Example of How To Screw This Up