Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout.

Abstract

There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance. This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings. 16 797 of 23 853 administered surveys were returned (70.4%). 5497 (32.7% of total) reported that they had participated in WR, and 4074 (24.3%) reported that they participated in WR with feedback. Work settings reporting more WR with feedback had substantially higher safety culture domain scores (first vs fourth quartile Cohen's <i>d</i> range: 0.34-0.84; % increase range: 15-27) and significantly higher engagement scores for four of its six domains (first vs fourth quartile Cohen's <i>d</i> range: 0.02-0.76; % increase range: 0.48-0.70). This WR study of patient safety and organisational outcomes tested relationships with a comprehensive set of safety culture and engagement metrics in the largest sample of hospitals and respondents to date. Beyond measuring simply <i>whether</i> WRs occur, we examine WR with feedback, as WR being <i>done well</i>. We suggest that when WRs are conducted, acted on, and the results are <i>fed back</i> to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making and the emotional exhaustion component of burnout. Whether WR with feedback is a manifestation of better norms, or a cause of these norms, is unknown, but the link is demonstrably potent.