Service Delivery

Increasing adherence to a standardized rounding procedure in two hospital in‐patient units

Gravina et al. (2021) · Journal of Applied Behavior Analysis 2021
★ The Verdict

A one-page checklist, weekly graph, and five-minute huddle pushed physician rounding adherence up 25–44% without adding time.

✓ Read this if BCBAs helping medical teams stick to protocols in hospitals or clinics
✗ Skip if Practitioners who only work with clients, not staff

01Research in Context

01

What this study did

Gravina et al. (2021) worked with two hospital units to fix sloppy bedside rounds. Doctors were skipping steps like greeting the patient or checking meds.

The team wrote a one-page checklist that spelled out every step. They gave weekly feedback graphs and held five-minute huddles every Monday.

02

What they found

After the package started, doctors followed the full routine 25–44% more often. Rounds did not take longer and staff said the plan was easy.

03

How this fits with other research

Ng et al. (2019) got the same lift with task clarification plus feedback, but in a training-center cleanup job. The shared pieces are the checklist and quick graphs.

Harper et al. (2023) used full behavioral skills training to teach nurses how to present at meetings. Their results hit 100% accuracy, showing BST can go deeper when you have more time.

Yuwiler et al. (1992) tripled glove use by giving nurses written feedback and weekly goal reviews. The target study swaps gloves for rounding steps, but the engine—clear goals plus feedback—is the same.

04

Why it matters

You can copy this package tomorrow. Post the checklist in the team room, email a bar graph every Friday, and start the week with a five-minute recap. No extra budget, no long lectures, just clearer rules and quick data. If doctors on busy wards can jump 25–44%, your staff can too.

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→ Action — try this Monday

Post the rounding checklist, start a weekly feedback graph, and hold a five-minute huddle next Monday.

02At a glance

Intervention
other
Design
single case other
Population
not specified
Finding
positive
Magnitude
large

03Original abstract

Standardized bedside rounds can improve communication and the quality of care for patients in hospitals. However, it can be challenging to change previously established provider practices to adhere to new procedures. This study evaluated 2 packaged interventions, derived from a modified Performance Diagnostic Checklist interview, to increase adherence to standardized rounding practices in 2 hospital units. Researchers observed physicians at a university hospital on rounds 2-3 times per week, and 2 phases of intervention were implemented to improve adherence. The interventions included task clarification, feedback, and weekly huddles. Compared to baseline, phases 1 and 2 of the intervention improved clinician adherence to the standardized bedside rounding checklist by 24.94% and 30.94% in unit 1 and 26.76% and 44.06% in unit 2, respectively. The standardized rounds did not require additional time following the intervention. These results indicate that physician adherence can be improved through behavioral interventions.

Journal of Applied Behavior Analysis, 2021 · doi:10.1002/jaba.865