Exposure to Leadership WalkRounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout.

Leadership WalkRounds, in which senior leadership visits directly with frontline staff on their clinical units with the goal of identifying and addressing safety concerns, has shown potential as a means of improving safety culture. However, initial enthusiasm for this approach has been tempered by a recent qualitative study and a randomized trial—both showed that walkrounds had little effect on safety culture. Conducted in 44 neonatal intensive care units, this cross-sectional study found that units who received feedback from walkrounds had lower rates of burnout and more positive perceptions of safety culture. The results of this investigation may help explain why walkrounds were not associated with improvements in other studies—when walkrounds are performed in a perfunctory fashion or when senior leadership does not systematically follow up on issues identified, frontline workers may become cynical and perceptions of safety culture may actually worsen.