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PSNet: Patient Safety Network
Journal Article

Walkrounds in practice: corrupting or enhancing a quality improvement intervention? A qualitative study.

Martin G, Ozieranski P, Willars J, et al. Joint Commission journal on quality and patient safety. 2014;40:303-10.

Although conceptually appealing, leadership walkrounds—visits by management to clinical units with the goal of engaging in frank discussion around safety concerns—have proven to be somewhat controversial in practice. Some studies have shown that walkrounds can improve safety culture, but both randomized trials and qualitative analyses have found that increased management visibility can paradoxically worsen safety perceptions, and executives often view walkrounds as an obligation to be endured. The United Kingdom's National Health Service uses walkrounds widely, and this qualitative study utilized interviews with management and frontline staff to identify key insights into why walkrounds succeed in some contexts and fail in others. According to this study, seemingly minor aspects of how walkrounds are conducted can result in staff perceiving that the rounds are being used for monitoring and evaluation rather than for their intended purpose of identifying and addressing safety concerns.