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Why 100 Percent Rounding Isn’t Moving the Needle

Why 100 Percent Rounding Isn’t Moving the Needle

Hospitals have long aspired to 100 percent rounding.  Overworked hospital staff has often struggled to achieve this goal.  Even before COVID, PPE teams were frustrated by the uncertainty that their efforts to achieve patient satisfaction were not making an impact commensurate to their effort in rounding.  COVID has only exacerbated this trend by squeezing budgets, furloughing workers, and encouraging social distancing.

Needle in a Haystack

HCAHPS scores reveal that dissatisfied patients are relatively rare — but carry a heavyweight against top box scores and make a significant negative impact on scores. For most hospitals, HCAHPS response rates have fallen to as little as 25 percent.  The percentage of not-top-box varies from 5 percent to 40 percent meaning that all of your negative responses are coming from less than 10% of the population and, in some cases, less than 2 percent.  That means that you’re visiting as many as 50 patients to find just one not-top-box respondent. Rounding is the only way to find these patients, but these numbers help us understand why modest changes in the number of patients visited have had a limited impact on PEX scores.

But it’s even worse than the numbers would suggest.  It turns out that our most vocal complainers rarely become not-top-box respondents. The optimist concludes that nurses are doing a great job addressing concerns for these vocal patients. The cynic concludes that these patients always complain so our performance doesn’t warrant the effort of a survey response.  As discussed in “Is OK a Red Flag”, this makes rounding efforts even more difficult.

Using AI for More Personalized PEX

All patients deserve excellent care, but HCAHPS scores show us that excellent care means different things to different people.  We need to treat each patient’s individualized PEX concern.  100% rounding is like chemotherapy, carpet bombing every patient with the same effort that — like the overzealous waiter that keeps popping up at your table asking “Is everything alright?” — may even be unwelcome.  What PEX needs is an MRI to pick out the cancer and Neutron Therapy to target those tumors.

Ambassador Software Works 

Ambassador Software Works provides AI-based patient insights through its proprietary APEXamenity Rounding Tool and through partnerships with leading Rounding Tool vendors. To learn more about how AI-based patient insights can improve your patients’ experience, HCAHPS scores, and VBP reimbursement, please call 855.349.4224 or email