A note on terminology: Rounding refers to the structured practice of care team members visiting patients during a hospital stay to check in on their experience, safety, and care needs. Scripts are the configurable question sets that guide those visits — what gets asked, observed, or documented during each round.
In this guide, clinical and patient experience leaders will learn:
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Why empathy alone isn’t enough: and which specific rounding behaviors actually move post-discharge outcomes.
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How to structure rounding conversations: around the three experience domains — teamwork, safety, and discharge readiness — that drive measurable operational improvement.
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How Community Health Network modernized its rounding program: by implementing an intentionally designed, EHR-integrated platform that unifies quality, safety, and experience rounds into a single patient-centered workflow and connects rounding directly to outcomes for the first time.
The challenge: Two rounding programs that couldn’t talk to each other
When I talk to peer organizations about patient rounding, I usually hear two things: “We already do that” and “We’re not sure it’s working.”
Both can be true at the same time. And for a long time, both were true for us.
At Community Health Network, Quality Rounds and Experience Rounds were separate workflows — different scripts, serving different purposes, used by different parts of the same operations team. Each program was running. But they couldn’t see each other, and neither could see whether the rounds being conducted were actually moving the outcomes they were designed to improve.
Research and white papers had long suggested the link between rounding and patient outcomes. But at the unit level, that relationship was difficult to prove directly — the data lived in different places, and connecting rounding activity to what happened after a patient was discharged required inference, not evidence.
Partnering with Qualtrics changed that. For the first time, rounding data and patient experience data live in the same platform, connected by a shared visit ID. We can now visualize in a single dashboard, what happens to patient experience and health outcomes depending on whether a patient received no round, an Experience Round, a Quality Round, or both.
Putting the patient at the center of that system, rather than organizing around scripts, is the foundation of everything we’ve built.
The gap between warmth and outcomes
It's not surprising that patients who felt cared for as a person had shorter lengths of stay (LOS). What our data revealed is more interesting: feeling cared for had no independent association with reduced readmissions or Emergency Department (ED) visits within 30 days.
Read that again. Empathy alone doesn’t move post-discharge utilization.
This was a significant finding for us, not because we wanted to deprioritize human connection, but because it forced us to stop treating warmth as a proxy for effectiveness. A patient can leave your hospital feeling seen and still end up back in your ED ten days later because nobody made sure they understood their discharge instructions.
What moved the needle? Three specific experience domains and the data behind each one held up even after controlling for gender, age, race, marital status, county, and new versus established patient status:
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Teamwork: Patients who perceived that staff worked well together experienced approximately 7.4 hours shorter length of stay and a 3.3% lower likelihood of readmission or ED visit within 30 days.
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Safety: Patients with higher safety perceptions had roughly 5 hours shorter LOS and a 3.4% reduction in 30-day utilization.
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Discharge readiness: Patients who felt prepared to manage their care at home were 3.8% less likely to readmit or return to the ED within 30 days and every 1-point improvement in preparedness (on a 5-point scale) was associated with a 13% decrease in ED likelihood and a 17% decrease in inpatient readmission likelihood.
Overall experience matters too. Patients who reported a strong overall experience, of which rounding is one part, had a length of stay approximately 1.2 days shorter than those who did not. Rounding alone doesn’t create that outcome, but it’s a consistent contributor to it.
These aren’t soft signals. These are the domains that rounding can directly and meaningfully influence, and they’re the ones we reorganized our rounding conversations around.
The Community playbook: 3 ways to restructure your rounding conversations
The quality and consistency of rounding matters more than the fact of rounding. Checking a box that a room was visited is not the same as reliably reinforcing a patient and care team’s sense of coordination, ensuring the patient feels safe, and confirming that they know what happens next. Getting that quality and consistency right, across units, across shifts, across patient profiles, is where Qualtrics became essential to how we operate.
Step 1: Make teamwork visible
Patients don’t observe your team huddles. They observe whether there is collaboration among care team members, whether clinicians are aligned, whether anyone seems surprised by information someone else already documented, whether the story of their care is being told consistently.
Narrating coordination is a practice worth building toward. Phrases like “I was just speaking with your care team and we’re all aligned on…” or “Dr. Benson and I reviewed your progress this morning, and here’s where we land…” communicate that no one is operating on an island. They reduce the ambient anxiety patients and family members carry when they feel like they’re the only ones holding the thread of their own care.
Care transitions are an extension of this same principle and some of the most visible moments of coordination for a patient. The difference between a transition that builds confidence and one that creates anxiety is often a single introduction: 'I'd like to introduce you to Sydney. She'll be your night nurse. I'm going to be leaving for the day, but you can ask Sydney anything you would have asked of me. And when I come back in the morning, she will have informed me of everything that happened with your care during the night.' That kind of handoff tells a patient that their care team, and the individuals within it, are accountable to each other on their behalf.
Your Playbook
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Script coordination language: Build toward narrating care team alignment at the start of each visit, even briefly.
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Audit for surprise: If patients or family members express surprise at new information, treat it as a coordination signal, not just a communication gap.
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Treat hand-off as a rounding moment: Hand-off is a critical point in a patient’s stay where quality, safety, and experience can all be impacted by incomplete communication. Treat care transitions as a rounding priority, not an administrative one.
Step 2: Make safety tangible, not procedural
Quality rounds are built as much on observation as on conversation. A nurse noticing an old central line dressing and asking when it was last changed. A rounder explaining why a quality check (hand hygiene compliance, PPE protocols, Fall Risk assessments) is happening and what it means for the patient’s day. These interactions build safety perception not by asking patients whether they feel safe in the abstract, but by showing them, in concrete and visible ways, that the care team is paying attention.
What the data confirms is that presence and follow-through are what patients remember. When a concern is surfaced, through observation or conversation, the act of addressing it and coming back matters. And the “know me” experience is foundational: patients remember not just whether someone came back, but whether that person their name, their situation, or their concerns.
Your Playbook
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Lead with observation: Safety awareness often begins with what rounders see, not just what patients say. Train teams to notice and act, not just ask.
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Close the loop and know the patient: Patients remember whether you came back and whether you knew them. The “know me” experience is foundational to perceived safety.
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Involve the patient in quality checks: When conducting hand hygiene, PPE, or fall risk assessments, explain what you're doing and why. Transparency during routine safety checks reinforces that the care team is actively working on the patient's behalf.[RD2]
Step 3: Make discharge a clinical discipline, not a final conversation
This is where we saw some of our most important findings and our most urgent gaps.
Patients who did not feel ready or comfortable for discharge had longer lengths of stay and that gap widened the longer they were hospitalized. Extended time in the hospital doesn’t automatically produce more preparedness. More complexity, additional medications, and added instructions to absorb can produce the opposite without intentional, repeated education along the way.
Among patients who felt unprepared to manage their care at home, the strongest predictors of readmission and ED visits were specific and actionable:
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Lack of understanding about medications
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Uncertainty about when or how to follow up with a provider
Both are highly addressable during routine rounding, not once at discharge, but repeatedly, across the hospitalization.
At Community, the Quality Discharge Round (QDR) is the named mechanism for this work. The QDR tracks whether critical discharge topics have been addressed during the patient’s stay, including medication changes, plan of care for the day, and barriers to discharge. It creates the opportunity to intervene while the patient is still with us.
What makes the QDR different in our new platform is the causal link it enables. Through a shared Visit ID and Medical Record Number, we can connect QDR completion data to post-discharge outcomes, readmissions, ED revisits, PCP follow-up compliance, overall experience, safety, trust, and others. That relationship used to be correlational. Now it’s causal.
Your Playbook
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Introduce discharge education early: Don’t save it for the end of the stay. Early framing reduces end-of-stay overload.
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Use the Quality Discharge Round as your mechanism: The QDR is the structured touchpoint for confirming medication changes, plan of care, and barriers to discharge have been addressed.
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Confirm readiness daily: The goal isn’t a discharge conversation; it’s a patient who is ready and comfortable to be discharged at any given moment during their stay.
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Connect QDR completion to post-discharge outcomes: With rounding and outcome data in the same platform, the impact of the QDR on readmission and ED revisit rates is now directly traceable.
What we stopped measuring
One of the most valuable insights our data gave us was clarity on where to prioritize our focus.
Global loyalty measures, likelihood to recommend, likelihood to continue care, were not significantly associated with post-discharge utilization. They measure something different — relationship quality, brand affinity — not clinical effectiveness.
We kept them in our reporting, but we stopped using them to evaluate whether our rounding was working.
LOS, 30-day readmission, and 30-day Emergency Department utilization are the right clinical accountability anchors, alongside overall experience, safety, and trust. All are outcomes of the same inputs: the round, the listening, the coordinated care. If you get the inputs right, the outputs follow."
Building the infrastructure: Intelligent rounding powered by Qualtrics
Knowing what to ask and observe during a rounding visit is one thing. Building the infrastructure to do it consistently, capture what happens, and connect it to outcomes is another entirely. What Community implemented is a rounding program built around the patient rather than the script, intentionally co-designed with frontline users.
The shift in design philosophy matters. In the old model, a patient lived inside multiple scripts — a Quality script, an Experience script, audit scripts — each used by different parts of the team in separate workflows. In the new model, all rounds and scripts live at the patient level. The platform integrates directly with Epic, so real-time EHR data including census, patient profile, and clinical flags such as CAUTI or Fall Risk determines which rounds apply. Every applicable script is attributed to that patient automatically. Rounders don't have to spend time deciphering which round applies to which patient. The right quality, safety, and experience content surfaces automatically in a single unified workflow. For the care team, this reduces burden significantly. No navigating disparate systems. No guesswork about which round applies. One workflow, one visit, everything the patient needs.
The platform also changes how rounders document. Instead of typed notes alone, care teams can now record audio, capture video, or take photos, because sometimes a picture of a dirty room or an unchanged dressing communicates what words cannot. The right documentation is the one that drives the right action.[MG3]
For leaders, the platform delivers a dynamic, accessible dashboard, not a static report on a distribution list sent once a month. When a pattern emerges at the unit level, we know about it this week. A discharge readiness concern flagged on Tuesday becomes a targeted follow-up by the care coordinator on Wednesday. A pattern of medication confusion on a particular unit becomes a nursing education conversation at the next shift huddle.
What this makes visible for the first time is the causal link between rounding and outcomes. With rounding data and patient experience data connected through a shared visit ID, we can now see, in a single dashboard, what happens to patient outcomes depending on whether they received no round, an Experience Round, a Quality Round, or both. The results are not subtle.
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Inpatient: Combined Quality and Experience Rounds vs. no round Among inpatient encounters, patients who received both a Quality and Experience Round showed meaningfully stronger results across every trust and experience dimension:
Emergency Department: Experience Rounds vs. no round In the ED, where Quality Rounds are less prevalent, Experience Rounds alone drove significant movement:
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These are not marginal improvements. They reflect what happens when the right round reaches the right patient and when that connection is visible in a single dashboard for the first time.
From rounding activity to operational outcomes
For a health system evaluating whether to restructure its rounding program, here is what the data shows is possible:
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All findings remained statistically significant after controlling for gender, age, race, marital status, county, and new versus established patient status.
Rounding shifted from a compliance function to a clinical intelligence system. Every conversation now feeds a feedback loop that surfaces systemic gaps, drives targeted follow-up, and compounds over time into measurable clinical and financial improvement.
The path forward: From rounding activity to strategic advantage
For health systems looking to make this shift, it is crucial to identify the specific experience domains that drive your operational outcomes, build the infrastructure to surface those signals in real time, and design your rounding program around the patient, not the script.
Start with the data you already have. Look past your overall scores and at your experience domain breakdowns. Audit your rounding program for discharge specificity. Train on coordination and presence. And ask whether your Quality and Experience rounding programs can see each other, because if they can't, neither can fully account for outcomes.
What we've built at Community Health Network proves what's possible when rounding data and outcome data stop living in separate systems and start driving decisions together. Rounding isn't just a care delivery activity; it's the moment where clinical intelligence is either captured or lost. The systems that capture it well will have an operational advantage that compounds every single day.
