As a retired RN who was certified in medical-surgical nursing, I remember the goals of the hourly rounding policy. Our patients were reassured to find out that staff would check on them every hour at a minimum for any needs they might have, and families could rest easy knowing their loved ones would not be ignored. Hourly rounding also helped prevent a patient from falling through the cracks on a busy shift—always my biggest fear, and one that would keep me up at night.

Obstacles to hourly rounding in acute care.

I also remember the challenges to this policy. Because in hospitals we are dealing with humans and not machines, unlike in factories, there are countless variables to sabotage our best efforts. Everyone has heard the line from the Robert Burns poem, “The best-laid plans of mice and men often go awry.”

The patient variables are unique to each primary nurse and her patient care technician (PCT) who have a plan to alternate rounding on those in their care: the patient who codes, the hemorrhaging post-op patient, the incontinent patient, and the cancer patient with intractable pain. The list is endless—situations that keep the primary nurse or PCT tied up in a room during their turn to do hourly rounds.

Some hospitals may have instituted tracking systems […]