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Exposure to Leadership WalkRounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout
  1. J Bryan Sexton1,2,
  2. Paul J Sharek3,4,5,
  3. Eric J Thomas6,
  4. Jeffrey B Gould3,4,7,
  5. Courtney C Nisbet3,4,
  6. Amber B Amspoker8,9,
  7. Mark A Kowalkowski8,9,
  8. René Schwendimann2,10,
  9. Jochen Profit3,4,7
  1. 1Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, North Carolina, USA
  2. 2Patient Safety Training and Research Center, Duke University Health System, Durham, North Carolina, USA
  3. 3Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, California, USA
  4. 4California Perinatal Quality Care Collaborative, Palo Alto, California, USA
  5. 5Center for Quality and Clinical Effectiveness, Lucile Packard Cahildren's Hospital, Palo Alto, California, USA
  6. 6University of Texas at Houston– Memorial Hermann Center for Healthcare Quality and Safety, University of Texas Medical School, Houston, Texas, USA
  7. 7Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, California, USA
  8. 8Levine Cancer Institute, Carolinas Health Care System, Charlotte, North Carolina, USA
  9. 9Duke University School of Nursing, Durham, North Carolina, USA
  10. 10Institute of Nursing Science, University of Basel, Basel, Switzerland
  1. Correspondence to Dr Jochen Profit, Department of Pediatrics, Section of Neonatology, Stanford University, 1265 Welch Road, x115, Stanford, CA 94305, USA; profit{at}


Background Leadership WalkRounds (WR) are widely used in healthcare organisations to improve patient safety. The relationship between WR and caregiver assessments of patient safety culture, and healthcare worker burnout is unknown.

Methods This cross-sectional survey study evaluated the association between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture and burnout across 44 neonatal intensive care units (NICUs) actively participating in a structured delivery room management quality improvement initiative.

Results Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. More WR feedback was associated with better safety culture results and lower burnout rates in the NICUs. Participation in WR and receiving feedback about WR were less common in NICUs than in a benchmarking comparison of adult clinical areas.

Conclusions WR are linked to patient safety and burnout. In NICUs, where they occurred more often, the workplace appears to be a better place to deliver and to receive care.

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