Acceptability, feasibility, and sustainability of proactive patient rounding: a mixed methods implementation study in an Australian local health district

INTRODUCTION: Proactive patient rounding (PPR) is widely promoted as a patient safety strategy; however, evidence regarding its acceptability, feasibility, and sustainability in routine practice remains limited, particularly within the Australian context. AIM: This study aimed to evaluate the acceptability, feasibility, and sustainability of PPR implementation in an Australian local health district from the perspectives of clinical and managerial staff. METHODS: A convergent parallel mixed methods implementation study was conducted across the South Western Sydney Local Health District. Acceptability, feasibility, and sustainability were evaluated using an electronic survey assessing perceptions of training, communication, engagement, documentation, resources, and perceived value of PPR, alongside semi-structured interviews exploring staff experiences of implementation, barriers, enablers, and long-term integration. Quantitative data were analyzed descriptively, while qualitative data underwent reflexive thematic analysis. Findings were integrated using a joint display approach informed by the CFIR, while reporting followed the GRAMMS guidelines. RESULTS: A total of 115 nurses and managers completed the survey, followed by 11 in-depth interviews. Acceptability of PPR was reflected in high levels of perceived importance for patient safety and reported training (78%) and communication regarding benefits (76%). Feasibility challenges included limited staff involvement (30%), low perceived ownership (36%), documentation burden (70%), and low-to-moderate resource adequacy. Sustainability was influenced by leadership support, local adaptation, safety huddles, and clinical champions. Four qualitative themes were identified: resistance to routine, leadership as a driver, constraints in practice, and sustainability through adaptation. CONCLUSIONS: PPR was considered an acceptable patient safety intervention but demonstrated variable feasibility and sustainability in practice. Leadership engagement, inclusive communication, adequate resourcing, and streamlined documentation processes are critical to sustaining PPR over time. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A638.