The 3WITH Question Method to Leadership Rounding

The 3WITH Question Method to Leadership Rounding

Rounding on patients and staff by leaders is an invaluable monitor tool. Rounding helps identify and make improvements in organizational processes. Studies have shown hospitals that round have had significant HCAHPS gains in overall rating, medication communication, cleanliness and hospital responsiveness domains. To increase employee satisfaction and engagement, rounding on staff is also important, per the studies.

With evidence proving that rounding results in positive outcomes, the question is, is there a right way of conducting a patient or staff round? I’ve shadowed hundreds of leaders and staff and have noticed varying styles of rounding. For example, some leaders have a prescriptive set of questions while others just spark up a conversation about the weather or sports.

These leaders simply end the round by asking just one overall question – which can be very effective, along with the 3WITH question method.

One or Many Questions

Leaders often ask, which is the better rounding method? Asking many questions or one simple question?

It is situational, in my opinion, so both are right. There are times you need to guide the rounding with thoughtful questions and there are times you don’t since the person is forthcoming in dialogue. The most important part of rounding is that you engage the other person in the conversation. Click To Tweet Regardless of which rounding method is used, I’ve found those who ask open-ended questions are more engaging and had better rounding outcomes.

Open-ended Questions

Open-ended questions help others to feel comfortable in conversations. For example, asking open-ended questions, such as “What questions can I answer for you?” implies that questions are common, and you’re interested in hearing what’s important to others.

These types of questions are much better received than a closed-ended question such as “Do you have any questions?” Closed-ended questions limit the quantity and quality of the response by receiving yes or no answers.


3WITH Method

A method that has helped me remember how to start conversations with open-ended questions is using the acronym 3WITH. In this acronym, the 3 reminds me there are at least 3 ways to start out the question with using words or phrases that start with the letters WITH. Here’s an overview:


  •  W – “What”, “when”, “where
  • I – “In what way”, “I want to hear more”, “If you had to explain this to a friend…”
  • T – Tell me more”, “talk with me more about…,” “take me back to ….”
  • H – Help me understand”, “how can I help”, “how did this occur”

Download my FREE PDF of the 3WITH Method Tool for you or rounding staff to use!

Keys to Asking Open-ended Questions

  • Ask open-ended questions when you want the person to think before they answer.
  • Ask open-ended questions when the answer provides you with more information.
  • Never ask open-ended questions when you need to maintain control.


Open-ended questions can contribute greatly to your leader rounding outcomes, so it’s important to learn how to make the most of them. Asking open ended question leads to good communication by hearing from the staff and patients’ own voice about their experiences, both positive and negative. Staff and patients learn to open up and share issues that they might not have been willing to talk about prior to rounding, and this helps solve problems and builds trust.


You can also learn more about leader rounding in my book, Critical conversations in healthcare: scripts and techniques for effective interprofessional & patient communication.




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