How Safety-Net Hospitals Are Improving the Patient Experience

Cheryl Clark, for HealthLeaders Media , July 16, 2013

There was a time that the organization's patient experience scores put them in the bottom 5% of the nation's hospitals. The turnaround was brought about through a focused effort toward the patient experience for more than a dozen years, says Terry Rusconi, the 751-bed organization's vice president for performance improvement. The key to success, he says, was in developing special customer-service training classes that begin with new-employee orientation, and a focus on hiring people with customer-service attitudes.

"We keep the instructor pool small to ensure consistency and maintain people who have a history with the organization," he says. "They listen to concerns and challenge people who want to say there are certain patient populations who just can't be made happy. We nip that in the bud because it's just not true."

One technique that Rusconi says has brought up scores in struggling units is having nursing staff spend five minutes "not giving medications, not checking vitals, but literally sitting at the bedside talking with the patient to get to know them better and understand what makes the patient tick from a personal perspective. They make a personal connection."

Executive-level attention to those HCAHPS scores, delivered weekly from Press Ganey, is at the root of their good results, says COO and CNO Tammy Peterman.

"This transparency sets the stage for this part of our culture," she says, and even helps with those departments that may be struggling.

"We believe every unit in the hospital has some best practices to share. One of our approaches has been to pair a unit having consistently favorable patient satisfaction with a unit whose performance has been less consistent. In the process, we have seen both units improve," she says.

"The unit with less consistent patient satisfaction has learned new approaches to earn higher satisfaction ratings. And the unit with consistent patient satisfaction performance has picked up ideas on improving safety, such as reducing falls. All teach and all learn. In the end, patient care and service are better."

Another element is regular reward and recognition for those units that score well on patient experience.

If special ethnic or low-income populations do have certain needs that can affect their comfort level while they're hospitalized, they're addressed in interdisciplinary huddles—daily meetings with the pharmacist, social worker, physician, nurse, or anyone else involved in that patient's care.

A financial services group helps identify patients very early in their stay who might not be able to afford to pay "and figures out resources we or they might tap into to help and support their healing," Peterman says.

The bottom line, these leaders say, is that patient experience improvement for the sickest and the poorest patients is possible. It just takes a hospitalwide effort.

This article appears in the June issue of HealthLeaders magazine.

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