Patient Experience Gets Attention

June 1, 2007
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GRAND RAPIDS — Now it’s all about you.

Patient satisfaction is on the agenda at Grand Rapids’ acute care hospitals. Starting in 2008, patient satisfaction scores are to be reported on a national hospital comparison Web site, and hospitals will face 2 percent cuts in Medicare reimbursements if they don’t participate. Those are two factors that have prompted hospitals in Grand Rapids to give consumer issues prime time.

“One of our corporate goals is to provide the best patient experience, and part of that best patient experience is patient satisfaction,” said Cindy Allen-Fodor, vice president of outcomes management for Metro Health Hospital.

An influential book about the patient experience was published in 2005: “If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently,” by Fred Lee, a consultant who has worked as a hospital administrator in Orlando and at Disney University. And South Bend, Ind.-based Press Ganey Associates, which works with about one-third of the inpatient hospitals in the U.S. to measure satisfaction and improvement, has upped the issue’s visibility with awards and reports.

The information is changing the way hospitals view themselves.

“We used to think they compared us to other hospitals. In reality, they compare us to other service industries,” Allen-Fodor said. “Our competition is not necessarily the hospital down the street. It’s the experience our patients and families have gotten at other service industries.”

“We don’t look at this as any type of a project or initiative,” Spectrum Health Grand Rapids President Matt VanVranken said. “We don’t use the word ‘service.’ This is not a service strategy. It’s really about driving cultural change here, the core of which is really focusing in on providing incredibly compassionate care to patients and families, care that is really tailored to individual needs.”

So how does a more than $2 billion organization provide individualized care to 60,000 inpatients annually?

“You come into health care with a certain degree of compassion, and want to do things that impact people,” added Kris White, Spectrum Health’s vice president of patient affairs. “To do that, you need an understanding of what are the things that are most important to patients and their family members. How do we really do that to a point of excellence?”

Again, communication is the bedrock, White said. Spectrum Health has a patient and family council, and also receives comments from about 1,000 patients per month, she said, as well as using Press Ganey to conduct surveys.

“One of the things, for example, that we know is important to patients and their families in the surgery and ambulatory department is the ability to share things you’re concerned about,” White said. “We’ve created a process, infrastructure and tools that the leadership team took to the staff to give them skills to deal with the issue in the moment.

“Those things are hard to do. It takes a lot of reinforcement.”

Allen-Fodor added, “It boils down to communication, letting patients know. If a patient puts on a light because they need a nurse, if you’re waiting for somebody, it can seem like a long time. We’ve done some work with the nursing staff to have them stop into rooms on a regular basis and ask the patient if they need anything. We’ve worked on courtesy and respect and communication quite a bit with our staff.”

Earlier this year, Spectrum Health was one of six hospitals nationwide to receive the Press Ganey 2006 Success Stories Award, which recognizes improvements in patient satisfaction and quality. Unhappy with the results of a 2004 patient satisfaction survey, Spectrum Health responded to 18 areas identified by the patient and family council and made changes in such areas as visiting hours, privacy and treatment decisions. As a result, its patient satisfaction score moved from the bottom third to the top third in 2006, a change that garnered a placement in The Wall Street Journal in February.

White said Spectrum is trying to drive the patient-oriented culture from the top down by creating “meeting-free zones” for unit managers and supervisors. They use that time, as much as 10 hours per week, to connect with patients, listening to their concerns and needs, she said.

At Saint Mary’s Health Care, feedback from patient surveys has had considerable weight in the design of new facilities, such as the Southwest Center in Wyoming and the Lacks Cancer Center, said Tom Stankewicz, director of strategic planning and research.

Not only locally but nationally, the communication issue has bubbled to the top on patient satisfaction issues, he said. One result: Saint Mary’s physicians’ network, Advantage Health, now takes phone calls during the lunch hour, unlike many doctors’ offices that close during that time.

“We heard time and time again in our ambulatory services areas: ‘When do you think I can make a phone call?’” Stankewicz said.

And when the Lacks Cancer Center opened, Saint Mary’s introduced room service to the Grand Rapids market, he said, based on patient feedback.

“Honestly, I think that the heightened sense of accountability has made health care look at this,” Stankewicz added. “I think that what you’ll see in the literature is the growing push toward accountability. And the competition is fierce. If you’re not providing it, somebody else is going to.”

The Centers for Medicare & Medicaid Services has been working on HCAHPS —Hospital Consumer Assessment of Healthcare Providers and Systems — since 2002. A standard survey was developed to measure patient perceptions of inpatient care at hospitals nationwide. The survey of adults who spent at least one night in a general acute care hospital will cover the following areas: communication with doctors; communication with nurses; responsiveness of hospital staff; pain control; communication about medicines; cleanliness and quiet of the physical environment; and discharge information.

Survey results will be posted at the CMS World Wide Web site, hospitalcompare.hhs.gov. The Web site already posts quality results for seven common diagnoses and lets consumers compare hospitals side-by-side in those areas. The patient satisfaction information is expected to be available on the Web site starting in March, but hospitals are expected to start implementation with next month’s start of the 2008 fiscal year.

The program is voluntary, but hospitals that decline to participate will receive 2 percent less money from Medicare’s next payment adjustment.

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