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TRANSPARENCY: Posting patient reviews of physicians

Some health systems have begun to post online patient satisfaction scores and patient comments about physicians on the medical staff.  Here are some systems that do this (there are said to be an additional 20 which are not identified by name):

  • University of Utah Health Care
  • Piedmont Healthcare
  • Wake Forest Baptist Health
  • Northwell Health
  • Stanford
  • Cleveland Clinic
  • University of Pittsburgh
  • Duke

The advantages of this approach are discussed in this brief Perspective article in the New England Journal.  There is also an audio interview in which the author discusses some of the logistics of doing this at University of Utah Health Care.

Source: Lee, V. (2017, January 19). Transparency and trust: Online patient reviews of physicians. The New England Journal of Medicine, 376, 197-199. Click here: http://www.nejm.org/doi/full/10.1056/NEJMp1610136  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Improving the Patient Experience Through the Health Care Physical Environment

A new report in the Hospitals in Pursuit of Excellence series looks at how the physical environment within a hospital can impact the patient experience. People, process, and place all affect the patient experience and should be part of a holistic approach for improvement.

The report identifies eight patient experience domains that HCAHPS measures and relates them to elements of the physical environment, such as noise, cleanliness, pain management, and staff responsiveness. Hospital leaders are encouraged to take a team approach to involve staff in improving patient satisfaction.

Brief case studies and resources for further reading are shared.

Source: Improving the patient experience through the health care physical environment. Health Research and Educational Trust/American Hospital Association, March 2016. http://www.hpoe.org/Reports-HPOE/gate/2016/2016-ASHE-guide-03-31-16.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

PATIENT SATISFACTION: Academic medical center improves the patient experience

This is a case study of University of Utah Health Care, a four-hospital system that was created in 2004 by bringing together the School of Medicine and the University Hospitals and Clinics.  Radically different cultures hampered the ability of the organization to achieve top patient satisfaction scores until launch of an initiative in 2008.  Working on aligning culture was one of the first tasks of the Exceptional Patient Experience (EPE) initiative.  Among the other EPE activities were revision of the mission, vision, and values statements; value-based hiring, retention, and promotion; and, sharing physician-specific patient feedback data.  Besides the improvement in patient satisfaction scores, the system has seen a big drop in malpractice premium rates and an increase in employee satisfaction.

Source: Lee, V.S., Miller, T., Daniels, C., and others. (2016, Mar.). Creating the exceptional patient experience in one academic health system. Academic Medicine. 91(3), 338-344.  Click here for publisher’s website: http://journals.lww.com/academicmedicine/Fulltext/2016/03000/Creating_the_Exceptional_Patient_Experience_in_One.25.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

PATIENT SATISFACTION: Would you like to be seen today?

“Thank you for calling the Cleveland Clinic.  Would you like to be seen today?”  You BETCHA!  There is a lot in this article about how the Cleveland Clinic has improved the patient experience, but that strategy is the one that blew my socks off.  Giving all patients the option of same-day appointments increased the new patient visit rate by 20 percent.  This is an engaging look at the gamut of changes made since 2009, when the Clinic’s CEO prioritized improving the patient experience.  The effort has paid off in remarkable gains in patient satisfaction.

Source: Merlino, J.I., and Raman, A.  Health care’s service fanatics: how the Cleveland Clinic leaped to the top of patient-satisfaction surveys.  Harvard Business Review;91(5):108-116, May 2013.  Click here for the publisher’s website: http://hbr.org/2013/05/health-cares-service-fanatics/ar/1  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Patient-family councils – case study in person-centered care

Who: Catholic Health Initiatives

What: Patient-family advisory council (system-wide initiative)

When: Planning was initiated in 2009; implementation began in 2010 and has been completed

Where: Englewood, CO-based hospital system with 76 hospitals in 18 states

How: Read article, including side bar on “How CHI Rolled Out Its National Program”

Why: To support CHI’s philosophy of person-centered care –

  • Personalization of care according to patient and family needs, preferences, and values
  • Comprehensive care encompassing body, mind, and spirit
  • Collaborative care that links patients and their families to providers

Source: Haycock, Camille.  Patient-family councils make the difference.  Health Progress.  93(2): 24-29, March-April 2012.  Full text at http://www.chausa.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=8147

CEO “mystery shops” to check customer service

This is a lively first-person account of how Office Depot’s CEO visited 70 stores incognito to see how customers were treated.  He found that many front line workers were more comfortable “with their backs, rather than their bellies, to the aisle,” in other words, they liked tasks that involved dealing with merchandise rather than with customers.  Office Depot made a number of changes, including downsizing stores and stocking just the more popular brands.  But changes in customer service training were instituted as well, such as the ARC, “Ask, Recommend, and Close” sales process model. 

What I liked about this article: The pithy observations:  1.) “Make sure you’re measuring things that really matter to customers.”  2.) “Remember that we need our customers more than they need us.”

Source: Peters, K.  Office Depot’s president on how “mystery shopping” helped spark a turnaround.  Harvard Business Review;89(11):47-50, Nov. 2011.  Click here for more information: http://hbr.org/2011/11/office-depots-president-mystery-shopping-turnaround/ar/3 Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

200 Hospital Benchmarks

Becker’s Hospital Review has updated and expanded its earlier 40 Hospital Benchmarks article to provide 200 national benchmarks for hospitals related to quality processes and outcomes, the patient experience, and financial and operational performance. Among the new indicators added are census disparity index benchmarks used for decision making on patient load measurement, budgeting, and projection of staffing needs. Also added are admissions, discharges, and transfers index benchmarks indicating the proportion of a hospital unit’s patient population turnover during the day, evening and night shifts, impacting patient flow. The benchmarks have been compiled from both government and commercial sources.

Source: Gamble M. 200 hospital benchmarks. Becker’s Hospital Review, Sept. 27, 2011.  http://www.beckershospitalreview.com/hospital-management-administration/200-hospital-benchmarks.html

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Parents like single patient room NICUs

Sanford Children’s Hospital (Sioux Falls, SD) opened the Boekelheide Neonatal Intensive Care Unit in mid-2006 to replace a traditional open-bay NICU that had a total capacity of 40 neonates.  The new single-family-room NICU has 43 rooms, sized at 200 to 250 sf, natural lighting, and many amenities for parents.  Satisfaction surveys demonstrate that there is a statistically significant improvement in parent satisfaction with the new model.

Why I like this article:  It has drawings of the old and new floorplans and a photo of one of the new patient rooms.  It mentions nurse staffing (caseloads) under the old and new models.  Also included is some hard to find data on NICU length of stay, tucked into one of the tables.  Remember this is just one hospital, but their NICU length of stay was around three weeks. 

Source: Stevens, D.C., and others.  A comparison of parent satisfaction in an open-bay and single-family neonatal intensive care unit.  HERD;4(3):110-123, Spring 2011.  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Striving for Top Box: Hospitals Increasing Quality and Efficiency

This latest release in the Hospitals in Pursuit of Excellence Signature Leadership Series shares insights and best practices based on visits and interviews with three innovative health systems focused on improving both efficiency and quality of care.

  • Novant Health in North Carolina shares its experience in two areas: creating a remarkable patient experience and moving toward a payer neutral revenue system and away from cost-shifting.
  • The top box strategy of Piedmont Health in Georgia focused on physician alignment/clinical integration and on robust use of clinical data and information systems for performance measurement of cost management/efficiency and of infection control and preventable mortality.
  • The performance improvement strategy for Banner Health in Arizona centered on creating a culture of accountability, consistently communicating and measuring performance initiatives, sharing best practices across the system, and recognizing employees for performance improvement.

Recommended key elements for top box improvement include:

  • Start by addressing supplies and staffing for cost reduction.
  • Focus on incremental improvements that will snowball into big gains.
  • Address areas that will have substantial cost and quality impact.
  • Develop action plans stating crisp aims for improvement.
  • Share data transparently throughout the organization.
  • Manage with a payer neutral revenue strategy.
  • Reduce unnecessary clinical variation for quality improvement.
  • Invest in data infrastructure for frequent and detailed reporting.

Source: Health Research and Educational Trust/Hospitals in Pursuit of Excellence. Striving for top box: hospitals increasing quality and efficiency. Chicago: American Hospital Association, May 2011. http://www.hret.org/topbox/index.shtml