The physicians at Peninsula Regional Medical Center, Salisbury, Md., were not happy. The center's 2004 medical staff survey showed dissatisfaction in a number of areas, including the administration's responsiveness (or lack thereof) to the physicians' needs.

Among the many ways PRMC addressed this issue -- holding department-specific focus groups to identify problems, creating action plans with accountabilities and timetables, and following up with regular progress reports at medical staff meetings - was with a very simple but effective communication tool: They set up a physician hotline.

The idea was to make it easy for physicians to communicate any type of complaint or suggestion that doesn't require immediate attention -- and get a response within 48 hours. Janet Pilchard, director of physician relations and medical staff services, said "this sent a powerful message to our physicians that we consider them our biggest internal customer."

Pilchard explained that hotline callers reach voice mail, which she checks constantly. "I listen to the message, determine what it's about, and then forward it via our email system to the appropriate vice president in charge of that service line. That person is responsible for follow-up, creating an action plan within two business days and then letting me know what has happened."

In the two years since the hotline was first activated, Pilchard said they've had dozens of calls. "There will be weeks when I don't get anything, and then sometimes I'll get three messages in one day. It just depends on what's going on."

Sometimes the call is about a parking problem, but the more serious ones typically involve a delay in care of some kind. An example is a complaint about delayed lab results. The vice president for that area investigated to find out exactly what was happening in the lab at the time to cause the delay and determine whether it was a process problem or an isolated incident, then instigated changes to ensure that all information needed for a patient's discharge is now available for physicians who do early rounds.

"It's a really simple process," said Pilchard, "and the physicians like it. They like the fact that their concerns are being addressed, no matter how minor, usually within 24 hours."

"It also let them know that whenever we aren't doing something they want, it's because we didn't know they wanted it, not out of malice," said Tom Lawrence, MD, MBA, chief medical officer and vice president of medical affairs. "Generally, communication breakdown leads to frustration, and the hotline allows for a more direct method of communication to improve the turnaround of important issues."

It seems to be working. Thanks to the hotline and a host of other innovative actions - including the creation of dedicated product line-specific nurse teams, involving all key physician stakeholders in the capital budgeting process, and setting up a web-based physician portal -- overall satisfaction in the most recent medical staff survey had moved PRMC up 37 notches in national percentile rank.

We couldn't resist asking: Does Pilchard ever get anonymous calls on the hotline? "Occasionally - but I always know their voices!"

Publication Date: Monday, August 24, 2009