• Pinpointing Ways to Improve Patient Satisfaction at Tenet Healthcare

    Mar 01, 2009
    Dallas-based Tenet Healthcare Corporation has created an online measurement system-called the Tenet Report and Query System (TRAQS)-that gives Tenet hospitals around the country real-time access to patient satisfaction data.

    TRAQS is aligned to the comparative satisfaction data in the federal government's Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Each Tenet employee has access to TRAQS via the company's intranet. When employees log on to TRAQS, they receive an overview of their hospital's current patient satisfaction/HCAHPS results, including comparisons to the previous month, previous year, and hospital-specific targets.

    "The system was designed to give more users access to patient satisfaction data and reduce report turnaround time across the organization," says Cindy Larkin, senior director of measurement systems and strategy. "The system also allows hospitals to benchmark against high performers and identifies areas for improvement."

    How Do We Compare?

    TRAQS, which is updated daily with patient satisfaction results, is designed to help hospital leaders drill down to pinpoint problem areas or areas for reward and recognition. The goal is to make the data available to employees and provide much of the analysis for them. Interactive queries allow employees to customize their analysis down to the unit level by question, category, time period, and setting (i.e., inpatient, outpatient surgery, ED, etc.).

    Icons help tell the story: A white "light bulb" icon next to a data point shows if the unit is at or above average. A red light bulb indicates a problem area. Clicking on the icon links users to a suggestion area with bullet-point ideas to improve their scores. More extensive resources, such as toolkits, research materials, and webinars, are also available via the online system. Hospitals also have the ability to identify top performers and seek counsel from those achieving the desired results.

    Hourly Rounding Makes an Impact

    Using TRAQS, Tenet hospitals have initiated evidence-based process improvement initiatives to impact the patients' perception of the care provided. For example, some have improved staff responsiveness to patients thanks to proactive, hourly rounding by nurses.

    Hourly rounding addresses the three Ps: pain, position, and personal needs. To maximize efficiency, nurses are trained to bundle their scheduled tasks or procedures into the hourly visits, says Julie Dippel, director of service excellence for Tenet. Proactively addressing the three Ps-all frequent reasons for call lights-helps nursing staff work efficiently as well as provide quality care. Staff members document their rounding on a simple log.

    Staff members are also trained to use key words during rounding. For example:

    • When entering the room, nurses should try to reduce anxiety by introducing themselves to the patient and family: "Mrs. Jones, my name is Susan, and I'm your nurse."
    • After performing their scheduled tasks, nurses should ask, "Is there anything else I can do for you?"
    • Nurses should let the patient know when they will be back: "I'll be back in about an hour."
    Research already shows that hourly rounding can improve patient outcomes. A study conducted by Studer Group and published in the September 2006 American Journal of Nursing found that rounding every hour during daytime hours and every two hours at night cut patient falls in half and reduced skin breakdown by 14 percent. Hourly rounding also reduced call light use by 37.8 percent-and increased patient satisfaction by 12 points.

    Tenet also has evidence that hourly rounding impacts patient satisfaction. For example, Frye Regional Medical Center in Hickory, N.C., has achieved solid performance in areas of responsiveness and nurses' explanations. Eighty percent of Frye patients surveyed by HCAHPS during the first public reporting period said their nurses "always" communicated well, which is seven percentage points higher than the national average. "Communicated well" means nurses explained things clearly, listened carefully to the patient, and treated the patient with courtesy and respect. In addition, 73 percent of Frye patients said they "always" received help as soon as they wanted-13 percentage points higher than the national average.

    The ultimate goal is to provide quality care to every patient every time. Hourly rounding is just one initiative implemented in Tenet hospitals as a result of the long-term partnership with a consulting group.

    This article originally appeared in The Business of Caring, a newsletter dedicated to helping nurse leaders develop business and management skills.