• Bethesda North Goes Back to Basics to Improve Patient Satisfaction

    Dec 13, 2011

    By Jason Bramwell

    Common-sense approaches to providing patients with an excellent hospital experience have boosted the organization's HCAHPS patient satisfaction scores from 70.2 percent in FY08 to 79.3 percent in FY11.

    In FY08, TriHealth's 363-bed Bethesda North Hospital, Cincinnati, did not meet its goal of ranking in the 75th percentile on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The hospital finished the fiscal year with a top-box patient satisfaction score of 70.2 percent, which ranked it in the 62nd percentile.

    So what did the hospital's staff do to increase patient satisfaction? They went back to basics.

    Starting with Communication

    Many questions on the HCAHPS survey relate to how well nurses, physicians, and other hospital staff communicate with and respond to patients. To boost communication, Bethesda North staff were encouraged to adopt key behaviors when interacting with patients and their families, including the following:

    • Introducing themselves every day
    • Smiling at patients and showing compassion
    • Apologizing-and offering a $5 gift card for the cafeteria, coffee shop, or gift shop-to patients for long ED wait times
    • Walking lost patients, family members, or visitors to their designations (versus just giving them directions)

    The hospital also gives patients thank you cards before discharge signed by all staff members who cared for the patient. "We are always looking for the 'wow' factor," says Shirley Calaway, manager of service excellence.

    To remind physicians of simple behaviors that can improve communication with patients, the hospital gave them a lapel pin of a traffic light to wear on their white coats or jackets. The colors of the traffic light represent:

    • Red: Stop and sit down
    • Yellow: Look at the patient
    • Green: Listen to the patient

    "The reality is, the patient may frequently forget what the physician told them, but they will never forget how the physician made them feel," says Robert Collins, MD, vice president of medical affairs. "That is the core of a good patient experience."

    Targeting Specific Satisfiers

    In addition, a number of organizationwide initiatives were launched across Bethesda North that helped improve the hospital's performance on specific HCAHPS questions.

    Hourly rounding for outcomes. Either a registered nurse or a patient care assistant is required to go into the patient's room every hour - rather than simply peeking their heads into rooms - to see if the patient needs help going to the bathroom or using the bedpan, to check whether the patient is in pain, and to address any other needs the patient may have.

    "This initiative really can help with scores on timely response, help to the bathroom, and pain management, which are three important HCAHPS questions we all struggle with," says Calaway.

    Post-discharge follow-up phone calls. Calaway says all of the hospital's inpatient units are now making post-discharge follow-up phone calls. According to Calaway, calls are made for the following reasons:

    • To see how the patient is recovering
    • To make certain the patient understands discharge instructions
    • To find out how the patient's care was during his or her stay
    • To ask the patient for suggestions on improving care and services

    "We're attempting to contact everyone. Sometimes we don't reach all patients, but we're getting some good feedback from this," she adds.

    Communicating medication side effects. Bethesda North wanted to improve its score on the following HCAHPS question: "Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand?" according to Calaway.

    "Now, we highlight maybe two or three side effects of medicines, and we verbally communicate them to the patient either on discharge or if the patient receives a new medicine during hospitalization," she says.

    Achieving Improved Scores

    Since taking a back-to-basics approach, Bethesda North's top-box HCAHPS scores have increased each of the past three years. In FY11, the hospital exceeded its goal, ranking in the 77th percentile on the HCAHPS survey.

    Jason Bramwell is associate editor, newsletters & forums, HFMA (jbramwell@hfma.org).

    This article is based on the following webinar from Premier's Advisor Live®: Creating an Award-Winning Patient Experience.

    Participating in the webinar were:

    Shirley Calaway, manager of service excellence, Bethesda North Hospital.

    Robert Collins, MD, vice president of medical affairs, Bethesda North Hospital.