By Jason Bramwell
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.
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:
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:
"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."
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:
"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.
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 (firstname.lastname@example.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.
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