One of the driving forces behind the changes taking place in the healthcare industry is the increasing importance of patient experience. The Patient Protection and Affordable Care Act and other changes in healthcare have led patients to take a more consumerist approach to deciding where to receive care. It is thus essential for hospitals and health systems to ensure that patient satisfaction at their organizations remain high.
Here, leaders and patient experience coordinators from various organizations with high scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey offer advice on how to improve patient experience and maintain high patient satisfaction.
Question: What are some of the strategies your hospital has implemented to improve patient experience and satisfaction?
Michelle Breitfelder, Senior Vice President of Clinical Transformation, Columbus (Ga.) Regional Healthcare System: Our CEO meets patients in the holding area for surgeries before they are taken back in for surgery almost every day. We have interdisciplinary work groups that help us identify opportunities for improving patient satisfaction — we involve everyone that handled the patient from the various departments. We even give out freshly baked cookies to every patient that leaves the hospital. The cookies have the hospital logo on them, and it is our way to bid a fond farewell to the patient. We also make sure that that our employees are recognized for their achievements by the entire staff of the hospital. We feel that happy employees make happy patients.
Maureen Broms, MS, RN, Chief Information Officer and Vice President, Health Care Quality and Compliance, New England Baptist Hospital (Boston): I would say that maintaining patient satisfaction is a cultural initiative. You need to have a very strong culture that is focused on serving the patient. This focus starts with the CEO and is infused throughout the organization. Without this focus, improving the patient experience remains an initiative and does not become part of the culture. We also have a hiring process that focuses on individuals with similar values and who are committed to creating an exceptional patient experience. We do our best to create a welcoming and inviting atmosphere. We have a hands-on process for responding to patient letters or complaints. Our CEO, vice presidents and physician chairmen are all involved in resolving patient concerns. We try to learn from those concerns, and differentiate between facts and what the patient experienced. Even if we are did everything correctly, it might still mean that the patient didn't have an acceptable experience. You need to take patient experiences as they are without trying to make it about validating your processes and proving the facts. It is equally important to figure out whether or not there was a gap in your processes, and also work with the patients and address their concerns.
Randy Yust, CFO, COO, IU Health North Hospital (Carmel, Ind.): We frequently review data and information that is related to patient experience and the patient satisfaction surveys at our manager's meeting, and at monthly meetings to check progress and make changes. We regularly recognize associates, departments and, when appropriate, volunteers for outstanding service and achievements. We do this through internal awards such as the Lasting Impressions Award, department baskets filled with goodies for associates to share and the DAISY Award for Extraordinary Nurses. There are other components as well, such as writing thank you notes to associates in recognition of a job well done, notes to patients thanking them for the privilege to provide their care and rounding that helps reinforce our service standards. Joy Graves-Rust, our patient satisfaction coordinator, is dedicated to working with leadership to interpret the data in a way that is meaningful and understandable. She helps them identify behaviors and activities that are indicated as having a direct impact on improving the overall patient experience.
Paul Calkins, MD, Interim Chief Medical Officer, IU Health North Hospital (Carmel, Ind.): IU Health North has intentionally introduced certain behaviors as expectations. These include behaviors such as greeting individuals with a smile and accompanying visitors and guests to their destination whenever possible instead of simply directing them.
Q: What are the most important factors influencing patient satisfaction?
Ms. Broms: First, make sure that patients' expectations are understood by the team, from how they want their meals served to the kind of environment they want to receive care in. Learning what those expectations are and creating a plan around that is important. Creating a warm and welcoming environment is also important, particularly because patients are anxious when they come to a hospital. Another important factor is how the physicians and nurses communicate with them especially in setting expectations of how and when the communication will occur.
Dr. Calkins: Treating patients as people, and making sure they know you consider them a person and not only a medical case or customer is important. So is hiring individuals who genuinely care and enjoy what they do.
Joy Graves-Rust, Coordinator, Patient Satisfaction Measures, IU Health North Hospital (Carmel, Ind.): One of the greatest strengths of IU Health North Hospital has been doing what's right for the patient and family because it's the right thing to do. When done automatically with an intention that is authentic and not mandated, the experience has the potential to become transformational. From the beginning, executive leadership has lived the culture and has extended service not only to our visitors and guests but also to associates and volunteers. The impact of this must not be underestimated as it sets a standard and expectation that has become ingrained in the culture of IU Health North Hospital.
Q: What are some of the challenges of improving patient experience?
Ms. Breitfelder: I think all hospitals in the U.S. have to do more with less. All hospitals have to be very efficient with staffing, for example. The bar is also being raised because everyone is trying to improve patient satisfaction scores — you can't just meet expectations anymore, you have to exceed them. Patients are really looking for a 5-star hotel experience when they come to the hospital now. And the final challenge is keeping all your employees engaged.
Mr. Yust: Changes are not immediate and instant. Improving the patient experience takes initiative, dedication and time.
Ms. Graves-Rust: In the world of regulatory compliance, documentation and gadgets, it can be difficult to maintain perspective or take a step back and examine processes. Individuals from all areas of the facility — clinical care to support services — are busy providing the best in service and clinical care each and every day. The challenge then becomes how we identify improvement initiatives and introduce or change behaviors that will allow us to step up our level of service in a way that's easily adopted, understood and integrated into the everyday routines the associates impacted.
Q: How would you recommend overcoming these challenges?
Ms. Breitfelder: First, you have to stay focused and keep an eye on your scores. Look at them weekly, if not more often. And I think you need to share the scores with all of your employees. Keep it transparent. Communication is key, and so is keeping your front-line employees engaged through celebrating successes not only at the hospital level but also at the unit level.
Ms. Broms: It is really important that healthcare organizations take out processes that do not add value or detract from the patient experience. We use the patient experience as a litmus test. If we are going to make change and if we quantify that it will result in a negative patient experience then we don't implement that change until we have a way to mitigate the negative patient experience, irregardless of the financial impact.
Q. What advice do you have for healthcare organizations trying to improve patient experience?
Ms. Breitfelder: One of the easiest things you can do is talk to hospitals with great scores. See what works for them and what you can incorporate into your own organization. The support needs to start at the C-suite level to improve patient experience. Then you need to set expectations for your facility and communicate the same message to everyone. When you do roll out process changes, you need to keep an eye out for consistency and continue to get employee input. At Columbus Regional, we have a value system put into place called ACE IT, which stands for attitude, commitment, enthusiasm, innovation and teamwork. We tell our employees the importance of ACEing IT every day.
Jonathan Goble, CEO, IU Health North Hospital (Carmel, Ind.): Organizations should stop focusing on the patient survey numbers and genuinely focus on the corporate culture of their staff because doing so fosters a sense of respect and value from the organization. When the staff feels respected and valued by their organization, they respect and value the patient.
Study: Only 9% of Clinical Departments Have Plan for Patient Satisfaction Improvement
Study: Contacting Patients After ED Visit Increases Satisfaction
Here, leaders and patient experience coordinators from various organizations with high scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey offer advice on how to improve patient experience and maintain high patient satisfaction.
Question: What are some of the strategies your hospital has implemented to improve patient experience and satisfaction?
Michelle Breitfelder, Senior Vice President of Clinical Transformation, Columbus (Ga.) Regional Healthcare System: Our CEO meets patients in the holding area for surgeries before they are taken back in for surgery almost every day. We have interdisciplinary work groups that help us identify opportunities for improving patient satisfaction — we involve everyone that handled the patient from the various departments. We even give out freshly baked cookies to every patient that leaves the hospital. The cookies have the hospital logo on them, and it is our way to bid a fond farewell to the patient. We also make sure that that our employees are recognized for their achievements by the entire staff of the hospital. We feel that happy employees make happy patients.
Maureen Broms, MS, RN, Chief Information Officer and Vice President, Health Care Quality and Compliance, New England Baptist Hospital (Boston): I would say that maintaining patient satisfaction is a cultural initiative. You need to have a very strong culture that is focused on serving the patient. This focus starts with the CEO and is infused throughout the organization. Without this focus, improving the patient experience remains an initiative and does not become part of the culture. We also have a hiring process that focuses on individuals with similar values and who are committed to creating an exceptional patient experience. We do our best to create a welcoming and inviting atmosphere. We have a hands-on process for responding to patient letters or complaints. Our CEO, vice presidents and physician chairmen are all involved in resolving patient concerns. We try to learn from those concerns, and differentiate between facts and what the patient experienced. Even if we are did everything correctly, it might still mean that the patient didn't have an acceptable experience. You need to take patient experiences as they are without trying to make it about validating your processes and proving the facts. It is equally important to figure out whether or not there was a gap in your processes, and also work with the patients and address their concerns.Randy Yust, CFO, COO, IU Health North Hospital (Carmel, Ind.): We frequently review data and information that is related to patient experience and the patient satisfaction surveys at our manager's meeting, and at monthly meetings to check progress and make changes. We regularly recognize associates, departments and, when appropriate, volunteers for outstanding service and achievements. We do this through internal awards such as the Lasting Impressions Award, department baskets filled with goodies for associates to share and the DAISY Award for Extraordinary Nurses. There are other components as well, such as writing thank you notes to associates in recognition of a job well done, notes to patients thanking them for the privilege to provide their care and rounding that helps reinforce our service standards. Joy Graves-Rust, our patient satisfaction coordinator, is dedicated to working with leadership to interpret the data in a way that is meaningful and understandable. She helps them identify behaviors and activities that are indicated as having a direct impact on improving the overall patient experience.
Paul Calkins, MD, Interim Chief Medical Officer, IU Health North Hospital (Carmel, Ind.): IU Health North has intentionally introduced certain behaviors as expectations. These include behaviors such as greeting individuals with a smile and accompanying visitors and guests to their destination whenever possible instead of simply directing them.Q: What are the most important factors influencing patient satisfaction?
Ms. Broms: First, make sure that patients' expectations are understood by the team, from how they want their meals served to the kind of environment they want to receive care in. Learning what those expectations are and creating a plan around that is important. Creating a warm and welcoming environment is also important, particularly because patients are anxious when they come to a hospital. Another important factor is how the physicians and nurses communicate with them especially in setting expectations of how and when the communication will occur.
Dr. Calkins: Treating patients as people, and making sure they know you consider them a person and not only a medical case or customer is important. So is hiring individuals who genuinely care and enjoy what they do.
Joy Graves-Rust, Coordinator, Patient Satisfaction Measures, IU Health North Hospital (Carmel, Ind.): One of the greatest strengths of IU Health North Hospital has been doing what's right for the patient and family because it's the right thing to do. When done automatically with an intention that is authentic and not mandated, the experience has the potential to become transformational. From the beginning, executive leadership has lived the culture and has extended service not only to our visitors and guests but also to associates and volunteers. The impact of this must not be underestimated as it sets a standard and expectation that has become ingrained in the culture of IU Health North Hospital.
Q: What are some of the challenges of improving patient experience?
Ms. Breitfelder: I think all hospitals in the U.S. have to do more with less. All hospitals have to be very efficient with staffing, for example. The bar is also being raised because everyone is trying to improve patient satisfaction scores — you can't just meet expectations anymore, you have to exceed them. Patients are really looking for a 5-star hotel experience when they come to the hospital now. And the final challenge is keeping all your employees engaged.
Mr. Yust: Changes are not immediate and instant. Improving the patient experience takes initiative, dedication and time.
Ms. Graves-Rust: In the world of regulatory compliance, documentation and gadgets, it can be difficult to maintain perspective or take a step back and examine processes. Individuals from all areas of the facility — clinical care to support services — are busy providing the best in service and clinical care each and every day. The challenge then becomes how we identify improvement initiatives and introduce or change behaviors that will allow us to step up our level of service in a way that's easily adopted, understood and integrated into the everyday routines the associates impacted.
Q: How would you recommend overcoming these challenges?
Ms. Breitfelder: First, you have to stay focused and keep an eye on your scores. Look at them weekly, if not more often. And I think you need to share the scores with all of your employees. Keep it transparent. Communication is key, and so is keeping your front-line employees engaged through celebrating successes not only at the hospital level but also at the unit level.
Ms. Broms: It is really important that healthcare organizations take out processes that do not add value or detract from the patient experience. We use the patient experience as a litmus test. If we are going to make change and if we quantify that it will result in a negative patient experience then we don't implement that change until we have a way to mitigate the negative patient experience, irregardless of the financial impact.
Q. What advice do you have for healthcare organizations trying to improve patient experience?
Ms. Breitfelder: One of the easiest things you can do is talk to hospitals with great scores. See what works for them and what you can incorporate into your own organization. The support needs to start at the C-suite level to improve patient experience. Then you need to set expectations for your facility and communicate the same message to everyone. When you do roll out process changes, you need to keep an eye out for consistency and continue to get employee input. At Columbus Regional, we have a value system put into place called ACE IT, which stands for attitude, commitment, enthusiasm, innovation and teamwork. We tell our employees the importance of ACEing IT every day. Jonathan Goble, CEO, IU Health North Hospital (Carmel, Ind.): Organizations should stop focusing on the patient survey numbers and genuinely focus on the corporate culture of their staff because doing so fosters a sense of respect and value from the organization. When the staff feels respected and valued by their organization, they respect and value the patient.
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