Improving patient experiences continues to be a hot topic and investment in hospitals across the country, with increasing financial incentives tied to HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey results, other value-based outcomes and venues such as the Emergency Department and outpatient services on the horizon for pay for performance initiatives. While financial reimbursements might be the catalyst for an increased focus on the topic, there are a multitude of reasons for making patient satisfaction a top priority.
Studies indicate that organizations in the top quartile on HCAHPS are also in the top quartile for profitability, have reduced employee turnover rates and are market share leaders. Patient satisfaction is more than just a number – it drives success across every aspect of the business. At the heart of this focus are improvements in communication, processes, teamwork, coordination of care and the culture of an organization. Hospitals and the industry as a whole have moved past the notions of smile campaigns to improve performance and instead focus on how to make meaningful connections and create long-term relationships with patients and their families. This new mentality is showing that patient experience metrics can be tied to other initiatives such as employee engagement, lean six-sigma systems, length of stay, population health and even productivity measures.
From pre-admission to post discharge, each patient interaction with an employee or physician creates a lasting impression about the hospital. These opinions inform future decisions about where to seek care and recommendations to others. For this reason, patient satisfaction must be evaluated holistically and proactively as more than just the clinical experience while in the hospital. Patient satisfaction does not distinguish a hospital, but an experience that exceeds expectations for what a hospital can provide creates loyal patients who return for future health needs and refer their family and friends.
While physicians, clinicians and nurses in general are intrinsically motivated to focus on the patients’ needs, at times their medical training often prioritizes clinical-decision making over how effectively they are connecting or communicating with patients. There is a growing list of distractions that take caregivers away from the bedside and forces attention to computer transactions and chart review.
Care teams that invest and see the value of patient engagement, establish practices that ensure great communication with patients and families, shape expectations and provide opportunity for dialogue and shared decision making where possible. Better communication fosters a more productive work environment, which ultimately leads to better patient care coordination that directly impacts length of stay, outcomes and readmissions.
At El Camino Hospital, we believe a combination of great communication, leadership, disciplined measurement and analysis and commitment to technology innovation are the formula for improving patient engagement and care. One of the biggest steps we have taken toward this effort is leadership rounding using mobile technology. It is a strategy designed to increase meaningful connection with patients and visitors, free up time at the bedside for nurses, reinforce other initiatives through intentional interviewing and capture the voice of our patients.
In 2014, we implemented Care Rounds from Vocera, a powerful tool that provides transparency and accountability about our patients’ experiences in real time, lending insight into trends or gaps as well as opportunities for staff recognition. Care Rounds helped us establish a real-time feedback system, quantify intangible information and provide our chief nurse with accurate information about how many managers round and how many patients establish connection with someone outside their care team as a go to resource.
Between our two campuses in Los Gatos and Mountain View, we have conducted thousands of experience rounds since implementation, generating nearly 83,000 patient inputs and proactively identifying more than 700 improvement opportunities. We have also conducted rounds with hospital staff, an exercise that has resulted in discussions about ways we can improve our processes and communicate better, improving staff moral and loyalty to our organization.
Overall, within one year of implementation, we were able to increase the percentage of patients experiencing leader rounding during their hospital stay from 15 percent to over 50 percent. As a result, our HCAHPS scores increased for nurse communication and staff responsiveness by approximately 25 percentile points. Additionally, we track referrals to Environmental Services, Facilities, Spiritual Care and other departments to ensure that any issues surfaced get resolved quickly.
We have built a communication system that is patient-centered and helps our care teams improve their relationships with patients. Designing a system that values the patient experience first is a win-win – it saves us work and also leaves them happier with their time in our facilities. Furthermore, we believe strong communication has a direct impact on treatment plan adherence – when we communicate clearly and regularly with patients, they are much more likely to actually follow through with recommendations provided by their care team.
Our patients think of El Camino Hospital as a member of their community – a hospital where they have access to the best possible care, delivered in the most personal way possible. Hospital leaders should strongly consider the value that boosting patient experiences has in enhancing performance across all departments and the goodwill and reputation in their community.
RJ Salus is the Director of Patient Experience at El Camino Hospital.