Hospital Leaders Create ‘The Culture of Always’ (INFOGRAPH)

“We’re able to do deep dives on extensive demographics to understand how patients rate their experience,” Merlino says. “For instance, we know that sicker patients at hospitals have lower satisfaction. When you drill down on that data, you realize they rank their experience that way because they require more robust communication. And so we can focus on improving communication to challenged populations, because we know that will improve their compliance, help them better understand their treatment, and reduce medication errors. Linking IT through the data that has been collected has been revolutionary for us.”

NOISE AND MORE

Across the landscape, hospitals have drummed up both obvious and unique ways to improve patient satisfaction scores and the overall experience. At Grady, Scott says part of their $4 million renovation has included more channels on the TV, better food options, and more private, high-tech friendly rooms. Changing the flow of the operating room, allowing for a more streamlined process for patients, is an ongoing project at Lafayette General.

Noise is the big thing at Phoenix’s Children Hospital, a 345-bed facility, where Deb Green, R.N., nurse manager for the cardiovascular intensive care unit, has led the implementation of a number of strategies to reduce noise in the ICU. This includes standard steps such as constructing noise-reducing walls and floors and more high-tech measures such as working with Vocera (San Jose, Calif.) and Philips Healthcare (Andover, Mass.) to reduce the noise monitors make by having a nurse’s handheld deviecs ring instead.

“Noise is something you don’t even think about often as a part of healing,” Green says. “You can’t get a calm body system if the noise level is so high it’s causing your heart rate to be elevated and your blood pressure to change.”

THE RIGHT THING

The HCAHPS initiative and the government’s “culture of always” are far from perfect in the eyes of many. For one, as Scott says, what the patient wants 100 percent of the time might not always result in the best outcome. She says the use of morphine to manage pain is an example where this could come into play. She also notes how unlike a vacation or a restaurant, going to a hospital is not something patients plan on doing.

However despite some possible hesitation about HCAHPS, Scott and others, are adamant that focusing on the patient experience is the right thing to do, not because of the incentive money tied to it, but because “it should be a part of what you do.” At Cleveland Clinic, it’s become such an intricate part of the culture, they took the entire workforce (43,000 in all) offline, sat them at tables of eight-to-10, and had them discuss how to best deliver the hospital’s “patients first” initiative.

“There are incredible opportunities to improve and change the way we deliver medicine. Don’t view this as a mandate, and don’t view it as something that’s being forced upon you. View it as something that’s right for patients and use the opportunity to improve the way we deliver care,” concludes Merlino.

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