This hospital is a top patient satisfaction performer

Quality Improvement Report, February 26, 2007

But what’s more important to Faye Deich, RN, chief nursing officer, is that the hospital’s commitment to patient satisfaction--which extends well beyond discharge--has actually saved lives.

“We do call-backs for our discharged inpatients, and I know we’ve saved a couple of lives in that process,” she says. “We’ve gotten people back to their surgeons because they were probably starting to develop an infection. We probably saved the life of a new mother who was a diabetic, who was deteriorating on the telephone and was home alone with her newborn.”

Sacred Heart launched its campaign to improve patient satisfaction in 1999, when it began surveying patients with Press Ganey. Back then, it was in the 87th percentile, with a goal to reach the 95th percentile. The Catholic hospital has since exceeded that objective and last year won Press Ganey’s prestigious Summit Award for scoring in the 99th percentile for three consecutive years.

Service excellence
“When we started, we had a strategic plan,” Deich says. “One of the components in that strategic plan was to focus on service excellence, so I became the champion of that as the chief nursing officer.”

The first thing the hospital did was to focus on leadership development. It brought all of its leaders, including supervisors, off-site for training on the hospital’s six pillars for success: quality, service, people, cost, growth, and congruency.

“We began with a lot of education for our leaders because we understood we had to role model the behavior we were expecting others to do,” Deich says. “We gave our leaders a lot of training and tools, and then we developed an accountability system to ensure that they would follow through on what we needed them to do.”

The hospital also began benchmarking both in and outside of the healthcare industry.

“We benchmarked with Ritz-Carlton and other hospitals that were doing very well, and we developed service standards that we instituted across the organization,” she says. “We had employees of all levels help us write those standards.”

Ultimately, those service standards became part of every employee’s job description.

“We connected it into our mission,” says Deich.

Employee satisfaction
The 344-bed hospital then turned its attention toward its workers.

“We realized that you can’t have happy patients without happy employees,” Deich explains. “We began to focus on employee satisfaction and what we needed to do to make the work environment more positive.”

Sacred Heart instituted peer interviews across the entire organization. Housekeeping applicants, for example, interview with other hospital housekeepers, nurses interview with other nurses, and so on.

“We engaged our employees,” Deich says. “They’re very astute at picking the right people, and then they’re very engaged in making sure they succeed.”

Deich and her CEO also take new employees out to lunch after 90 days to find out whether the job is what they expected and whether there are any reasons why they would consider leaving.

Managers meet with new employees after 90 days as well.

Challenge of consistency
The hospital’s patient satisfaction scores rose from the 87th percentile to the 92nd shortly after it began working with Press Ganey, but it couldn’t climb to its goal of reaching the 95th percentile.

“I think our biggest challenge was consistency,” Deich says. “You focus on something and it gets better, then you focus your attention somewhere else, and it drops.”

To make sure all employees stayed focused on patient satisfaction, Sacred Heart linked the service standards it developed to performance reviews hospitalwide.

“You can’t just treat [patient satisfaction] as a program,” Deich says. “It really has to be integrated into the culture. And that took us years to accomplish.”

The hospital now sends weekly reports to every department, detailing how well it’s doing on patient satisfaction surveys.

Deich can’t recall exactly what year the hospital hit the 95th percentile, but she remembers that shortly after it reached its goal, the scores quickly climbed even further.

What do patients want?
“Ninety-nine is really great,” Deich says. “But it’s really what 99 represents. And what that 99 represents is that any patient, any day of the week, regardless of who’s working, can come to this hospital and receive very good care.”

One way the hospital guarantees that consistency is by asking every patient at admission what he or she needs to get very good care. Spirituality and emotional needs are usually high up on the list.

“This is where we’re probably the most fortunate hospital in the world,” Deich says. “We have in-house pastoral care 24/7. Our pastoral care staff pretty much see every patient. Our mission really is to be there for people in their hour of need, and even though we’re a Catholic hospital, it’s a very ecumenical approach.”

HCAHPS trial run
Deich hopes that the hospital’s success with Press Ganey surveys will translate to high performance on the Hospital-Consumer Assessment of Healthcare Providers and Systems. Starting with July through September discharges, hospitals must report HCAHPS data to CMS in order to receive their full market basket update for fiscal year 2008.

In order to submit the data, hospitals must have participated in a CMS dry run, the last of which is scheduled for March. Sacred Heart will participate in that final dry run.

“The difficulty with HCAHPS is that it’s a different tool than Press Ganey’s,” Deich says. “We might not look the same on HCAHPS as we do on Press Ganey.”

Deich advises quality improvement directors who may be new to the surveys to look at the questions on the HCAHPS and start querying their patients in advance.

“Obviously, you need to be courteous and respectful to people, and timeliness is important,” Deich says. “But I really think that asking patients what it is that is most important to them [and] what will make them feel as though they have received the care that they need, to me, that’s where it all starts.”

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Lisa Buckley is the editor of Quality Improvement Report. She may be reached at lbuckley@hcpro.com. This story first appeared in the February edition of Quality Improvement Report, a monthly newsletter by HCPro Inc. For information on all of HCPro’s products, visit www.hcmarketplace.com.