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How Safety-Net Hospitals Are Improving the Patient Experience

Cheryl Clark, for HealthLeaders Media, July 16, 2013

Feinberg says he began spending "a couple hours a day" walking hallways, knocking on doors, and asking patients about their care. "I say, 'Here's my cell phone number. Call me 24 hours a day if you or your family ever need anything.' " He still does this with 10 patients a day.

Now, "the whole management team does this. We have structured rounds, with 250 people who go out two or three times a week." Even the CFO.

The hospital draws from what Feinberg calls "a melting pot" of uncountable ethnicities around Los Angeles, and where nearly one in five patients is self-pay or Medicaid.

Ronald Reagan UCLA Medical Center also launched a talent program developed by Ritz Carlton to ensure the hiring of service-minded people. There are training programs that guide the way providers enter a room and interact with patients to convey their engagement.

Staff use current events to start conversations like, "Did you know it's the 70th anniversary of Little League?" and housekeepers ask, "Is there an area you want me to clean?"

And there are movie tickets, cafeteria coupons, or $10 gas cards if something goes wrong, "like you're waiting a half hour for your MRI because there was an emergency. It's a small token of appreciation for the hassle we put patients through," Feinberg says.

Some of this strategy has worked. According to Hospital Compare, 80% of patients give Ronald Reagan UCLA a 9 or 10 on a scale of 0 to 10, compared with the California average of 67% and the national average of 69%. And 83% would definitely recommend the hospital, compared with 69% statewide and 70% national.

Ronald Reagan's NRC Picker surveys indicate favorable responses to the "Would you recommend" question are getting better, with 93% as of June, 2012.

But responses to other questions still trail—for example, those about nurse and physician communication.

"Yes, our scores are much, much better than they were before, but my honest opinion is that they're still terrible," Feinberg says. "The next patient who comes in really doesn't care about the Nobel Prize winner on our staff or that we published this paper. All they care is that the people standing around them with badges are explaining what's going on. Are they listening? Are they engaging the families?"

Staff still give excuses: "We can't be as good as other hospitals because we don't have a new building. Or because we have residents and trainees. Or because we take care of really old, very sick patients. There are hundreds of excuses."

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