One example of change that's come about as a result of the process is how nurses conduct admissions. It takes about an hour for a nurse to do an admission assessment—a long time away from patients for a nurse with a typical roster of about six patients. One unit decided to solve that problem by taking a team approach to admissions. Now, one nurse does the interview and assessment while another might get orders or do medication reconciliation. Partnering can cut down the time each nurse is away from his or her patients to 25 minutes. "They feel it's easier for a nurse to give up a half hour than an hour. So if they split that between two nurses, they feel they're more efficient," she says.
"Truthfully, I have some concerns about the admission process because I didn't want to break the continuity of the admission. But if it's the paperwork portion, I can live with that," Brennan says.
Trusting the staff has paid off. As a result of these programs, patient satisfaction has improved dramatically, Brennan says, rising 9 to 10 percentage points in one month. Staff morale has improved, as well.
The private practice: A one-stop shop
To Ronald DeMeo, MD, an anesthesiologist and pain-management specialist with Meridian Pain & Spinal Diagnostics in Coral Gables, FL, patient-centered care means coordinating patient care from diagnosis to treatment to discharge, managing their appointments and referrals, filling their prescriptions, and collaborating with other physicians, specialists, and alternative providers along the way. The practice is a "one stop shop," he says. "We try to control, basically, all the variables and aspects of their care in order to get a better outcome."
To patients, the process is seamless, he says—and less of a hassle. They don't have to travel as much, they don't have to wait as long, and all of their medical records are contained in one chart. "It also reduces a lot of redundancy. We have the labs on file. We don't have duplication of testing, and we also have efficiency in terms of scheduling," he says. An organizational model that addresses patient-centered care puts the focus not on the CEO, but on the patient, DeMeo says. "You basically are the cog of that wheel . . . You focus your efforts on that patient—it's a comprehensive approach and basically you try to contain it and reduce redundancy and improve efficiency."
It also "dramatically improves" the bottom line, by adding ancillary services revenue, increasing efficiency and productivity. "You'll save an enormous amount of time and expense and improve efficiency, and basically improve the efficiency of care to the patient, which they respond to positively." That, in turn, leads to more referrals. "Patients will tell their friends how easy it is to get treatment at this facility versus another and how they work with you," he says. It's not just about a disease state; it's also about the patients' psychosocial state, financial situation, and availability or lack of insurance, he adds.
The freestanding imaging center: Navigating patient satisfaction
Training, patient navigators, and software that gathers patient feedback are three of the tools used at Insight Imaging in Lake Forest, CA, which operates 45 freestanding imaging centers, 17 fixed-site centers, and 110 mobile imaging units.