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How Safety-Net Hospitals Are Improving the Patient Experience

Cheryl Clark, for HealthLeaders Media, July 16, 2013

After tweaking the culture with targeted campaigns, both Press Ganey and HCAHPS survey scores improved.

For the period April 2011 to March 2012, Medicare's Hospital Compare shows Jefferson's HCAHPS were better than both national and state averages in six of 10 questions and were similar in a seventh. In response to the last question—would patients definitely recommend the hospital?—76% said yes, compared with 68% in Pennsylvania and 70% in the nation.

One area in which the organization still struggles is physician communication with the patient; scores lag a few points behind state and national average, although more recent surveys show improvement, says Jennifer Jasmine Arfaa, PhD, Jefferson's chief patient experience officer. "Many of our physicians were not aware that patients were being surveyed about their entire patient experience at Jefferson, let alone the fact that there is a section in the survey where patients can rate their physicians and the whole hospital can see that in a comment report," she says.

Arfaa cites several campaigns—under the leadership of Elisabeth Kunkel, MD, vice chair for clinical affairs, department of psychiatry and human behavior, and chair of the MD Care Task Force, and Susan Krekun, MD, director of thedivision of hospital medicine and cochair of the MD Care Task Force—that have helped improve patients' perception of their experience related to their physicians:

  • Chairs are placed in patient rooms with a directive to physicians and other staff to sit down and make eye contact with their patients as they speak with them.
  • Staff and doctors wear lapel buttons that ask "What questions do you have for me?" and notepads and pens are placed in each patient's room so they may jot down questions that occur to them.
  • White boards are available for patients to list their three most important things. "It might be something as simple as, 'I want to see my husband every day.' Then the housekeeper comes in, looks at the board, and can have a positive interaction. 'Oh, Mrs. Smith, did your husband come in today?' " Arfaa says.

Arfaa and McQuaid say Jefferson hospitals don't try harder with safety-net patients. "Our patients are our No. 1 priority, and every patient is treated the same, with dignity, respect, and integrity," Arfaa says.

At University of Kansas Hospital in Kansas City, a safety-net hospital where more than one in five patients is on Medicaid or self-pay, patient experience scores are higher than the state and the national levels for six questions, including "Would you recommend ..."

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