Scores of employees of the Anne Arundel County (MD) Department of Health and Fort Meade descended on the county’s two hospitals to test their preparedness for facing a flu pandemic. Anne Arundel and Baltimore Washington medical centers practiced assessing a surge in patients to the emergency department, amid their own mock shortages in staff. In addition, the Department of Health and the Office of Emergency Management tackled their own challenges of having staff reduced by influenza and directing their remaining resources. The joint effort is the first time the groups have come together in a realistic exercise.
A Central and Southwest Florida developer hopes to tap into Polk County, FL's growing and aging population by building a $250 million medical center. The center will include an assisted and independent living community, a fitness center, medical offices, and a pharmacy. Representatives from the company said its neighbor, the 142-bed Heart of Florida Regional Medical Center, will help lure patients to the medical facility because the hospital plans to provide physical therapy and other healthcare services at the new site.
AMA delegates this week pondered an ethics council recommendation to endorse the practice of secret or mystery shoppers—undercover patients hired by a hospital or physician group to pretend they are patients and report back on their experience.
Physicians who oppose the measure fret that the "fake" patients will interfere with the treatment of real patients. They worry that they might be disciplined if they happen to make one small misstep. They say mystery shoppers aren't a good way to measure quality.
But I don't think these or any other arguments hold water.
For starters, the ethics council proposal as written already addresses many of opponents' concerns:
Mystery shoppers should never go through with an inspection if it would interfere with the treatment of emergency patients. (In fact, many mystery shopping firms use people who need tests or procedures anyway.)
Healthcare organizations should inform doctors that they will be using mystery shoppers, though not announce the exact time of the visit.
Physicians and others who come into contact with mystery shoppers should not be disciplined for any issues that arise, but rather be counseled on how to improve based on the feedback.
But more importantly, think about the message physicians who oppose mystery shopping are sending to your patients: that they'll only behave if they know they're being watched. It might not be true, but do you really want your patients to think that physicians will only be on time or explain delays, wash their hands, be thorough in their examinations, explain treatments, tests, and procedures, and make sure to answer patients' questions if they think the patient might be a mystery shopper?
The American Medical Association ethics council's mystery shopper report points out what should now be obvious to every healthcare marketer and leader. "As healthcare becomes a more competitive marketplace in which ‘healthcare consumers' (patients) comparison shop for healthcare services, individual physicians and hospitals are realizing that patient perception is key to maintaining and growing practices," the report states.
In consumers' minds, perception is reality.
Take for example a doctor who washes her hands before entering the exam room. She doesn't see a problem—until the mystery shopper reports back that she didn't wash her hands. A simple adjustment to her usual routine—washing her hands in front of her patients—can change patients' perception of her.
In its report, the ethics council cites the many potential benefits of mystery shopping. For example, information from secret shoppers has led to improved patient flow and wait times and warnings about potential breaches of patient privacy. Business improvements might include more effective hours of operation, better customer service, a more pleasant waiting room, larger type on signs, and even nicer telephone exchanges between staff and patients.
"In addition to using secret shoppers to identify opportunities for improvement, information can be used to reinforce desired practices. Some healthcare facilities, for example, reward employees who receive positive feedback from secret shoppers with a range of incentives from cash, to better parking spaces, to engraving their name on a wall plaque."
I have another idea: Let's start treating every patient as if he or she is a mystery shopper.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
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Nurses aren't trained to be managers. They're trained to be clinicians. So how can your hospital ensure that it is providing the additional training and leadership development needed to create the next generation of chief nursing officers? The first step is identifying which nurses have the personality traits to be effective managers—and just because a nurse is a great clinician doesn't mean she'll be a great leader.
Recently, I spoke with M. T. Meadows, director of professional practice at the American Organization of Nurse Executives in Chicago, about the different skill sets that nurse executives need in smaller community hospitals versus larger health systems. She said that nurses in rural or critical-access hospitals have numerous responsibilities; for example, they may be in charge of the nursing units plus housekeeping and pharmacy. "They need to be able to identify with the groups of people that they are leading. They may have a nursing and a non-nursing department, and the needs of those departments are going to be different, so they have to wear more hats and work on their objectivity in dealing with multiple departments," she says.
I have heard that hospitals should be looking for nurses who don't intimidate easily, are confident and compassionate, exhibit objective and independent thinking, have the ability to see the big picture, and embrace change as an opportunity for growth. But identifying potential leaders is just the first step. Next is establishing an in-house training program—which may be difficult for mid-sized or smaller hospitals because they often lack the infrastructure and resources required to establish such programs. One training tool that is fairly easy to implement whether you're a small or large hospital, however, is a mentoring program. Mentors can help groom new nurse executives by helping nurses identify what their learning needs are and directing them to that information. They can also help nurses transition into a new role by acting as a sounding board for new nurse leaders' questions or problems.
While it is beneficial for the mentor to have knowledge of the nurse executive's role, is it absolutely necessary to have only nurse managers mentoring other nurse managers? I wonder if smaller hospitals should establish a mentoring program in which non-nursing executives are partnered with new nurse leaders—especially since nurses in these facilities assume multiple responsibilities. Why not have the chief financial officer or chief operating officer mentor the new nurse executive? The CFO or COO could help get the nurse leader up to speed on the financial elements of the job—an area frequently requiring additional training—or the operational elements of the organization.
In addition, this type of mentoring program could give smaller organizations the opportunity to pick truly great mentors—people who have good communication skills and understand how adults learn—rather than choosing mentors based solely on their job. The bottom line is that the organization needs to foster an environment that supports learning. Staff members need to feel comfortable sitting down with a colleague and saying, “Tell me what I need to know about this spreadsheet.”
If you have a unique approach to mentoring or training new nurse executives, I would love to hear about it. Please drop me a line at cvaughan@healthleadersmedia.com.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.
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Cooperation is absolutely essential to quality healthcare in rural areas, according to a national expert. The word "collaboration" might have negative connotations for some people and groups, but it is "central to what we're trying to do in rural American, rural health," especially because in rural areas, competition and free-market forces are sometimes entirely absent, Forrest Calico, MD, told a gathering of agencies that came to Plymouth State University in New Hampshire for a forum.
About 15 third-year medical students from Touro University College of Osteopathic Medicine in Vallejo, CA, will spend one year in North Coast clinics providing care to rural communities. The rural clinical rotations in Humboldt and Del Norte counties are new for the university, and give students opportunities to work at rural clinics as opposed to large, often hierarchical hospitals, say Touro University representatives.