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Improve Patient Satisfaction Scores, Boost Medicare Reimbursement

By HCPro Staff  
   June 22, 2016

Most patient satisfaction survey tools, including HCAHPS, are ­multidimensional. Thus, the physicians, nurses, other care providers, food service, and housekeeping staff must tackle patient satisfaction scores from multiple angles.

Healthcare providers understand that patients are customers, and customers can take their business elsewhere if they are unhappy about any aspect of their experience.

To keep patients, and thus reimbursement, coming in the door, hospitals must focus on achieving strong patient satisfaction scores. The Centers for Medicare & Medicaid Services’ (CMS) reinforces the idea. Its value-based ­purchasing program has incorporated Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) scores into its inpatient prospective payment system, so there is no better time to hop on the patient satisfaction wagon.

Most patient satisfaction survey tools, including HCAHPS, are ­multidimensional. Thus, the medical staff, nurses, other care providers, food service and housekeeping staff must tackle patient satisfaction scores from multiple angles, according to Peter Short, MD, senior vice president of medical affairs at Beverly Hospital, (MA).

The HCAHPS survey contains 18 patient perspectives on care that ­encompass eight key topics:

  • Communication with doctors
  • Communication with nurses
  • Responsiveness of hospital staff
  • Pain management
  • Communication about medicines
  • Discharge information
  • Cleanliness of the hospital environment
  • Quietness of the hospital environment

“When you talk about HCAHPS, you are talking about the whole patient experience. To demonstrate to patients that we have their best interests at heart, we have to be a team. It takes a team approach to improve HCAHPS,” says Short. Medical staff leaders can help heighten the team spirit by creating a patient-centered medical staff culture using the following hospitalwide tips.

Implement multidisciplinary rounds

Jonathan Lovins, MD, SFHM, assistant clinical professor of medicine at Duke University Health System and hospitalist at Durham Regional Hospital (DRH) in Durham, NC, says that multidisciplinary rounds have helped improve the organization’s HCAHPS scores by 5% during the past three years because patients perceive a more coordinated approach to their care. “I think one of the things that disheartens patients the most is when they hear different stories from different providers,” says Lovins.

Every morning, nurse managers, case managers, nurses, physicians, and pharmacists meet for 10–20 ­minutes to discuss each patient.

“As a hospitalist, I don’t feel like it saves me time, but at the very least, it seems to make patients more comfortable,” says Lovins.

Not only do multidisciplinary rounds help get all care providers on the same page, but they also help reduce mistakes that result from miscommunication (or noncommunication). In addition, they help all members of the healthcare team feel included in care decisions.

To implement multidisciplinary rounds, the medical staff appointed a physician to serve as the medical director for each of DRH’s two floors. Patients were then distributed geographically, meaning Dr. Jones’ patients are clustered on the first floor, while Dr. Smith’s patients are clustered on the second floor.

“That was the hardest part. When we distribute the patients in the morning, we try to make sure that each physician gets patients only on that floor, which was hard because we have to sacrifice things like continuity of care to a degree,” explains Lovins.

For example, although hospitalists, who generally work seven days on and seven days off, were previously not assigned new patients on their last day of work, they sometimes now receive new patients so that patients are located on the correct floor for the hospitalist who starts work the next day.

According to Short, Beverly Hospital also performs multidisciplinary rounds. One of the major benefits, he explains, is that the same group of nurses works with the same handful of physicians, creating a team environment.

“We go in the patient’s room together to see the patient. That way, if anyone has a question, they can get the same answer from the nurse or the doctor, and the patients know it is a team approach. Patient satisfaction is about communication to their family and the rest of the caregiver team,” says Short.

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