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Make a good first impression: It's critical
Improving patient satisfaction is "a high priority" for the patient access department at Advocate Illinois Masonic Medical Center in Chicago, according to Michael F. Sciarabba, MPH, CHAM, the hospital's director of patient access services.
"We believe strongly that we have an important role in transforming the patient experience," says Sciarabba. "A positive first impression is critical to that end."
Patient access staff, says Sciarabba, are the ones who "guide our patients through the complex world of health care. As a critical support department, improvements must be continuous to positively impact the patient's impression of the hospital and our department."
In light of this, any process and technology improvements made by patient access must always consider the impact on patient satisfaction. "Still, the ability of patient access departments to meet established organizational survey goals are complex and challenging," says Sciarabba.
Here are some successful approaches to improve satisfaction:
Create a patient access team.
This was recently implemented at Methodist Charlton Medical Center in Dallas, with the goal of providing timely patient access to health services in all areas of the hospital. The team places specific emphasis on the emergency department.
All members of the patient access team meet every two weeks to act on and review initiatives to improve patient throughput. They also monitor dashboard metrics related to patient throughput across the organization.
"We look forward to working collectively as a team to improve process efficiency and efficacy," says Jeanette Foulk, the hospital's director of admitting/discharge.
The patient access team includes the hospital's president, vice president of operations, critical care director, inpatient director, representatives from care management, human resources, the emergency department, the hospitalist medical director, chief nursing officer, admitting/discharge director, ED director, and the cardiology/radiology services director.
Here are the patient access team's goals:
Quantifiably assess barriers to excellence, and recommend resources to eliminate these.
Drive systemic accountability toward achieving best-practice benchmarks and processes for ongoing monitoring.
Provide recognition to individual members for meeting milestones toward metric benchmarks.
Recommend organizational changes and policies and procedures in support of patient access and flow.
Implement action steps through teamwork to "hardwire" sustainable change and excellence across the organization.
Create a culture of organizational change related to improving access to health care services for communities served.
Use kiosks to survey customers.
Emory University Hospital Midtown in Atlanta recently piloted patient satisfaction kiosks. These allowed the access department to survey patients about particular areas of registration. Two kiosks were placed in corners of the waiting area to allow privacy and avoid a "backup" in the area.
"We used the data to determine if improvement was needed, and to reward staff who were mentioned for doing a great job," says Elease Brown, assistant director of patient financial services. "We reviewed these data with our staff. Collectively, we brainstormed to develop ways to improve satisfaction. If our budget allows it in the future, we may pursue it again."
Upon completion of registration, patients were encouraged to go to the kiosk to complete the survey. If time did not permit, the patient was invited to return to complete the survey. Here are some of the registration questions patients were asked:
Were you pre-admitted (registered via phone) for today's visit? If you spoke with a staff member by phone, how courteous was the person you spoke with?
Please rate your overall satisfaction with your registration experience today at Emory University Hospital Midtown.
Please rate the ease of the registration process and waiting time in the registration area?
What was the degree to which you were informed about delays in the center?
How well were billing and insurance questions handled?
Please rate the comfort of the waiting room.
How helpful was the staff at the registration reception desk?
How courteous was your registration representative today?
"We tried to capture most aspects of the registration experience," says Brown. "There was an option to enter comments and leave a contact number as well. We chose to have candy kisses as our token of appreciation for completing the survey, because they were less costly due to volumes." Other tokens considered were parking passes and coupons for movie theaters, the hospital cafeteria, and local restaurants.
Weekly summary reports were received. "We reviewed them to see which areas our patients were most satisfied or dissatisfied with," says Brown. "While most of the ratings were high and comments were positive, we did receive some that required our attention."
Surprisingly, patients also gave some unsolicited comments about other areas. "Admissions and physical therapy were the only areas involved in the pilot, but I guess patients needed an avenue to express their concerns about other areas as well," says Brown.
Give patients tokens of appreciation.
Emory's access department is "constantly looking at ways to improve patient satisfaction," says Brown. One small way of doing this involves "wowing" patients with tokens.
"These are things to let them know who we admissions are," says Brown. "Each patient, in all registration areas, is offered an emery board with our logo. They are a big hit, even with the men."
Also, patients are given a personalized, hand-written thank you card when they make a payment. This helps with upfront collections in all areas of admissions, including the emergency department, pre-registration, inpatient, and outpatient departments.
"Our pre-registration staff members will mail the cards, along with the receipt, to patients who make upfront payments via phone," says Brown. "We've received positive comments about the thank you cards."
Use role playing.
When a new patient access employee is hired at the Cleveland Clinic in Independence, OH, he or she attends an eight-hour customer service training program including a lot of role playing. The new hire interacts with "patients" who are nervous or angry about various situations, says Susan M. Milheim, senior director of patient financial services.
Each year, employees attend a four-hour "refresher" course. Training staff act as the patients, using real-life examples provided by front-line staff or customer service representatives. One scenario involves a patient who has come in as a direct admit and is irate because he thinks waiting for a bed is taking much too long.
"Role playing is very important. It gives the employee the opportunity to practice their newly learned skills," says Milheim. "The role playing is videotaped and available for employee review for future reference or a quick refresher."