Priorities: Safety, quality come before profitability
Priorities: Safety, quality come before profitability
By Stephen W. Earnhart, MS
President and CEO
Earnhart & Associates
Dallas
Now is a good time to do a reality check and refocus on the priorities in your surgical department.
Since I have been doing this longer than many of you, I have the "wisdom of the old" on my side. Now, these are my priorities and not yours, but let’s see if we are in sync:
1. Patient safety
2. Quality of patient experience
3. Profitability
These three areas always have been my mantra in setting up facilities, managing departments, and troubleshooting.
• Patient safety. This has to be your No. 1 priority. If it isn’t, then it’s time to retire or move on to another career. Patient safety has to be No. 1 because of the nature of our business. There is a difference between quality of patient experience and patient safety.
When we do audits, we look at a number of patient safety areas, such as — I know you will laugh — directions to your facility. Are the directions clear? Are they going to get confused and smash their cars looking for a street sign that was torn down a year ago?
What about your parking lot? Is it safe? Is it lighted properly? Is there adequate parking, or do your patients have to walk across a busy street on crutches to get to your facility?
Are your sidewalks treated when there is snow or ice? I know. You say that is the responsibility of the landlord, but it is not. It is our responsibility, because these are our patients. Make sure the landlords are doing their jobs by providing a safe environment for our patients.
What about the patient selection criteria? Have they been updated and reviewed by the appropriate departments in the system? Has your medical director changed, and has he or she taken the time to sit down and review your protocols for discharge?
When was the last time you looked at your "operative site identification" protocol, so we operate on the right body part? Reading the news lately, it is obvious that some of us have not.
Is the sterile corridor protected? I can tell you for a fact that, in most places, it is not. Patient infections are issues related to patient safety and respect for their trust.
• Quality of patient experience (formally known as "quality of patient care"). It is time to toss out the antiquated, misused, and poor perception of how well we as professionals do our jobs. The fact that our infection rates are low should be expected, not an indicator of how good we are! The fact that we have a low hospitalization rate for our outpatient cases is the way it should be!
As nurses, we try to make ourselves feel good about the job we do by picking and choosing areas of patient care that we do well at providing. What we need to focus on is the quality of the patient’s experience that is important — not little snippets of the process. It is time to open our eyes.
Understanding true meaning of quality’
Sad to say, most do not understand the word "quality." It is very rare to find quality anymore in any workplace and business. One rude person on your staff completely blows your perception that you have great quality of care for your patients. We delude ourselves by thinking we have great patient care, but unfortunately, we are lacking in so many areas.
It is the quality of patient experience that is the new way to quantify the program’s quality. It begins with the posting of the case and ends with the final payment of the patient bill.
Do you really want to know about the quality of your care? Call patients three months after their surgeries and ask them. Listen to their complaints about the hassle they had with the insurance company, or the lack of returned phone calls from your billing department. That, my friend, is the true patient experience — not just the fact that they didn’t get an infection under our care! It is more an issue of respect then instrumentation.
The true measure of your quality of care begins with how soon your patient’s surgery can be posted. Is it taking three weeks to get on your schedule? You don’t think that it your problem? Whose is it — the patient’s? The surgeon’s? No. It is YOUR problem. By not managing your surgical block, posting protocols, or desiring to expand your facility to accommodate your clients (the surgeons and their patients), you are not providing quality of care to your patients.
Now that I have you angry or frustrated, let’s continue. What about Mary, that passive-aggressive difficult employee who is rude to everyone who registers at the front desk? She has a bad night, and every patient who comes into the department pays for it. Why is she still working there? If you wanted real quality of patient care, you would have gotten rid of her years ago.
It doesn’t stop there. What about the surgeons who have too many age-related limitations to be doing surgery? Sure they donated half a million dollars to the hospital for a new wing, but does that give them the right to still have surgical privileges? Why do we have a different standard of quality of care for his or her patients?
I get so sick of hearing administrators or department heads telling me how good their "quality of patient care" is when I see the messy waiting room, rude staff, ignored patients, or hallways filled with every manner of equipment and boxes (let’s talk sometime about "visual quality of care") that would scare the heck out of any patient who isn’t zonked on pre-ops being wheeled down the corridor. A "caring group of health care professionals" statement is destroyed by one staff member who doesn’t know how to smile!
• Profitability. If you have a safe environment and positive experience for your surgeon’s patients, you will increase your profitability. Period. It is called customer service. Treat them right, and they will come back. Try it.
(Editor’s note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 5800 Padre Blvd, Suite 210, South Padre Island, TX 78597. E-mail: [email protected]. Web: www.earnhart.com.)
Now is a good time to do a reality check and refocus on the priorities in your surgical department.Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.