At some point raising your HCAP score will do no more for your hospital than being able to calculate the next decimal place of pi.  The law of diminishing returns.

The CBS Sunday Morning program ran a piece on medical dummies used to train doctors in a variety of procedures and specialties.  Practicing on a dummy, students could learn how to perform spinal taps, drain knee fluid, administer anesthesia, and deliver a baby. Medical schools are also hiring actors to help doctors improve their bedside manner. 

These medical mannequins cost upwards of three hundred thousand dollars.  They can exhale CO2, have dilated pupils, and swollen tongues.  Hospitals invest millions of dollars to ensure that the treatment their patients receive is the absolute best.  Doctors and nurses spend thousands of hours ensuring that the treatment they provide their patients is the absolute best.

They do not do this just to improve the patient’s experience; they devote their resources and their time to get it right, as right as they can as often as they can. How does that devotion translate to how patients rate their hospital experience?

What do we know?

• All procedures are as good as the doctors and nurses know how to make them
• All patients undergo certain procedures
• Most patients undergo an array of different procedures
• Almost no patients undergo identical procedures in the identical order
• Improving the efficacy of a single procedure is good for those patients having that procedure
• That improved procedure only impacts a small percentage of the total patient population
• Small improvements of discrete processes will not improve the total patient experience rating for the hospital

What else do we know? (for simplicity let us focus on in-patients)

• All patients are scheduled, admitted, housed, fed, discharged and billed.
• Improving any one of these areas will improve the satisfaction of all patients

The big unknown.

• Why is nobody focusing on the things that will raise patient satisfaction across the board

The hospital business processes for scheduling, admitting, housekeeping, food service, discharging and billing affect each patient.  Has your hospital ever asked your patients what their expectations are of these processes? I have not come across one that has.  But for those hospitals that do not know what patients expect from these processes, I guarantee you that your patient’s satisfaction barometer is measured against the one other service they purchase that has scheduling, admitting, housekeeping, food service, discharging and billing—staying in a hotel.

But we are not a hotel.  Please, no whinging.  Because patients have spent hundreds of nights in a hotel, their expectations of scheduling, admitting, housekeeping, food service, discharging and billing are predetermined and fixed. Each of these processes, at least when compared to medical procedures are exceedingly simple and the most repeated processes in the hospital.

The chances of your hospital exceeding your patients’ predisposed expectations are slim.  The chances of underperforming are great.  If you have not worked hard at reinventing these processes, your call center, your CRM, and your patient portal in the last two years, your chances of satisfying anyone border on nil. If you are being honest, some of these processes have not changed since the hospital was built.

What do we know about the employees who deliver scheduling, admitting, housekeeping, food service, discharging and billing to your patients?  They are the lowest paid, lowest skilled, least educated, least trained, and lowest tenured people in your organization.

These same people, what they do, and how well they do it contributes greatly to how patients will rate their level of satisfaction with your hospital.  My guess is that what they do and how it is perceived probably accounts for at least fifty percent of how they rate your hospital.

Here is what I propose.  Back to the medical dummies and the actors.  Could they somehow be employed to improve patient satisfaction for scheduling, admitting, housekeeping, food service, discharging and billing?  Imagine having someone in your billing department trying to get a dummy to explain the wherefores of a forty-thousand dollar invoice and you will get a pretty clear picture of how the patient feels when they have a question about their bill.

Remember, a rising tide lifts all boats, and that is a good thing unless you happen to be the person tied to the pier.