Reinventing Patient Satisfaction One Process at a Time

If a blog falls in the woods and nobody reads it does it make a sound?

I was watching the news today and heard the reporter state that the victim was shot in the garage—I guess that is a lot better than being shot in the backside.  My bad, but I am sort of a syntactical enforcer.

When basketball was invented players shot the ball into a peach basket.  When a player scored the game was halted to allow someone to bring over a ladder so the ball could be retrieved from the basket.  The game was very slow.  It was very slow for seven years until someone got the idea to cut the bottom out of the basket.

Suppose someone asks you to give them the Cliff Notes version of Patient Satisfaction.  What is the best way to convey such a complex issue?

There are some 5,000 hospitals in the US.  There are some 2,500 hospitals being penalized for having poor patient satisfaction scores.  As compared to what, did anybody ask the patients?  Use a highlighter or underline this on your monitor—being in the top half of the patient sat scores does not mean that your patients are satisfied with your hospital.

I spoke with one of the chiefs of a large New England IDN. He told me his wife was having surgery, so he arranged for her to have a white-glove experience. Afterwards she raved about the experience.  But, when they viewed her HCAHP survey, her scores did not reflect the great experience she had; they reflected her experience as was defined by the survey.  There is a big difference between the two recorded experiences. In one experience, the one defined by HCAHPS nobody asked her about her expectations, and nobody asked her how she would rate her own experience.

Of the hundreds of thousands of patients who have completed the survey, none of them were ever asked about their expectations. Maybe the survey’s authors did better in Clairvoyance 101 than I. I think a lot of us knew HCAHPS was not the best solution for improving patient experience. Hindsight is a wonderful thing; and the smart people get their hindsight in first.

To the chagrin of the ‘six sigmatists’, here is a news flash.  Shaving thirty-two seconds off of the time it takes to be admitted does not yield satisfied patients.  If making the admitting the process shorter is a good thing, would it not make sense that doing away with the patient admitting process would be a really good thing?  Maybe it is time to cut the bottom out of this peach basket.

There are dozens of other processes for which the same analogy holds water. Improving patient experience may seem a little chaotic, but there are many threads in the chaos, and trying to solve the problem using HCAHPS involves pulling the wrong thread. Is the noise I am hearing the sound of the first pieces beginning to fall into place?  I think the thought behind those who decided to use HCAHPS as the measure of patient satisfaction intended for it to be easy—just a few dozen questions. Instead, it has become like counting votes in Florida.

If your hospital has not recently reinvented how it electronically interacts with patients and potential patients through a world class patient portal, it is way out of touch with how patients interact with other organizations with which they do business.

How would you like to be admitted if you were going to the hospital two days from now?  If you are like me, you would want to navigate to the hospital’s web site the evening before you are scheduled to check in.  You want to pull out your iPad, go to the web site, complete the check in and be given a room assignment.

Patient satisfaction just went up.

I may be wrong but I doubt it.

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