improving patient satisfaction scores in the ed and ip setting
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Improving Patient Satisfaction Scores in the ED and IP SettingRyan Sundermann MDTracy Reittinger MDSt Luke’s Hospital Cedar Rapids, IA
Improving Pt Satisfaction in the ED at St Luke’s Hospital
Ryan Sundermann MD
St Luke’s Satisfaction DataThen vs Now
St Luke’s ED Provider Satisfaction Data
St Luke’s ED Provider Satisfaction Data
Breaking Down Physician Scoring• Courtesy: what do you do when you enter the room• Took time to listen: sitting down, leaning forward,
repeating what the patient says• Took my problem seriously: “My job is to think of
the 5 worst things this could be.”• Kept me informed/Re-evaluated: Fly-bys, providers
go over D/C with all patients• Concern for comfort: water, blankets, coffee for
EVERYONE.▫(Note: what happens in between #3 and #4? Have
you ever been there????? Can you say ANXIETY!)
Engaging Providers • Must be top down: Must come form the CEO as part of
the Mission Statement• Must have a true believer/evangelist for satisfaction:
Who is this in your facility?▫Oldest doc, director, youngest doc, respected doc?
• Hire well and train early: Old dogs, new tricks adage applies, but not impossible. “Embrace their skills, but empower change.”
• Get rid of misconceptions▫Drug seekers are not the ones that move the bar (docs
with bad scores feel that they might have to hand out vicodin to improve scores)
▫Lots of evidence on the PG website
Engaging Providers •Must have reliable data
▫Just like D2Doc, LWOBS, etc▫Must be specific to doc, not overall number▫May not be accurate, but must be precise
to find outliers•Its about GOOD CARE, not MARKET
SHARE▫But you might be surprised how one follows
the other
Hit’em in the Pocketbook• Make bonus contingent on perfomance
▫How much?• What is the target
▫65%ile• How often
▫Quarterly with rolling 12 month• What if they don’t meet for one period
▫Hold for 1 qtr, use 2 qtr bonus to pay for Satisfaction CME
• What if they don’t meet repeatedly (or ever)▫Jack Welch theory on “C players”
Where do you send them?•Jay Kaplan/ Studer Group- looks at whole
facility, front door to back-he will also come to you
•Stephen Beeson-focuses primarily on the patient/doctor experience-will come to you
•Crucial Conversation/Confrontations-awesome, awesome course
Other Measures•What can you do as a physician leader
▫Physician Rounding▫How do you handle patient complaints
•Staff Survey: careful how you present this data▫Present Rank or score with average
must know your providers to decide thisComments can be a very touchy subject
Good Scores For Dr BED provider surveyDr B
Answer Options 1 2 3 4 5 Response Count
Sum of Scores
Average Score
Ranking
Initially sees and treats patient in a timely manner 0 0 3 13 54 70 331
4.728571 1
Evaluation and treatment done in a timely manner 0 0 4 11 55 70 331
4.728571 1
Has the ability to move patients efficiently and prioritizes well 0 1 4 17 47 69 317
4.594203 2
Is immediately available/communicates his/her location when not present 0 0 3 16 51 70 328
4.685714 1
Treats ED staff in professional and courteous manner 0 0 0 2 68 70 348
4.971429 1
Effectively communicates to staff and is easily approachable with questions 0 0 0 2 68 70 348
4.971429 1
Shows caring and concern for patient/their families 0 0 0 4 66 70 346
4.942857 1
Explains the problem and treatment to patient and/or family satisfactorily 0 0 1 4 65 70 344
4.914286 1
Is able to remain calm under stress and is able to handle crises well 0 0 1 4 65 70 344
4.914286 1
Overall rating of healthcare provider's clinical judgment/technical skill 0 0 0 6 64 70 344
4.914286 1
Overall rating of the total care of the patient by this healthcare provider 0 0 0 8 62 70 342
4.885714 1
Overall rating of the ease of working with this healthcare provider 0 0 0 3 67 70 347
4.957143 1
Comments 27 58.20849 1
answered question 70skipped question 26
Bad Comments for Dr X• Dr. X has very poor communication when
treating pts and does not communicate the plan of care to the nursing staff. Dr. X does not move pts through the ED in a timely and does not move pts through the ED in an effective manner.
• Dr X is not approachable in a learning environment. She can be rude when working together. ▫BE VERY CAREFUL WITH COMMENTS.▫ SCREEN HEAVILY AND ONLY PRESENT THE
OVERALL THEMES.
Other Factors•Appearance of Facility-less important than
you think•Appearance of docs: best to dress all the
same•Convenience of Facility-more important
than you think (coat hangers, blankets, parking)
•Wait times▫What is your process for getting them in?▫What is your process for getting them out?▫Do your providers know their metrics for
both?
Other FactorsIf Disney ran your ED
“Under-promise, Over Deliver”
Other Factors• Concierge service: Guest Relations, Valet
parking•Housewide: “Standards of Excellence”
signed by CEO•Work with other departments to improve
interaction so you all look like you have the same agenda: radiology, lab,
•Some of this starts to blend into Process Improvement….but that’s ok. It’s the adoption of an overall mentality
Tid-Bits•Business cards/Bio cards•Follow-up calls•Protocols for pain/nausea: We don’t do
this but some places find it successful. •Work from blinded, to unblinded provider
data•Adaptive Design: the world’s problems
can be solved using this system. If you don’t use it in your facility, you should start tomorrow. Great way for providers to solve their own problems.
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