Sustaining Exceptional Patient Centered Cultures in an Urban Healthcare Organization

The Challenge: 

No longer are patient satisfaction scores something that can be "put on the back burner.”  Effective October 1, 2012 the Value Based Purchasing Model has been mandated for all hospitals to receive incentive payments only if they meet or exceed certain performance benchmarks set by the Centers for Medicare and Medicaid (CMS).  CMS mandates that we use the patient’s perception of their care in conjunction with clinical outcomes as our new measure of an exceptional hospital.  As important as positive results are to reimbursement, they also play a critical role in the reputation and image of hospitals as they relate to the “word of mouth” experiences of patients.  

Since the inception of HCAHPS in 2008, healthcare organizations have been diligently implementing patient satisfaction strategies and tactics to improve the patient experience.  It would stand to reason that following the implementation of these tactics, hospitals would experience scores that continue to rise year after year, however that has not been the case.  Although improvement strategies exist in almost every hospital in the U.S., less than half of those hospitals are currently receiving reimbursement.  To overcome these challenges, BOOST Patient Experiences partners with hospitals utilizing a proven process to improve and sustain patient experiences. Their aim is to create patient focused healthcare-organizations.  With the seasoned mentoring and guidance of BOOST, managers, are guided and mentored to create unit and departmental cultures that ingrain the patient experience and prevent backsliding.  

The BOOST Patient Experience Solution

A local New York hospital was struggling to sustain consistently positive patient experiences.   At the outset of HCAHPS, their staff and committees initiated strategies that initially increased their patient satisfaction scores.  However, just as fast as they went up, they went back down, the backslide.  Sustainability evaded them.  They tried another new strategy and once again plans were put in place and the cycle continued.  At one point in this process, staff could not even remember which improvement initiatives were in place and could frequently be heard asking, “Are we still doing that?”  Four years ago, they knew they needed help and sought the expertise of an outside consulting company.  At first things started to look up, the staff followed specific tactics but sustainability continued to evade them.  Hard work for the staff and disappointing experiences for the patients ensued, causing this hospital to once again try to improve patient satisfaction on their own with committees and teams.

Two years later and with much hesitation about anyone being able to help them as a result of their previous consulting engagement, the hospital called in BOOST Patient Experiences and it was a game-changer.  BOOST capitalized on its own company’s strength, RN’s and Business Executives, to develop clinical managers with business acumen to improve and cement the patient experience. Their impeccable attention to details during every consulting engagement ensures that healthcare managers lead powerful teams, resulting in patient’s receive quality, professional healthcare, all the time, every time.  They maintained laser-like focus to discern the underlying issues that needed to be addressed in this hospital, while keeping their eyes on the bottom line to uphold the hospital’s mission, vision, values and finances.  On this engagement, they worked with all departments that directly or indirectly impact the patient experience, not just Nursing, to achieve the ultimate goal of making every patient’s hospital experience a positive one.  
Implementing BOOST Patient Experience Principles

BOOST’s many years of healthcare experience provides them with the “clarity of distance” as their starting point for an assessment of the hospital environment.  Within days they saw what the causative factors were for this NY Hospital’s history of HCAHPS backsliding.  To achieve the kind of sustainable results they are known for, they began by working with the managers in Nursing and Support Departments to create a foundation for the sustainability of HCAHPS scores.  Their work extended to housekeeping, lab, case management, residents, physicians and engineers, to name a few.  Their strong focus on the managers to lead the change, coupled with the process improvement, is what drove the turnaround and sustainability for this hospital.  Campbell notes that “when there’s a problem, we show the managers how to train their staff to get to the root cause to effectively and efficiently resolve problems and once we are all aware of the behavioral expectations, we showed the managers how to hold staff accountable for their behaviors.” The BOOST process changed the way the management team led all their patient satisfaction efforts.  Unit by unit, as the managers were trained, change began.

The Results

This hospital’s goal was to create positive sustainable growth in two HCAHPS categories, “Nurse Communication” and “Responsiveness of Staff”.  The transformation of the culture is reflected below.  The hospital’s perspective of their partnership with BOOST Patient Experiences, was best summed up by the CNO with the following quote, “They were the instruments we needed to effect sustainable change in our hospital.”

HCAHPS Categories