Saturday, April 19, 2008

More than medicine

For the first time the federal government is reporting how well hospitals satisfy the patients they care for. These are statistics hospitals have looked at internally, but they’ve never been publicly compared before.

Among Syracuse hospitals, the patients at St. Joseph’s Hospital Health Center gave it somewhat higher satisfaction scores. My congratulations to CEO Ted Pasinski & the staff at St. Joe's. Community General Hospital's patient satisfaction is the next best locally, as reported by the federal Centers for Medicare & Medicaid Services (CMS).

Since last year, all hospitals have been required to submit to CMS the results of their patient satisfaction surveys using a standard methodology called the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS, pronounced “H-caps”). Hospitals that fail to submit such data will have their Medicare payments reduced by two percent – so there is an incentive to comply.

Although the HCAHPS scores were posted only recently, the federal government has been developing its patient satisfaction methodology for years. As a matter of fact, Community was one of 132 hospitals nationwide that helped pilot a version of the HCAHPS survey in 2003.

Last month the HCAHPS scores were posted on the CMS website. In the list below are the patients’ scores for Syracuse hospitals for the first five of ten HCAHPS questions. These data are for patients surveyed during the period October 2006 - June 2007.

Nurses always communicate well
Community - 72%
Crouse - 66%
St. Joseph's - 77%
University - 68%

Doctors always communicate well
Community - 78%
Crouse - 73%
St. Joseph's - 77%
University - 73%

Patients always received help as soon as they wanted
Community - 60%
Crouse - 48%
St. Joseph's - 64%
University - 49%

Pain was always well controlled
Community - 65%
Crouse - 61%
St. Joseph's - 68%
University - 63%

Staff always explained about medicine before giving it to patients
Community - 54%
Crouse - 51%
St. Joseph's - 53%
University - 52%

Notice that the government reports the percentage of responses from patients who said they were “always” satisfied with respect to the specific question.

“Always” is a demanding standard. “Always” means a hospital did not fail to meet the patient’s expectations even a single time during the course of a hospital stay. To give this perspective, would your spouse say that he or she is “always” satisfied with the way you manage the finances, discipline the kids, or maintain the lawn? Would your co-workers or your supervisor report they are “always” satisfied with your performance on the job?

HCAHPS scores do not address the underlying issues of quality care, only its social aspects. But hospital care is a mix of clinical processes and interpersonal communications. Hospital care is "more than medicine." I have written before about the importance of two-way communication and the personal touch. [1]

Patients expect hospital quality to be first rate. They expect us to provide the right care to the right patient on time and as promised. They do not expect errors or omissions. Quality care is baseline. It’s what they need us for. But care that is delivered respectfully and with a personal touch is always recognized, always welcomed, and always appreciated.

That is why we acknowledge members of our staff who are especially kind, helpful, and responsive. Our STAR award honors physicians who demonstrate “sensitivity, thoughtfulness, appreciation and respect,” and our WOW award recognizes employees who make “an extra effort” to assure a patient’s needs have been met, even exceeded.

CMS will update the patient scores on its website each quarter. We as an industry – and we as an individual hospital – have more to do to improve the percentage of patients who say we “always” meet their needs.

[1] See these postings on the “More than Medicine” blog: The importance of listening , Stop me if I say something you don’t understand, and Whatever became of bedside manner

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