Patient satisfaction is part of job performance
Employees are graded on survey scores
It’s easy for hospital administrators and quality managers to forget that customers sometimes have their own ideas about the meaning of quality care. So it might be a shock to learn that despite your hospital’s best efforts to make technological advances and improve care, patients give your hospital a less than stellar rating.Lapeer (MI) Regional Hospital learned this lesson in 1995 after receiving the results of its first customer satisfaction survey. The survey placed the 222-bed hospital’s customer satisfaction in the 35th percentile, meaning 65% of the other hospitals included in the South Bend, IN-based Press, Ganey Associates report had higher customer satisfaction levels.
Lapeer administrators took this message as a challenge and went to work, implementing a three-pronged approach to improve satisfaction that focused on education, communication, and employee recognition. Their efforts paid off. A year and a half later, Lapeer Regional’s customer satisfaction had soared to the 98th percentile.
The hospital administration started with the philosophy, coined by L.L. Bean in Freeport, ME, that you must "treat employees the way you want them to treat your customers," says Kathleen Ambs, MA, director of community relations for Lapeer .
With that in mind, the hospital formed a process improvement team in late 1995, consisting of representatives from all disciplines. Its first task was to review all quarterly scores and identify the key areas that needed to be improved, Ambs says.
The team’s chief actions were to:
• monitor, review, and evaluate patient satisfaction scores;
• recommend implementation of action plans for improvement;
• review action plans effectiveness;
• oversee all efforts to improve patient satisfaction;
• identify threats to its success.
Then team members brainstormed to find solutions and came up with 32 ideas. "We divided them into three categories of education, communication, and recognition, and each team member independently prioritized them," she explains.
They decided the priorities would be described as:
• high impact, high ease of implementation;
• low impact, high ease of implementation;
• high impact, low ease of implementation;
• low impact, low ease of implementation.
Solutions that had a high ease of implementation became the top priority, Ambs says. "Those two categories affect a wider area throughout the hospital. Those solutions that were excellent ideas but harder to implement were put on the next priority list."
The hospital wanted some quick fixes that could be shared with the staff, Ambs adds. The team chose to focus on communication and education. The top priorities were:
• Develop a hospitalwide patient satisfaction program.
• Increase staff’s awareness and understanding of customer satisfaction.
• Improve communication of survey results.
• Recognize and reward staff efforts.
Some team members attended a Press, Ganey conference that year and brought back some ideas of business practices established by the most successful hospitals. They divided these ideas into five areas:
• Use a quality selection process in staff recruitment.
• Educate and train staff to behave in expected ways.
• Reinforce outstanding service through rewards and recognition.
• Create awareness of customer satisfaction through communication and visibility.
• Make everyone accountable for results.
Lapeer Regional Hospital administrators decided in November 1996 to implement a computerized software program that has a valid predictor of job performance and use it as a selection tool. Everyone who applies for a job is screened through the tool.
Next, as part of staff development, a group of employees on the performance improvement team created five "house tips" for patient satisfaction. "Some people call it golden rules,’ but our staff didn’t want rules, they wanted tips," Ambs says. The tips were:
• be courteous and considerate;
• provide information;
• listen and respond quickly;
• maintain privacy and confidentiality;
• look and act the part.
Then the group, led by Laurie Jackson, decided to turn these tips into a video that could be used for staff development. They recruited other employees, wrote a script, acted, held a cast party, and found an agency to volunteer editing services. The 30-minute video cost almost nothing.
Another team, led by Jennifer Hanson, RN, MSN, also started a patient satisfaction expo for the staff. It began with an educational focus and became more of a social event, Ambs says. Each quarter the hospital holds the expo, which includes snacks and gifts, in a conference room near the cafeteria so that it is convenient for all employees during their breaks.
It’s held shortly after the quarterly survey reports and includes booths that graphically display the results along with positive customer comments. The expo is held over a day and a half and is open during the early morning hours so night shift workers may also participate.
The hospital’s other major actions have involved improving its employee recognition and reward programs. "We have an unbelievable recognition committee," Ambs says. (See story on Lapeer’s employee rewards, p. 24.) The hospital also publishes a biweekly employee newsletter and a quarterly physicians newsletter. These highlight employees, physicians, and volunteers who have done well. The hospital sends everyone a copy of the survey results and a summary of the hospital’s progress and successes.
The hospital’s awareness campaign includes making patient satisfaction an agenda item at all meetings and making it highly visible within the hospital.
"We have departmental bulletin boards within the cafeteria, physician lounge, volunteer lounge, and employee lounge," Ambs says. "And we have a poster campaign about customer satisfaction."
Patient satisfaction is now part of each employee’s performance evaluation. Besides hospitalwide goals for patient satisfaction, each department has its own goals for patient satisfaction. Employees are encouraged to talk about and accept responsibility for their actions whether it is failing to get information to their departments or taking too long with discharging patients, Ambs says.
Other accountability practices include:
• making daily patient rounds;
• implementing 30-day action plans;
• discussing agenda items at all hospital meetings;
• focusing on identifying opportunities for improvement;
• creating multiple committees at all levels.
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