Preliminary survey helps keep physicians happy
Knowing what to ask is the key
Whether you’re trying to meet accreditation standards for information services or performance improvement goals, it helps to know what your customers think of your department.
One of the standards set by the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, that health information managers have had most trouble with is IM 1. This standard says hospitals must plan processes to meet internal and external information needs. It requires a comprehensive needs assessment that addresses the needs of users.
The trouble is, you have to come up with the questions. And how can you be sure you’re asking the right ones?
That was the dilemma confronting Kay Bauer, RRA, director of health information services at LDS Hospital in Salt Lake City. The more she thought about it, the harder it seemed to construct a satisfactory questionnaire.
"We didn’t want to assume we knew what physicians expect," Bauer explains. "We wanted feedback from physicians about what is really important to them."
Bauer turned to LDS Hospital’s marketing department for help because it had the survey development skills she felt she lacked, and it understood the survey process.
Bauer knew what she wanted the survey to reveal:
• information priorities for service quality planning;
• how physicians judge health information services quality;
• key physician motivators to facilitate staying current with charts;
• the right questions to include in a satisfaction survey.
The marketing department recommended she begin with a preliminary survey. The department also agreed to formulate the questions and do the survey.
"Having them do the survey was helpful because they were independent of anyone in our department. We felt people would talk to them openly. And on a professional basis, they knew how to ask questions," Bauer notes.
The preliminary survey was constructed in an open-ended format to allow for a broad range of responses. It consisted of three questions:
• How do you judge quality in the health information services department?
• If you were the health information services manager, what would you do differently to better serve physician needs?
• What would motivate you to keep your charts current?
A range of specialties
Then the surveyors hung out in physician dining rooms and physician lounges, scouting for physicians willing to respond. In the end, 11 physicians from LDS Hospital were interviewed. Another 15 from two other LDS facilities in Salt Lake City and Cottonwood and Alta View Hospitals, all in Utah, also participated. Surveyors tried to make sure they represented a range of specialties, so the answers would not be skewed toward the interests of any one group.
Bauer says she’s glad she did a preliminary survey before launching a comprehensive questionnaire because she got some answers that surprised her. For example, her department takes pride in being able to have records delivered to physicians within five to 10 minutes. That, it turned out, was not fast enough for them. "It’s going to be challenging to fix that," Bauer admits.
Physicians also were interested in the timeliness of transcription. She notes that there are three elements to transcription services: the transcription itself, processing in the health information services department, and delivery of the transcribed report by a messenger. Physicians, she discovered, don’t care where in the process the breakdown occurred. If a transcribed report isn’t ready, her department gets blamed.
The survey also revealed that physicians felt decisions by the health information department were made in a vacuum without physician consultation. "They aren’t [consulted] because we have a medical records committee that makes these decisions, but that’s the perception. It’s important to understand the perceptions, too," Bauer says. She says this finding indicates the need for improved communication with physicians.
Bauer is using the preliminary questionnaire as the basis for the hospital’s formal survey of physicians. She plans to use a scoring methodology that will allow physicians to rate how they feel about specific elements of the department’s job. She also plans to ask questions related to information technology, such as how willing physicians would be to accept electronic signature and other devices.
And now for the answers to the $64,000 question: What would motivate physicians to keep their charts current? One group of respondents said penalties work best. Another group said penalties don’t work gentle encouragement does. A third group said it all boils down to personal factors: People who are organized will complete their charts; those who aren’t, won’t.
Kay Bauer, RRA, director of health information services, LDS Hospital, 8th Avenue, Salt Lake City, UT 84142-0001. Telephone: (801) 321-5011.
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