PRAISE’ program boosts patient satisfaction
Agency’s action plan puts it on the right track
Patient satisfaction is such an integral part of clinical care and administration at the Shore Health System in Easton, MD, that employees’ raises partly are based on how well they have satisfied their patients.
The health system, which includes a small home care agency that makes about 22,000 visits each year to an area encompassing Maryland’s Eastern Shore, recently was named a finalist in the South Bend, IN-based Press, Ganey Associates’ client success stories contest.
"Our patients trusted our technical ability to deliver health care, but they wanted more," says Brian H. Childs, PhD, director of ethics and organizational development for the health system.
Patient lists needs
Patients told the health system:
• They wanted their emotional and spiritual needs.
• They wanted their privacy protected.
• They wanted some appreciation for the inconvenience they had to go through in order to receive health care.
• They wanted to perceive that there was team work among the various health care professionals.
• They wanted to know that they received all the necessary information.
"If each department were to approach those things they needed, we knew we would increase our ability to make patients satisfied through one of the most personal experiences of their lives," Childs says.
The health system formed a committee called Promoting Responsive Attitudes in Service Excellence (PRAISE) that developed a program to enhance patient satisfaction. After one year, the health system’s patient satisfaction scores on Press Ganey surveys rose from the 20th percentile to the 80th percentile.
Employee bonuses are given to show staff how seriously the health system takes in pleasing patients. Employees receive bonuses when the hospital system’s patient satisfaction level rises and when the operating margin increases.
"Right now, the bonus is based on patient satisfaction and on our fiscal responsibility in keeping expenses down and quality up," she explains.
"Last year, each employee got a percentage increase in base pay and a cash bonus," Childs adds. "The greater the patient satisfaction, the greater the market share."
Shore Home Care built on the systemwide program with its own patient satisfaction measures after experiencing a drop in its satisfaction rating between its baseline quarter and the second quarter. The satisfaction rate went from an 88.5 percentile to 81.8 percentile. "Our staff were just devastated and very upset," says Kay Satchell, RN, a performance improvement specialist at the agency.
"We immediately formed five performance improvement teams that focused on the plan of care, complaints, home health aides, scheduling, and our on-call process," Satchell says. "It took a huge effort, and almost everyone on the staff is involved in a team."
The efforts showed an immediate payoff. The agency’s patient satisfaction rate bounced back to an 87.7 percentile. Here’s how the agency’s conducted its performance improvement (PI) program:
1. Form charters. Each of the five PI teams formed a charter developed from an overall action plan. (See P1 Action Plan insert.)
Teams were multidisciplinary, and each selected a team champion. "The champions were the volunteers who had the most interest in the project and would have day-to-day involvement," Satchell says.
The champions recruited volunteers to help with the project. Then teams made a priority list with the highest priority going to the customer satisfaction areas in which the agency did the worst.
2. Develop plans to improve care. Each PI team identified problems within their sphere of concern and developed possible solutions. (See story on solutions identified during patient satisfaction PI process)
For example, the PI team that focused on the plan of care saw that patients did not feel they were truly involved in planning their own care and wanted to be a part of the process.
Involving patients in creating care plans can enhance patient motivation as well as patient satisfaction, Satchell says. The plan of care team decided that the agency needed a new patient orientation booklet for the staff. This would better educate employees about how to include patients into the plan of care during the admission process.
3. Change policies and encourage patient input. One of the changes Shore Home Care made to promote better patient satisfaction was to provide merit raises that are based, in part, on patient satisfaction.
"Our annual performance evaluations are based on job responsibilities and care factors, which talk about community and allegiance, responsiveness, and excellence, and then significant contributions, training, and development," Satchell says. "This links their patient satisfaction and the care factors to their performance evaluation and merit raise."
Any comments made on patient satisfaction surveys go into the employee’s file and those comments are brought out during the performance evaluation process, she adds. Patients can compliment employees through "CAREgrams." CARE is an acronym for community allegiance, responsiveness, and excellence.
The idea is that employees should focus on the community they serve, placing their patients and co-workers first. The characteristics of an employee who does this are commitment, decency, employee relations, fortitude, and perceptiveness.
Allegiance means the employee focuses on communication and cooperation, delegation, integrity, and perseverance. Employees demonstrating responsiveness show a high energy level, independent judgment, industry, planning, and professional presence. Those exemplifying excellence have accountability, adaptability, creativity, knowledge, and technical expertise. "We have little cards that say CAREgram,’ and these lists the care factors and a heart on the left hand corner," Satchell says.
The card’s text reads, "To: ____ I want to thank you for showing care in the following way . . ."
The completed CAREgrams go to the human relations department. Then each quarter, the agency has a celebration with ice cream for employees who have received CAREgrams.
"We gather to recognize the employees for doing a good job, and they get a little pin," Satchell says.
• Brian H. Childs, PhD, Director of Ethics and Organiza-tional Development, Shore Health System, 219 S. Washington St., Easton, MD 21601. Telephone: (410) 822-1000, ext. 5259.
• Kay Satchell, RN, Performance Improvement Specialist, Shore Home Care, 29515 Canvasback Drive, Easton, MD 21601. Telephone: (410) 822-1000, ext. 8713.
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