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By Eric B. LoMonaco
Exceeding patient expectations is not only important; it is essential. Quality care generates income that rewards those who deliver legendary service.
The Affordable Care Act of 2010 mandates that CMS implement a Hospital Value–Based Purchasing (VBP) Program that incorporates several quality domains. One of these quality domains is the Patient Perspective of Care, also known as HCAHPS. The HCAHPS accounts for 30% of a hospital’s total VBP plan. This “at risk,” or as CMS calls it, “incentive” reimbursement is based on the patients’ experience and may account for millions of dollars in lost revenue for many hospitals over the next five years. This means that healthcare organizations today cannot afford to ignore the ramifications of low patient satisfaction scores.
One of the greatest challenges of the HCAPHS survey is that it is not sent to the patient until several weeks post discharge. It is common knowledge that one very effective way to improve quality performance is with immediate objective feedback.
Because the HCAHPS survey approach takes so long to distribute and retrieve, it can cripple a hospital or healthcare provider that is trying to immediately resolve a patient’s concerns. Too often this process takes months to receive the data from CMS, making it almost impossible to implement effective or proactive preventative change in any organization. Not to mention, the patient is waiting six to eight weeks to hear back from a hospital or healthcare provider about a concern filled out on the survey, often leaving them even more dissatisfied than with the initial encounter. For example a patient once told me that if we cared about his concern we should have resolved the issue weeks ago when he was still in the hospital.
Community Hospital of the Monterey Peninsula (CHOMP) in Monterey, CA, with the support of our CEO, Dr. Steven Packer, is now incorporating instantaneous electronic feedback to improve the inpatient and outpatient experience. We find that our promise to our patients, “when it comes to your health, everything matters,” is more fully implemented when real time listening and follow up accompany our services.
We utilize Excellence 24/7 (E 24-7) which links a QR bar code located throughout the hospital to manage real time patient initiated electronic communication. By using a free scanning app and a smart device such as a phone, PDA, Droid, or OS7 product, this bar code triggers one question upon scanning: “If we have exceeded your expectations or fallen short please let us know how we can help?” Once the question is answered, the patient’s message is instantly routed to a hospital management team member for immediate attention. In most cases the patient and management team member meet face to face within minutes, sometimes seconds, after a concern is communicated.
Experience the tool first hand by scanning the QR code below.
The impact of implementing this program has been nothing short of incredible. With E-24/7, CHOMP is better able to address the patient experience immediately and in real time, with the most dramatic payoff being that the patient has been shown respect and attention while still in the hospital. E-24/7 puts the patient in control of what is important to them prior to being discharged. As a direct result, CHOMP has created a patient-centric, portable, easily accessible, straight forward, closed-loop patient satisfaction program.
Employee performance scores have also improved significantly because their corrective behavior is tied to real time responses. Effective behaviors are also recognized and praised immediately while the patient’s encounter is still embedded in short term memory. On the contrary, less than favorable employee behaviors are discovered sooner rather than later and are corrected through immediate conversations or on the spot training regarding more effective patient service.
Team members from registration and clinical areas, to discharge and billing are engaged in continuous improvement behaviors in order to exceed patient expectations. CHOMP’s E-24/7 program process provides immediate and actionable information. In our experience, the results speak for themselves.
Here is a sampling of our results (click images for larger view):
Eric B. LoMonaco is the director of diagnostic and interventional radiology at the Community Hospital of the Monterey Peninsula in Monterey, CA. He can be reached at eric.lomonaco@chomp.org.
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