Managers’ weekend rounds win approval
Managers’ weekend rounds win approval
Satisfaction rises and falls on the little things
The patients at Brockton (MA) Hospital experience the management’s caring in a most unusual way. On weekends, when the patient advocate is off, the hospital’s top brass pay a visit to each newly admitted patient. While the managers began weekend rounding in January this year, Brockton’s CEO Norman Goodman has been a consistently visible presence in patient rooms throughout his tenure at the hospital.
"We want to make patient satisfaction part of our hospital culture, and now everybody understands what that means," notes Carol Martin, Brockton’s director of Cardiopulmonary/ Rehab-ilitation Services and coordinator of QI initiatives. "Our chief financial officer was one of the first volunteers for weekend rounds." Although Martin does not pinpoint a direct cause-and-effect relationship between managers’ rounds and the hospital’s financial well-being, she does note that admissions have shown a steady rise in recent years, and the facility finished last year in the black.
Each administrator signs up for visitation one weekend day every three months. Vice presidents are kept apprised of which of their managers participate in the voluntary program, and participation is tied to performance reviews. The managers act primarily as patient advocates. Following are a typical day’s duties:
• Pick up admissions sheet at the information desk. It includes an average of 30 patients. In semi-private rooms, the manager checks on the roommate as well.
• First stop on a unit is the nurses’ desk to inquire if any patients have conditions, such as confusion, that would make a visit inappropriate.
• After managers introduce themselves, they explain, "I’m interested in your experience here. Is there anything you need or anything we can do to make you comfortable?" They also talk with visitors. If the patient is away from the room, the manager leaves a note and an invitation to leave requests in the patient advocate’s voice mail.
• Managers resolve issues personally or through the proper channels. They might check the status of delayed food trays, expedite delivery, and follow up with a complimentary fruit basket. For complaints about noisy roommates, they would look into a room change. More complex matters involving referral to a community service, for instance, are conveyed to the patient advocate.
• For each patient, the manager charts requests, resolutions, and notes compliments. The data enable tracking of customer satisfaction issues and trends for patient service goal setting.
As you might expect, the overall reception has been positive. Most of the managers embrace the opportunity to visit patients, even those who resisted because of heavy work schedules or unfamiliarity with patient contact. Patients appreciate the attention.
Even those who make no specific requests note on their satisfaction surveys, "Someone came to visit, and I told him that everything was all right." Martin notes that the program reflects Brockton’s dedication to correcting problems up front instead of allowing them to fester and surface after it’s too late to correct them.
The visits "elevate the patient focus to our managers’ and clinicians’ awareness," she observes. Now, she adds, the management understands the connection between the full-time patient advocate position and the hospital’s high patient satisfaction levels.
Staff nurses are delighted with the program. Managers handle patient requests that otherwise might wait until the patient advocate could check in on Monday morning. By giving administration a first-hand view of the work load employees handle on weekends, the program fosters a realistic consideration of staffing budgets.
While there is no doubt that patient advocacy must run through the weekend, it’s still undecided whether the facility will continue to handle it through voluntary visits from managers or add a paid staff position.
"Every patient deserves a visit," Martin contends, "and our CEO thinks every new admit should have the opportunity to see someone from the management team to show them they are important to us and to the clinical staff as well."
If an administrator had any doubts about Brockton’s excellence in patient care, they have vanished with the opportunity to witness the bedside services, Martin says. Other outcomes are equally important:
1. The experience reminded top managers that assumptions about patient service miss the mark. "You don’t know what people want until you ask them. And it’s usually the smallest things," says Martin, "like moving the table closer to the bed or showing them how to use the phone, or just the comfort of having somebody spend time with them."
People forgive a lot if they’re well treated, she observes. For example, Brockton’s telemetry unit, located in one of the oldest areas of the facility, consistently rates above the 90th percentile in patient satisfaction. Four patients, the majority with cardiac problems, share each bathroom; sinks are outside the bathrooms. The turnover is high. "It’s old but immaculate, and the manager rounds on every patient every day. They clearly see that the staff want to make them comfortable."
2. Brockton consistently garners customer satisfaction ratings in the 96th percentile of Press, Ganey’s database of several hundred institutions. Press, Ganey, based in South Bend, IN, specializes in the measurement of health care satisfaction. Martin explains that to achieve such levels, institutions must consistently receive fours and fives on a scale of one through five. "And you can’t do that unless you exceed expectations."
3. The area’s largest medical group, consisting of 100 physicians, recently contracted to admit all of their patients to Brockton Hospital. Martin credits the arrangement to the facility’s longstanding record of excellent patient care and its growing reputation for stellar customer satisfaction.
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