Bert Thurlo-Walsh, RN, associate chief quality officer, didn’t always have patient experience under his area of influence at Newton-Wellesley Hospital, which is part of Boston’s Partners HealthCare. In fact, leadership of the patient experience used to reside under three different vice presidents at the hospital.
That all changed when Michael R. Jaff, the hospital’s new president, took over the helm in 2016 and Thurlo-Walsh was subsequently promoted to his current role in February. As a result of his promotion, he now has Press Ganey, quality reporting, and patient experience as part of his responsibilities at the hospital.
With his arms fully around the patient experience at Newton-Wellesley, Thurlo-Walsh can help drive and monitor program results that are intended to improve the patient experience.
What follows are six initiatives hospitals have undertaken to improve the patient experience.
1. Educate patients about medication side effects
To provide education about medication side effects and to encourage adherence, patients in Newton-Wellesley’s rooms, including the emergency room bays, see posters prompting them to “Ask Me 3”—or three questions—about their medications of their physicians. Another component of the campaign, which kicked off in early 2017, is telling patients that their physicians may ask them medication-related questions.
“This way, they know it’s a bi-directional conversation,” says Thurlo-Walsh. “Usually, patient satisfaction tends to be one-sided, but this experience becomes a collaborative experience between the two. It also helps to engage the patient in their own medication management in ‘owning’ those [medications], which is what we need them to be able to do when they leave the hospital.”
Equally important to learning about side effects is adherence, which can be a challenge among the elderly and patients with fewer economic resources. If patients can’t afford their medications, there’s a downstream effect which can result in a hospital readmission. In situations where finances are a challenge, the patient is matched up with a member of the case management team who can help troubleshoot this issue on their behalf.
Once the staff began to roll out the campaign, Newton-Wellesley witnessed an initial increase in communication about medication scores. However, over time, it became clear that additional education was required.
“We saw a slight decrease in the [Hospital Consumer Assessment of Healthcare Providers and Systems] HCAHPS score, which continued until January and February, that correlated to an increased inpatient medical consensus. The nursing leadership have worked with teams to reinforce the need to be consistent,” he says.
2. Acknowledge and thank patients for feedback
Most patients spend about seven minutes completing the HCAHPS survey that gives feedback about their healthcare experience. Thurlo-Walsh wants to make sure Newton-Wellesley does something with that information—namely, reaching out to patients to acknowledge receipt of their comments.
“Patients make comments. Some are good, some aren’t so good. But you can drive improvements based on those comments,” he says. That’s why when the surveys come back to Newton-Wellesley, the results will go back to the manager or area director, who then calls the patient to thank them for their feedback.
These follow-up phone calls typically take place approximately four months after the patient submitted their survey, but it takes between six and eight weeks to receive the results from Press Ganey, says Thurlo-Walsh. Feedback from patients is broad, and can include comments about cold hospital rooms or that a “nurse was crabby,” for example.
When patients complain in person during their hospital stays, the employee’s manager will get involved in addition to the patient advocate to mitigate the situation, he adds.
Responding to patient feedback in real time at the hospital “lets patients know that they’re heard, that their feedback didn’t go into a ‘black hole,’” says Thurlo-Walsh. While it doesn’t happen often, he says the hospital will sometimes send flowers or a parking coupon to a patient who had a negative experience. That’s part of what he calls the hospital’s “service recovery,” which involves acknowledging that the hospital should have done better and is taking note of specific patient comments.
3. Drive change in response to feedback
Patient feedback goes to the service operations team on a monthly basis, says Thurlo-Walsh. At weekly team meetings, which include managers of all of the service lines and ancillary services, negative comments are selected and then randomly assigned to team members. Each team member is then responsible for following up with the patient impacted by the negative event and determining if there are more “global problems” impacting the larger patient population that need to be solved, such as an infection control problem, for example.
Other feedback from patients has included comments about the need for kosher foods, which the hospital’s new director of food services has addressed, and the need for more parking. Thurlo-Walsh explains that parking will likely always be a challenge on the suburban hospital campus because it’s landlocked.
One service that garners a great deal of positive feedback from patients and their families is Newton-Wellesley’s valet service, whereby patients can hand their car keys to a valet outside the emergency room entrance. For $9, the valet will park the patient’s car and retrieve it for them after their visit.