Tuesday, May 6, 2014

The road to 99th percentile satisfaction

Nurse Carolyn Garrison talks with patient Gaylon Henderson on the Med-Surg unit at Cox Monett. Garrison says the department has always done a good job relating to patients and recent efforts implementing tactics such as AIDET and key words have reinforced good customer care behaviors.

When it comes to patient satisfaction, the Medical-Surgical unit at Cox Monett has accomplished the nearly impossible: the department has reached the 99th percentile in satisfaction, and they’ve maintained that performance over four consecutive quarters.

Equally impressive is how they did it: by focusing on the basics. Staff members are working daily to perfect the way they interact with patients. The tactics are surprisingly simple, and they can be implemented by any of us, in any department, starting right now.

“Like any good team, we always want to be working on our game and making it better,” says Kurt Harter, nurse manager. “Our staff members do a tremendous job working together and supporting each other as a team.”

Harter says that the keys to the team’s performance lie in the tactics promoted by The Studer Group: AIDET, key words and rounding. When Harter came to the unit in early 2013, he was already familiar with the tactics from his 27-year career at CoxHealth. At Cox Monett, senior leadership was committed to “hardwiring” the Studer approach and Harter was tapped to help teach classes. In one month, 100 percent of staffers in Monett and Cassville had been trained.

Within a few months, the positive effects started to show up in the scores. Even those who doubted the tactics would work started to become believers.

Jodi Curry, a PCA with 12 years of experience in Monett, admits she was skeptical at first.

“You wouldn’t think it would really work, but it has,” she says. “We get positive feedback from patients and morale has blossomed.”

Staff members say that many of the tactics were already a part of their work, but the training reinforced those behaviors and gave them a formal structure. AIDET, for example, standardized the way staff members:

• Acknowledge patients
• Introduce themselves
• detail the Duration of what they’re doing
• Explain what they are doing as they are doing it
• and Thank the patients.

Harter says clear communication with patients is just part of providing great care.

“People think we’re in it for the patient satisfaction scores, but those scores are just a vital sign of how good of a job the staff is doing in explaining the care they’re delivering,” he says. “Explaining that care decreases the anxiety patients are having. The biggest thing a patient asks is ‘why?’ The more we narrate our care, the more we answer that question.”

Staff members also focused on using key words with patients: reminding them that they were in good hands and “managing up” their co-workers, by explaining that a co-worker or a physician has years of experience.

Leaders and staff members say the team atmosphere at Cox Monett has been key to the patient satisfaction success. Harter and Curry are quick to point out that the patients on the Med-Surg unit are supported by assistance from departments such as Respiratory Therapy and Environmental Services.
Avoiding “silos” is a big part of Cox Monett’s culture.

“Everyone knows it’s a team effort – it’s not ‘us’ and ‘them,’” says Yvette Adams, supervisor in Respiratory Therapy. Adams points out that new hires in Respiratory Therapy are informed upfront about the collaboration with Nursing, which can include passing meal trays and answering call lights.

“It’s very important to view it as areas working together for one goal: providing patient care. No one says, ‘that’s not my job.’ They say, ‘how can I help you?’”

Harter says it can be easier to see how your work affects the whole patient care team in a small setting like Monett, but the same principles apply in facilities of any size.

“Communication and accountability are the two biggest pieces of making this work,” Harter says. “It goes both ways, everybody is accountable to their supervisors and supervisors are accountable to their staff. The lines of communication are always open.”

Curry agrees: “People taking responsibility for their actions – it’s been wonderful and that’s what has taken us to the 99th percentile.”

And the department is continuing to improve: they’ve sustained their percentile ranking and they are seeing the percentage of patients rating their care as a “9” or “10” increase.

Harter says that no matter the setting, staff members have the power to make the patient experience better. Simply adopting the right behaviors can go a long way.

He points to an example Quint Studer uses: an older hospital in Chicago didn’t have the funds to renovate the facility, but they were able to improve satisfaction just by adopting AIDET and key words.

“This effort has lit a fire under people – they want to go out and try some of these tactics,” he says. “It can be tough, remembering to thank the patient, thank your co-workers and ask how you can help. People say, ‘I don’t have time,’ but you have to make it a priority.”