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The Linkage between Quality & Patient Satisfaction

Quality is one of the fundamental cornerstones of building a highly satisfied customer/patient base.  Over the last twelve months I have made increasing a sustaining a high patient satisfaction rate job one.  Here at Advocate Lutheran General we measure quality using the Press Ganey survey instrument and are compared with similar hospitals of greater than 400+ bed teaching hospitals from across the country.  Needless to say this is a challenging group to compete in to say the least.  Our leadership team within Advocate has set forth the goal of operating consistently within the top quartile of this survey, I however believe we can maintain performance within the top decile and I aim to achieve that goal within the current year.  We are measured in terms of patient satisfaction by three elements within the Press Ganey survey instrument they are Friendliness of staff, Ease of the Registration, and Waiting Time during the registration.  The Press Ganey Survey instrument is sent to a representative sample of patients from six distinct outpatient service areas which serve multiple clinical modalities.  Data from the past 12 months does show positive trending overall but between the months there is a great degree of variability, some if not all of the components to our performance improvement have not yet been hard wired.

Recently our organization partnered with the Studer Group to improve the overall patient experience as part of our journey to service excellence.  While the tools and training provided by the Studer Group have helped in this regard there is a process component to Patient Satisfaction which patients have and still express frustration over.  No one wants to come into a hospital environment when they are not at their best and be asked the same registration questions as they were asked maybe only the day before.  Not only is this a big dis-satisfier to our patients it is waste within our operations.  During the middle of last year the data I was getting back from Press Ganey indicated very high scores with respect to Friendliness of Staff, while the Ease of the Registration and Wait-times showed to be an area in which we could still improve upon.  In attempts to improve in this regard we recently completed a Lean Workout Initiative in one of the Outpatient Radiology Registration areas.  What we quickly discovered through the workout was that a lot of our waste in the current process could be attributed to either not completing enough of the tasks prior to the patients arrival or more importantly re-doing work which already had been completed by the Pre-Arrival Team because we didn’t trust the quality of what they were providing to us.
So once we shined a light on our process it became apparent that we had come as far as we were going to come with the people component of patient satisfaction, i.e. teaching the associates successful customer service skills.  What we needed now was a more efficient registration pathway and improved quality in the inputs of the information we were receiving.  This new pathway would have to be created from the patient’s perspective and would have to be as lean as we could possibly make it through waste reduction and improved communication.  Changing this culture was going to be challenging our culture within the Patient Intake Department here at Advocate Lutheran General has historically been a very strong, “touch it & own it” mentality which would first have to be broken, quality tools and expectations would have to be established, QA & QI would have to be conducted in a fair and responsible manner.

In this endeavor we reached out to Passport during the second week of January to partner in the creation of a weekly and monthly scorecard which would be then shared with the staff to promote self auditing and continuous improvement though real-time feedback.  I am pleased to report that in the past two months of receiving Press Ganey data we have ranked in the 90th percentile overall when compared to peer hospitals in the month of January and 80th percentile during the month of February in conjunction with sharing the Passport Scorecard on a weekly and monthly basis with all Point of Service Registration Associates.

I realize that changing a culture can be a daunting task but we are up to the challenge to meet and exceed the expectations of our patients and knowing that our deliverables are of a high quality will be a large part of this undertaking.

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