In the current health care system, patient outcomes, and patient satisfaction are increasingly important. With the hospital value-based purchasing program, Medicare adjusts payments to hospitals based on the quality of patient care they provide. Hospital consumer assessment of health care providers and systems scores are tied to Medicare reimbursements. Under the hospital-acquired condition reduction program, hospitals in the highest quartile of hospital-acquired conditions are subject to a 1 percent payment reduction, while the HRRP (Hospital Readmission Reduction Program) program reduces hospital reimbursements up to 3 percent for excess readmissions. Patients post about their experiences online, and patients often pick hospitals based on online reviews and word of mouth. In other words, hospitals are incentivized based on patient satisfaction and quality of care.
Hospitals spend large amounts of money on the aesthetics of a hospital, its facilities, and hospital equipment. Investing in these makes sense, and its outcomes are tangible — a fresh coat of paint on the walls and new modern furniture in the lobby improves patient satisfaction, and innovative surgical equipment allows for cutting edge procedures that generate revenue.
But how about the other things, the things that aren’t so concrete? Things that don’t generate visible outcomes are often dismissed by the administration as being not important, and therefore lacking in hospitals. These, however, are often what leads to better patient outcomes, higher patient and employee satisfaction, and are more cost-effective in the long-term.
1. Invest in employees. And I don’t just mean doctors! I mean nurses, technicians, assistants, environmental service workers, dietary staff — everyone! The employees are your front-line workers, the ones directly providing patient care and services to patients. Listen to staff, address their concerns, and treat them with respect.
Their concerns often impact the safety of all employees and patients and can easily be addressed. For example, when employees say there is no cell phone service in parts of the hospital, they are not just complaining because they want to make personal phone calls, they also want to make sure they don’t miss the call from the nurse taking care of the patient or the lab calling with a critical value. When employees request extra PA speakers to be placed, they want to make sure they can hear codes and emergency alerts throughout the hospital. When employees ask for extra lighting in the parking lot at night and increased security patrol in certain areas, they obviously feel unsafe and want additional security measures in place.
Investing in employees leads to increased employee satisfaction, increased employee retention, and decreased turnover, resulting in increased productivity as well as improved patient outcomes and satisfaction. Experienced staff knows the ropes of the place, whereas recruiting, hiring, and training new employees every week costs a lot of money. Some roles, such as specialty nurses, can be extremely difficult to find and expensive to train. Furthermore, employees who are happy and engaged are more likely to put in that extra effort and go the extra mile.
2. Invest in education. Health care and medicine are constantly evolving with new techniques, guidelines, protocols, etc. Education is necessary to broaden skills and better equip employees to solve problems, which increases productivity and patient outcomes. And I don’t mean more online modules. I mean relevant, active, interactive on-the-job training, such as simulation training. New graduates need mentoring, everyone needs in-services on new products and equipment, and everyone needs to stay current on the latest advances and techniques as well as evidence-based practice as it applies to practice. In addition to interactive training, there has to be a demonstration of competency and continued refresher classes. Continued education improves competency and productivity, leading to improved quality of care.
3. Invest in quality improvement and research. When people think research, they often think large teaching hospitals running clinical trials that generate revenue for patient enrollment. This is true, but community hospitals can take part in research and quality improvement projects as well, especially targeting issues that affect that hospital. For example, hospitals with high fall rates or high infection rates can develop predictive risk stratification models along with interventions targeted for their specific patient populations. Hospitals with high complication and readmission rates can implement pre-procedural and discharge interventions and education to mitigate risk. These all improve hospital efficiency and patient outcomes, which improve patient satisfaction and decrease hospital costs.
Patient outcomes and satisfaction are highly dependent on the employees that work at the hospital. Investing in the employees, investing in staff education, and investing in quality improvement and research will not only lead to improved employee satisfaction and staff retention but also improved patient outcomes and satisfaction and increased hospital profit.
Christine Lau is a physician.
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