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Hospital knows what it takes to make them happy
It’s the little things that sometimes count the most when a rehabilitation facility is attempting to improve patient satisfaction. Patients already expect therapists to do their jobs competently and cheerfully, and they may not give you a lot of credit for meeting those expectations. But they will notice if their dinners are lukewarm or if no one is paying attention to their complaints.
Those are the lessons Warm Springs Rehab - ili tation Hospital in San Antonio has learned during its long focus on improving customer satisfaction. The hospital’s success with patients recently was recognized by the Press, Ganey Associates of South Bend, IN, which named the hospital a 1999 finalist in its "Client Success Stories" awards. (For more information, see story on the hospital’s lab department’s efforts to improve patient satisfaction, p. 7.)
Making patients happy sometimes boils down to simply making sure they receive their cold food cold and their hot food hot, notes Beverly Rhodes, MSHP, RRA, director of quality standards/risk management for the hospital. "Small things make a big difference."
Rhodes and other managers dissected their patient satisfaction survey results and discovered that many problems centered around patients’ special diets. "We have them on a special diet, and we have no choice in what they can eat, and so they think, Yeah, I’m on a special diet, but if they ask me if I like it, then the answer is no, I don’t like it,’" Rhodes says.
There were other little irritations that caused patients to rank the hospital lower than managers would prefer. So the hospital’s quality standards staff and managers set about to make changes that ultimately increased scores from 85% to a peak of 89.5%.
Here are some of the hospital’s changes:
• Improve food service. While hospital staff couldn’t do much to change patients’ special diets, they could make sure the food at least was served at the correct temperature. Patients had expressed dissatisfaction with their meals’ temperatures, so the hospital invested in microwaves on every floor and examined its entire food delivery process.
Managers discovered that the food often cooled before it was served for two reasons: the insulated serving trays were old and had begun to lose some of their insulating ability, and it took a long time for employees to serve patients. One employee might have 30 trays to take to a unit, but as he is delivering meals, patients would make additional requests. For example, a patient might ask the employee for help in sitting up or with taking a pain pill or with going to the bathroom. Handling all of those requests takes time and results in cold food.
The facility solved that dilemma by altering staff’s lunch and dinner breaks, so nurses and others would be available to provide extra assistance during mealtimes. If a patient says her meal is cold, staff can heat it up in the microwave on the floor.
Because this required staff to spend more time with patients during their meals, hospital managers emphasized to them the importance of improving patient satisfaction.
• Handle family communication. This is a tricky issue because different family members will have different expectations and agendas, and their perceptions might lead to an unhappy patient.
"One family member might want to take Mom home, while another wants to put Mom in a nursing home," Rhodes says, adding that there might be several different perceptions of what the goals should be for the patient. Plus, the nursing staff might think the family wants one thing, while therapy staff have an entirely different idea. Communi cation problems between family members and departments can become confusing.
Warm Springs Rehabilitation Hospital has found that the best way to prevent major com munication problems is by meeting with family members to set goals before expectations can become unrealistic.
"We ask family members, What are your expectations for your loved one?’ and we use that information along with the physician’s goals and clinical goals," Rhodes says. "This way, we have a better idea of what everyone’s expectations are and what the patient’s ability and potential is."
• Make the pediatric wing more fun. It’s difficult for children to spend weeks in a hospital, so Warm Springs has attempted to at least make the pediatric rooms more fun with Winnie the Pooh bedspreads and children’s videotapes, toys, and books. The waiting room is comfortable area with bright colors, fun pictures, soft floors, and bean bags. The rooms are painted in bright colors and have soft floors with bean bags.
"We can show families pictures of different options for the their children’s rooms," Rhodes says, "and we make sure the staff is trained and understands how to treat children differently from adults."
Staff make sure families are closely involved in children’s care, and staff understand that treating pediatric patients means they essentially are treating the parents as well, Rhodes adds. "The family members are the ones who are going to take the kids home and continue the treatment."