Defining Hospital Service Excellence
- November 29, 2016
- ByYogin Patel
ApolloMD Divisional President, Dr. Yogin Patel’s Take
Hospitals and healthcare systems across the country are redefining their missions to provide service excellence and enhance patient experience. As the new paradigm of healthcare, the mission of service excellence is vital to cultivating patient engagement and integral to the long-term sustainability of every hospital and healthcare system in the country.
The formula for successfully cultivating a culture of service excellence is not one size fits all. Many elements are customized depending on a facility’s needs. However, several elements prove to be key components for providing the optimal patient experience. Dr. Yogin Patel, ApolloMD Divisional President, provides his key elements to reengineer the patient experience in the emergency department (ED).
The Patient Encounter
Every moment is critical when crafting the perfect patient encounter. Physicians and advanced practice clinicians (APCs) should remember the patient encounter begins as soon as a patient enters the ED and does not end when they leave, but after the post-discharge follow up.
Use the welcome period to make the best first impressions.
- Rebrand the waiting room to a family reception area to set the tone of the ED visit
- Include televisions with health-related information on loop, marketing materials on new service lines and information on the ED team to create adequate diversions
- Initiate triage protocols, round in the reception areas, and set up Rapid Treatment Areas.
Minimizing delays in initiating treatment is important to satisfying patients and will improve treatment times, overcome capacity constraints and allow for clear communication with patients.
During the patient encounter, providers should provide positive FAST assessments (First impression, Apologize for the wait, Sit down, Touch the patient). Use whiteboards and continue to round on patients to ensure clear communication and to keep patients informed.
When a patient is prepared for discharge, it is important to ask if he or she received excellent care. Provide a discharge packet to each patient. This will serve as a tangible takeaway of the visit and should be accompanied with the verbal summary of the visit given by the provider.
Remember that the visit does not end there, consistent phone follow up is important for service recovery and patient satisfaction. Prep all patients for a satisfaction survey and set a goal with the follow-up percentages clearly defined.
Scripting for Success
A customized, detailed facility script is critical when creating a positive patient encounter and ensuring consistency from all providers. The script should outline every course of action from the moment the patient enters the ED to post-discharge follow up procedures.
When building the perfect script for your facility, use the ED patient satisfaction survey as a guide and remember that scripting involves standardizing both non-verbal and verbal communications. Language should be kept positive, inclusive and specific. An effective script covers the following:
- Developing patient rapport
- Laying the foundation for the workup and evaluation
- Explaining the diagnosis, treatment and follow up
- Asking the patient about the satisfaction with the visit
- Setting an expectation of a follow-up call from a provider
- Laying the groundwork for a follow-up survey
Behind every successful department is an exceptional leader who is consistent in providing guidance and feedback to all providers. A successful leader offers over communication and leads by example.
Dissemination of individualized provider feedback, goals and group data is key when coaching providers to success. While it is important to post or email satisfaction scores to the group, sitting down with the providers to discuss scores one-on-one is more important to long-term development. Share actual data, patient grievances and letters so everyone can see first-hand how patients perceive them. Review each provider’s patient approach and provide constructive feedback and strategies for improvement.
Identify high-performing providers to enable peer-to-peer learning for increased patient satisfaction scores in the future. Give providers several periods to raise their scores, implement new strategies and demonstrate a trend of improvement, while providing ample resources to providers.
As an effective leader, it is important to review scores with administration to establish clear communication of performance and real-time monitoring of the group trends. Effective leaders recognize top performers and celebrate their successes publicly. Praise should be done so liberally and often to ensure the team is recognized and appreciated.
Read more about ApolloMD’s Medical Director Training | Skills for Successful Clinical Leadership.
Developing an Action Plan
Action plans serve as an additional customized communication piece that help track department goals and projects relating to the overall success of the department. A detailed action plan results in the following:
- Breaks down areas of focus
- Provides details on the goal or project
- Establishes timelines and expectations
- Allows leadership to assign tasks and hold team members accountable for their components
Under-performance is easily identified using an action plan, resulting in leadership developing unified solutions to address each team member properly.
Operational efficiency in the ED can directly affect patient satisfaction. Using innovative technology such as ER Express, ED Passport and Scribe Documentation improves patient satisfaction in a number of areas.
ER Express allows patients the capability to reserve time in the ED where they can be seen, avoiding unnecessary wait times and delays. The program can be instrumental in building voluntary patient volume. ER Express patients have specific expectations around their care and often represent low acuity complaints. Since these patients are typically seen upon arrival, they represent the ideal opportunity for achieving an excellent patient encounter.
ED Passport is designed to encourage the transfer of patients into the ED from surrounding clinics, offices and urgent care facilities with a quick and seamless process for all community providers. While these patients are higher acuity, the use of ED Passport allows us to demonstrate how we control the continuum of the patient’s care. It also conveys to patients that they are a priority for us.
Scribes allows providers to spend more time with patients and less time documenting. Scribes can meaningfully impact the documentation of the encounter, freeing up providers for patient-centered tasks. It can also enhance the productivity and efficiency of slower providers boosting the ED’s overall throughput. In addition, they can provide reliable, real-time flow feedback and prompt physicians when results are back.
Understanding service excellence and why it matters should be directly communicated to the department. While each team member benefits differently, it must be communicated that satisfied patients result in a successful emergency department. Leadership, scripting the ideal encounter, rewarding the good and burying bad behaviors can change the overall tone of the department and further lead to success.
As a Divisional President with ApolloMD, Dr. Yogin Patel serves our health system partners and oversees practices along the East Coast in our collective mission to drive better patient care and higher quality outcomes. Dr. Patel joined ApolloMD in 2007 and has been involved with establishing new practices, new physician recruitment, clinical operations, leadership development, and strategic growth initiatives. From an operations perspective, he has driven the success of several large-volume emergency departments, by maximizing throughput, enhancing the patient experience, and improving clinical quality using strong, performance-based incentives to align providers with our health system partners. He combines his clinical and business acumen to bring creative solutions to our client’s toughest challenges. In addition to his leadership role, Dr. Patel is a practicing Emergency Physician proudly serving communities throughout the Carolinas.
Prior to joining ApolloMD, Dr. Patel received his BS with Concentration in Neuroscience from Duke University. He also completed his MD, and his MBA focused on Health Sector Management from Duke University. He completed his residency in Emergency Medicine at Oregon Health Sciences University where he was inducted into AOA and served as Chief Resident in Emergency Medicine. He also concurrently served as Legislative Advisor for the Emergency Medicine Resident’s Association, and remains active within the American College of Emergency Physicians.