CMS plans to use hospital patient satisfaction survey data to determine reimbursement. Here’s how radiology groups can improve their scores.
In 2014, CMS will add yet another factor into the mix of how your reimbursement payments are determined. That’s when hospital patient satisfaction surveys- known as HCAHPS - will begin to play a role in your bottom line.
Surveying patient satisfaction with health services isn’t new, but HCAHPS - Hospital Consumer Assessment of Healthcare Providers and Systems - is the first national effort to collect this information. Once implemented, the survey has three goals: produce comparable data on how patients perceive their care; give hospitals information needed to improve their care quality; and increase transparency surrounding hospital care. Eventually, CMS plans to use this patient satisfaction data to determine the level of reimbursement it will give hospitals for services rendered.
Concern over patient satisfaction has already taken hold in many hospitals. In a recent poll of hospital-based imaging directors and managers on the MarkeTech’s imagePRO panel, roughly 85 percent reported that maintaining or improving patient satisfaction ranks among the top third of their organizational priorities. In addition, 65 percent said hospital administration is committed to making those enhancements happen.
In radiology where providers often have little-to-no direct patient contact, why is it important for you to think about how happy patients are with the services you provide? It turns out, said James Lipcamon, outpatient imaging services manager for East Cooper Medical Center in Mt. Pleasant, SC, patient satisfaction is a big deal for today’s radiologists, both in the hospital and private imaging center setting.
“For any patient coming into a hospital setting or an imaging center, they already expect our competency. That’s not what they’re mainly concerned about; they’re looking for the warm fuzzies,” he said. “And, if you’re in a competitive market, patient satisfaction is critical because word-of-mouth drives a lot of health care business. Someone has a bad experience with you, they’ll tell 10 people. If they have a good one, they’ll tell three or four.”
Improving Your Scores
Fortunately, there are several steps you can take to maximize patient happiness, and most strategies are fairly simple. The HCAHPS data can give you a clear understanding of how much patients approve or disapprove of your department’s performance, Lipcamon said.
For example, use patient satisfaction cards to gather opinions and recommendations from patients about areas where you can improve. Ask them if it was easy to make an appointment, if the front staff welcomed them warmly, and if they received clear directions during the visit. You should also inquire about how quickly they were seen once they arrived for the appointment. Phone surveys are also an effective way to collect responses.
Radiology departments and practices can also improve their HCAHPS scores through an initiative known as AIDET - Acknowledge, Introduce, Duration, Explain, and Thank You - said Jason Scott, director of imaging, cardiac diagnostics, pulmonary, and neurodiagnostics at Witham Health Services in Lebanon, Ind. AIDET works, he said, because it creates a culture that makes patient satisfaction a central priority at all times.
“Imaging staff needs to be constantly reminded that management expects patients to be taken care of in a quality manner,” he said. “Having an engaged staff is critical in achieving and sustaining patient satisfaction goals.”
When used properly, AIDET can give your staff the guidance needed to effectively address any problems that occur during a patient’s visit, such as an extended wait, during the time of service. Each person should also take the time to introduce themselves, describe what they do, and detail their level of experience. Informing the patient can relieve any anxiety they feel over an imaging study, Scott said.
In that vein, keep patients and any accompanying family members informed about anticipated wait times and how long a test will reasonably take. It’s also important for your staff to explain each step in a procedure and why they’re doing it. For instance, let patients know why an IV line for a contrast agent is necessary, he said. And, most importantly, thank patients not only for their cooperation during a procedure, but also for choosing your practice or department for their study.
By keeping patient needs and responses in mind at all times, some radiology departments are already experiencing success. The radiology departments at Ministry Eagle River Memorial Hospital and Howard Young Medical Center recently announced their patient satisfaction scores, determined by patient satisfaction survey company NRC Picker, put them in the top 10 percent of hospital radiology departments nationwide.
“Keeping the patient first is our No. 1 priority,” Rebecca Morin, vice president of patient care services, said in a written statement. “Our radiology technologists are very respectful and responsive to the needs, wants, and values of each patient.”
The Challenges of Patient Satisfaction
Even with satisfaction protocols in place, keeping all patients happy with your performance can be difficult. In many cases, the greatest challenge to doing so sprouts from inside your practice, Lipcamon said.
“In many offices or departments, you’re dealing with a culture that has existed for 10 to 12 years, and now it has to change. That doesn’t happen in three or four months; it often takes one to two years,” he said. “It can often take months for people to feel comfortable doing things differently because it pushes them outside of their comfort zone. It can be difficult for some people to make frequent eye contact and talk with patients.”
It can also be difficult to maintain clear communication with your staff and hold everyone accountable for their actions when you’re serving a large number of patients each day, Scott said. Reiterating the importance of patient satisfaction and delivering the best quality care during weekly staff meetings is an easy way to reinforce behaviors that ensure high HCAHPS scores.
Administrators should also strive to create an environment where, if a staff member witnesses discourteous behavior toward a patient, he or she can quickly and privately discuss more appropriate actions with the colleague. Practice leaders can also stay current on how their staff performs by reviewing any patient comment cards daily. Reading the cards ensures all staff members are serving patients with the most respect, efficiency, and quality. And, if any staff member is mentioned positively by name, Scott recommended displaying those kudos in a centralized place for everyone to see.
The Unseen Customer
In addition to your daily roster of patients, Lipcamon advised you shouldn’t forget the other parties who need to be happy with your performance: insurance providers and referring physicians.
Although insurance companies do not currently include patient satisfaction in their decision models, the advent of HCAHPS scores could change that, he said. He predicted many companies will soon analyze your patient satisfaction scores before they decide whether they will cover services provided at your facility.
Referring physicians, however, are already basing their referral decisions partly on how well you provide service.
“Generally, a referring physician will look at a number of factors when choosing which practice to send their patient to,” Lipcamon said. “If he or she doesn’t have confidence from previous experiences that a radiologist can treat a patient with respect while providing a high degree of service, you can kiss that referral goodbye.”
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