Recently, I attended a program at Simmons titled, “Is Bigger Better in Health Care? As mergers increase, how should we respond?” A panel of three economists discussed topics such as horizontal and vertical integration, the role of competition, anti-trust issues and value-based contracting. It was a great discussion, but one that approached healthcare solely from a macro perspective.
I, on the other hand, tend to look at the industry from the ground up. That’s why, as I was listening, I couldn’t help but think: “But how does this impact us, as healthcare consumers, who are finding our way through an incredibly complex system, so we can get good quality healthcare, when we need it, without going bankrupt?”
Eventually, I got to thinking of my dad and his terrific experience this past summer, when he had a knee replacement.
Before, during and after surgery
When it became clear my dad had a problem with his knee, we went back to the same orthopedic surgeon who did a fabulous job three years ago when dad needed a hip replacement. The surgeon is well educated, very experienced, and was wonderfully communicative about both the procedure itself, as well as what my dad needed to do before and after surgery to have a positive outcome.
My dad was going back to the same hospital where he had great inpatient experiences and outcomes previously (good news!).
On the day of surgery, everything went like clockwork:
Mom, dad and I arrived at 6:15 AM; he was in the operating room by 9:00 AM; he was in his room by 12:30 PM; he was up in the chair by 1:30 PM having some fluids for lunch. (See photo).
By 1:30 PM the next day, he was back home and comfortable.
All in all, it was a “perfect patient experience.” But, as you might imagine, these things don’t happen by accident. Let’s look at why dad’s experience went so well.
The Perfect Patient Experience
On the “Quality, Performance and Safety” link of the hospital’s website, it states that, “Every day, we strive to provide a perfect patient experience. When we find areas where we can improve, we have mechanisms in place to make improvements.” It goes on to describe The Albright Read Institute for Healthcare Improvement Science and Medical Research (ARI) that advances the hospital’s commitment to process improvement.
This Institute is one example of many quality improvement efforts underway in healthcare settings. You may have read about The Institute for Quality Improvement (IHI) or the Hoshin Planning Process and Lean Management, all quality improvement efforts implemented in healthcare settings around the world.
In the hospital my dad was in, and while serving on the Patient Family Advisory Council previously, I had the privilege of participating in a major quality improvement effort. This institution had a culture of excellence and improvement, and we felt it.
Here are some of the things that contributed to our satisfaction with my dad’s experience:
- Excellent pre-surgery communication about where to go and what to do to prepare, including detailed instructions about pre-medications and skin preparation.
- Pleasant and informative staff members who greeted us on arrival and told us what to expect, every step of the way.
- Inclusion of me and my mom in the pre-op meetings with the surgeon and anesthesiologist.
- Warm blankets – not only for my dad, but for my mom as well, who was cold from the air conditioning.
- An electronic communication board in the waiting room that allowed us to “follow” where my father was – from the OR, to the recovery room, and to his room – so we didn’t have to wonder.
- A post-op visit from the surgeon, in a private space, to review my dad’s experience and to outline what to expect next.
- A welcome by the primary nurse responsible for his post-operative care, resulting in us feeling like she was taking care of all three of us, and not just my dad.
- Helpful staff on my dad’s unit, all of whom welcomed my check-in calls at midnight and 5:00 AM the next morning.
- Inviting my mom and me to arrive early the next morning to participate in his physical therapy evaluation and the discharge decision.
- Excellent discharge instructions, covering pain control, plans for homecare services, and when to see the doctor for a follow-up appointment.
- No more than a five-minute wait for the wheelchair transporter to take us downstairs and help us into the car. (This one really hit home for me. Many times, I have waited up to an hour with patients awaiting discharge.)
As I said, a perfect patient experience!
Evaluating your healthcare options
The Agency for Healthcare Research and Quality (AHRQ), an agency of the U.S. Department of Health and Human Services (HHS), defines quality in health care as:
- Providing the most appropriate care
- Achieving the best outcomes for all patients
When obtaining care from a physician practice or from a hospital, look for a commitment to quality by asking about quality initiatives. Expect transparency about them.
Specifically, ask about…
…how (if it’s a physician practice) change efforts surrounding preventive care and management of common chronic diseases such as high-blood-pressure or diabetes are measured and initiated. Just as important, ask how patients experience care.
…electronic medical record systems and how information gets communicated during transitions of care.
…how quality is measured and what impact it has on the way insurance companies pay.
…Patient Family Advisory Councils and how patients participate in quality improvement efforts.
…how feedback is shared with physicians and staff.
…how the organization compares to national and state benchmarks of quality.
Yes, our healthcare system is complicated! But we, as consumers, need to be assertive, do our homework and assess the quality of care we plan to access, thus making informed decisions.
The culture of an organization and how it resonates with you and your needs is important. That organization may not always be around the corner, but as my dad’s wonderful recovery can attest to, the extra effort is worth it!