Wednesday, June 17, 2009

The Big Three: Cleanliness, Courtesy, Food

Last month, I co-led a course at an American College of Healthcare Executives conference with my consultant friend, Gail Scott. With the title, "Beyond the Silver Bullet: Ensuring Employee and Patient Satisfaction," I shared my thoughts at one point in the course about the three areas where most patients will judge hospitals. These are cleanliness, courtesy, and food.

Recently, Anthony Stanowski, one of the particpants in the course, wrote about this course in his blog, Observations on Operations. You can read it here. Anthony raises some excellent points about "why food matters" when it comes to patient satisfaction, even though it is not directly measured by HCAHPS.

Why cleanliness, courtesy, and food? Because most patients are able to best judge things they are familiar with, like being treated with courtesy and compassion, enjoying a clean and safe environment, and eating tasty food. Patients know if the room isn't clean. They know if the staff was courteous or not. Although typically not feeling well, they can still determine how the food tasted to them.

What most patients don't know is the technical stuff. Most of us aren't able to judge whether or not their physician made the right decisions about diagnosis or treatment. Few of us really know if the nursing staff technically handled their situation correctly. But we know if our food is cold or doesn't taste good. We know when we are treated with special care and attention. We can easily see if things are dirty or unkempt. This is what the majority of patients know about and that's where we have to work a little harder to be impressive. If we make sure that the hospital, the entire hospital, looks clean and orderly, that patients are greeted by friendly, compassionate people, and that the food they eat is tasty and served at an appropriate temperature, then folks have a sense of satisfaction.

Clearly patients expect and deserve competence in their care. I believe it is the service that really differentiates one hospital from another. Individualized and personal care; along with fresh and tasty food make for an excellent patient experience. I am proud of the people dedicated to doing just that day in and day out at GRMC. Striving for the best possible outcomes with an obsession for service, with an eye to efficiency and cost containment is our goal.

Thursday, June 4, 2009

A Crystal Ball for Healthcare Reform

The internet, the talk shows, and the newspapers are full of stories about healthcare reform. The pundits and the experts are batting around proposals and various solutions related to healthcare. There is some allure to throwing our current healthcare system out and starting over. Realistically, that just isn’t possible.

I’ve said it before: reforming healthcare is like peeling an onion. There are layers under layers, under layers that must be addressed before anything that looks like reform can be useful. Medicare, Medicaid, private insurance, personal responsibility, preventive and public health emphasis, physician payment, medical liability, pharmaceuticals and medical device manufacturers, single-payor system, tax credits, electronic health records, fee for service, pay for performance…these are just a few of the issues being addressed. Each is complicated at best on their own, but extraordinarily so when trying to fit them all together into one cohesive package.

Last week I attended a meeting in Cedar Rapids with Senator Grassley on the topic of healthcare reform. It is the committee he serves as ranking minority member (and former chair), the Senate Finance Committee, that is currently shaping the debate. He hopes for a bipartisan approach to this monumental task; I share that hope. He is pushing for all involved parties to have some skin in the game; that also makes sense to me. Finally, he noted we must not have government making decisions about individual healthcare issues; another ideal I share.

Several years ago when I was on the American Hospital Association board of trustees, we started discussing healthcare reform. More recently, the AHA set out a framework for change which includes the following five tenants: healthcare coverage for all; paid for by all; focus on wellness; most efficient affordable care; highest quality care; and best information. These principals and ideals seem like a great place to start.

We’re hearing that there should be some healthcare reform legislation crafted this summer to be ready for the President before Congress takes a recess in August. It’s entirely possible that we will have a different sort of healthcare system by the end of the year. My crystal ball is certainly no clearer than anyone else’s, but it is clear to me we will have some big changes by year end. The question is, will it be meaningful reform or just window dressing…

It could be a very hot summer in Washington.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.