At Twin Rivers Regional Medical Center in Kennett, Mo., physicians and Associates have taken G2G to another new level: humanizing the patient experience and reestablishing the human-to-human connection between patients and caregivers. The results of their efforts are inspiring: Twin Rivers Regional has improved 25 percent in top box scores over the previous year, and the scores continue to rise. The hospital has improved in patient perceptions for every domain of the HCAHPS survey, a feat that is difficult to obtain and particularly impressive for an effort that began just nine months before.
Reestablishing the human connection
Last year, Steve Pu, DO, the medical director at Twin Rivers Regional, had been thinking about ways to reinvigorate the G2G initiative. In late 2010, Dr. Pu was listening to M. Bridget Duffy, MD, CEO of ExperiaHealth, a subsidiary of Vocera Communications. ExperiaHealth is a consulting firm that works with organizations to restore the human connection to health care through innovative solutions and technologies that improve patient outcomes.
“As I listened to her talk, something clicked,” Dr. Pu said. “I realized that this directly applied to G2G — that we had to restore the human-to-human connection with our patients, and the physicians had to lead the effort. This also extended to reestablishing that connection between physicians and Associates. Before we could improve the patient experience, we had to improve our Associates’ experience.”
Dr. Pu shared his insight with Dr. Ronald Riner, Chief Medical Officer; Ann Barnhart, Western Division CEO; and Gary Tomcik, and received immediate support. They began a pilot project at Twin Rivers Regional and brought in ExperiaHealth to assist. In December, ExperiaHealth visited the hospital to perform assessments and hold brainstorming sessions with physicians and Associates. A number of valuable concepts came from those sessions.
Putting concepts into action
One of the most significant concepts, known as the “Sacred Moment,” was initially an idea of Nelson Perez, MD, OB/GYN, and further refined by Edmund Landry Jr., MD, Orthopedic Surgery. The Sacred Moment refers to what is sacred to the patient — emotionally and spiritually — and focuses on restoring the human connection at key points throughout the patient’s visit. For example, during the admission process, patients are asked about insurance, allergies and whether they have a living will, which can often feel procedural and dehumanizing.
“Instead, we ask patients what they are most worried about, who is in their support system, and whether they have any spiritual needs,” Dr. Pu said. “Questions like these are more humanizing, provide a better experience for the patient, and restore that human-to-human connection. It also improves Associates’ satisfaction by making them feel better about the experience, and taps into why they went into health care in the first place. When you accomplish these two things, it naturally leads to better patient care.”
Another concept that evolved from the brainstorming sessions was the No Excuses Team (NET). The team was created to tackle the various problems for which no one was accountable. “We empowered members from all the G2G teams to think outside the box and take ownership of a project until it was completed,” Dr. Pu said. “We’ve solved a lot of problems, and have had full support from our CEO Ken James on all the new practices we’ve put into place.”
One particular problem involved a printer that was constantly breaking down. All the lab and x-ray reports were sent to this printer, so it was extremely frustrating for physicians and Associates. A NET member took ownership of the problem and called a repairman. When the repairman said he needed additional parts and would have to come back, the NET member refused. He brainstormed with the repairman and they came up with a solution using parts from an unused printer. The printer now works flawlessly.
Influencing care across the country
Twin River Regional’s health care improvement concepts have been gaining attention both locally and across the country. The Arkansas Hospital Association has asked Dr. Pu to speak at their CEO meeting, and Dr. Pu’s involvement with ExperiaHealth’s National Patient Experience Collaborative has generated national interest. The Collaborative, a partnership between Stanford University’s Clinical Excellence Research Center and ExperiaHealth’s member hospitals, focuses on finding new ways to improve patient care and staff experience, and studies and develops best practices. Members meet a few times a year and share ideas for improving health care, implement the ideas, and collect data to determine what works. After Dr. Pu presented on the Sacred Moment and NET at a meeting, a number of organizations have adopted the practices.
“Through our National Patient Experience Collaborative, we hope to put science behind the human experience of care,” Dr. Duffy said. “We want to demonstrate that innovative ideas — such as a Sacred Moment at admission — actually improve quality, lower cost, and increase employee and patient loyalty to the organization. It’s through enlightened leaders like the executives, physicians and nurses at Health Management that we will focus on what really matters in health care today: the human experience of care. With their leadership, we are creating a national research agenda that will define the components of an optimal healing experience that actually improve outcomes.”
Dr. Pu notes that physicians and Associates feel rewarded with the recognition that Twin Rivers Regional has received, but they are more interested in sharing the hospital’s success to improve the delivery of health care for all patients. “We need to get back into what we originally went into health care for, and that’s caring for people,” Dr. Pu said. “Medicine is more art than science, and when people are passionate about what they do, everything else follows — better outcomes and greater patient satisfaction.”