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Patient satisfaction scores continue to rise Service Pillar: Serving the public with compassion, respect and excellence  Overview of patient satisfaction for MUSC Health   During the months of January through March, MUSC Health leaders watched scores either stabilize or increase in almost every area.   For example, the Adult ED raised its percentile rank 35 percentile points from 28th to 63rd. The adult and children’s hospitals maintained increases experienced in the second quarter of fiscal year 2007 (FY2Q07). Ambulatory Care surpassed its year-end goal by achieving the 65th percentile. At the unit and clinic level, 2CCV raised its percentile rank from 12th to  81st  in three months. Congratulations are also due for the West Ashley Bone and Joint Center for increasing its percentile rank from 18th to 86th in three months.   The top performing units also continue to show what is possible: 2JRU (90th percentile); 8D CH (81st percentile); IOP Adult Resident’s Clinic (92nd percentile); Women’s Health Prenatal Wellness Center (97th percentile); and RT1 Pediatric Orthopaedics (83rd percentile).   Ambulatory Care exceeds patient satisfaction goal   Ambulatory Care clinics focused on reaching a patient satisfaction goal of 62nd percentile by the end of the fiscal year. Currently, there are more than 85 individual survey sites within Ambulatory Care, and the clinics have used Press Ganey for more than two years to measure patient satisfaction.   The numbers for the most recent quarter (January through March) are the highest scores recorded in the last two years and exceed the year-end goal. The overall mean score for Ambulatory Care was 90.3 and the overall rank was the 65th percentile. This is an increase from the previous quarter’s scores of 89.9 and 59th percentile. In addition, 69.2 percent of responses to survey questions were “very good,” or a “5.” The number of patients who returned surveys grew—3,494 surveys were returned this most recent quarter compared to 3,243 returns from the previous quarter.   “We are seeing more and more teams working together to improve patient satisfaction,” said Dave Neff, Ambulatory Care administrator. “Teamwork will be the key to achieving and sustaining a culture of service excellence in our outpatient clinics. Congratulations to everyone for their hard work. It is thrilling to exceed our goal.”   As of May 3, the FY4Q07 quarter-to-date scores for Ambulatory Care was an overall mean score of 90.6 and ranked in the 71st percentile. AIDET: Reality hits hard in Children’s Hospital and Perinatal Services During the months of October and November, all of Perinatal Services and Children’s Hospital staff participated in AIDET training conducted by leadership. Assessments were completed immediately to get staff acclimated to this communication technique. The success was incredible as both areas saw the Children’s Hospital’s patient satisfaction overall score rise from the 42nd percentile to the 77th percentile in the second quarter. The third quarter was similar, but leveled at the 73rd percentile.   During January, like most of the Medical Center, Children’s Hospital was busy. The focus on AIDET diminished and the numbers began to slip. Hardwiring this technique takes more than a one-time blitz. It takes continuous effort to improve patient satisfaction and also maintain it.    An example of a unit where the staff is constantly talking and living the principles of AIDET is 5W. Debra Jones and her unit continue to watch the score soar. The Medical Center has learned a valuable lesson from this group in the Children’s Hospital and Perinatal Services.   For units like 5W and 7C, the use of AIDET has not only provided better ways to work with patients and  families but has also helped with internal communications. AIDET is essential for staff to gain trust from those we serve and work with daily. The concept is simple but takes time and persistence to make it work. IOP inpatient satisfaction exceeds goal For several years, the Institute of Psychiatry (IOP) has hosted a Customer Service Committee. With the start of MUSC Excellence, this committee transitioned into the IOP Patient Satisfaction Team and has embraced AIDET as its main focus. Training programs and AIDET scripts were developed for use by clinical staff. All staff on inpatient units, as well as employees with child and adolescent partial hospitalization programs were trained using role-playing designed for use with psychiatric patients.    To promote AIDET, IOP developed an advertising campaign with a new monthly theme. Examples of previous themes include “AIDET, Just Do It” and “AIDET, We Love It.”  Posters placed in strategic staff locations help re-enforce the monthly AIDET theme and staff receive a small poster with theme-related candy. Using AIDET consistently has resulted in a steady improvement in patient satisfaction scores. In the third quarter of the year, the IOP exceeded its overall goal of 50 percent by reaching 51 percent. The 4N unit achieved a quarterly score of 57 percent.   IOP also developed the IOP Engagement Model, which contributed to improvements in patient satisfaction. This model includes interacting with patients who have experienced trauma in combination with other psychiatric disorders; using language that is free of jargon; minimizing the use of unit rules; and working to engage the patient in their treatment. The focus of staff is to maintain a therapeutic community that is safe, comfortable and promotes trust. Patients have said they have been to other psychiatric hospitals but “IOP is the best.” IOP is looking forward to continuing to “hardwire” AIDET and to implement the principles of engagement. People Pillar: Fostering employee pride and loyalty Medical Center Town Hall meetings conclude Medical Center staff had an opportunity to hear updates from Stuart Smith, vice president for clinical operations and executive director of the Medical Center, throughout late April and early May. Leadership held 13 sessions with approximately 1,000 staff attending and representing about 20 percent of the Medical Center staff. A video of the meetings is available at http://mcintranet.musc.edu/muscexcellence/townhall/townhall.htm.    Evaluations from the meeting are being tallied and results will be available at the video site. Quality Pillar: Providing quality patient care in a safe environment NICU and nurseries celebrate The Neonatal Care areas made great strides by decreasing two major morbidities that often plague the neonatal patient. Both rate of infection and chronic lung disease decreased in response to major efforts made by all care providers. Numerous multi-dimensional initiatives are responsible for this improvement in outcome. After identifying the problem, a multidisciplinary team was developed. To ensure the issue would be addressed in a consistent manner throughout the health care team. Staff involvement was critical for change to occur as many of the necessary changes have a direct impact on patient care and the traditional way of providing this care.   All changes would be embedded within the concept of evidence-based medicine. A literature search identified many models of practice and resources. To address the need to decrease the infection rate, a bundle approach from the Institute of Healthcare Improvement was systematically introduced. As a member of the Vermont Oxford Network (VON), the NNICU became involved in a sub-group working on potentially better practices to decrease the rate of Bronchopulmonary Dysplasia or chronic lung disease. Using the PDSA cycle model from VON, plans for change were placed and evaluated for effectiveness. Staff education was provided  for each initiative  to explain the rationale for changes. Continued feedback was available regarding successes and failures to keep staff informed, motivated, and engaged. Ongoing monitoring continues in both areas to ensure consistency and permanence of change, plus help identify other possible areas of improvement.     Friday, May 11, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.