a. All weekly discussion board questions are provided to the student via the Course Syllabus at the beginning of the course. There are generally from 1 to 3 questions posed for the week.
b. Each student is expected to post a response to the week's question as well as respond to any questions asked by other students based on what I post. Finally, each student must post a response to at least at least 2 others student posts during the week.
c. All posts to the discussion board must be cited and referenced using APA format.
d. My routine is to do the reading during the week, outline my responses to the questions on Saturday, finalize and post my responses on Sunday.
Below is an example of what I posted in response to one of last week's questions:
Question:
Since customer satisfaction is a key driver in today’s healthcare organization, discuss ways that providers can educate patients and families about what is “quality care” and how they can play a role.
With the advent of insurers successfully tying reimbursement to both cost and (more recently) clinical outcomes, health care providers are learning the results of their quality measures will influence their future success. National regulators, i.e. Joint Commission (Joint Commission [JC], 2010) and CMS (HCAHPS, 2010), are working to develop measures that compare providers fairly. Private for-profit services such as HealthGrades ("Healthgrades", 2010) have seized on the quality comparison movement and are successfully using their formulas to rank both hospitals and physicians based on a 5-star point system. HealthGrades promotes their website to consumers to help them identify the “best” providers in their areas. Hospitals with 5 stars purchase the rights to use the HealthGrades brand in advertising.
The general consumer is obviously a key audience for broad based quality messages. A coordinated public relations strategy built over years of positive promotion is key to building general awareness of the quality of care a hospital and its’ medical staff offer them when they need it. Internal risk managers and hospital attorneys advise against using descriptors such as “best” in messaging as those messages come back to haunt them in litigation. Instead, hospitals use awards and external recognitions such as HealthGrades, Magnet accreditation (Magnet, 2010), and J.D. Power (JD Power, 2010) customer satisfaction results to promote the quality of the organization and its services.
The availability of diagnostic and treatment technology can influence a consumer’s choice of provider and potentially defines the quality of the organization even further. In addition, the availability of physician experts as well as the expertise of staff providers are important components of building the quality image of the organization. My own organization regularly includes physicians/surgeons in advertising promoting the latest technology such as the DaVinci robot. We also have touted the high percentage of advanced training credentials held by our nurses. Obviously, any report of a quality measure must be defined well and accompanied by an explanation of why the measure means that the organization offers quality services.
Patients and their families may choose a provider based on the foundation built by quality messages they have heard or seen over time. After the time they enter the system, though, quality is judged moment to moment.
Examples of items that might impact the public perception of the quality of an organization may include things such as: How long did they have to wait in the Emergency Department? Were the staff and physicians they encountered kind and supportive? Did they read the Joint Commission “Speak Up” posters and then count the number of times someone forgot to check their hospital identification bracelet? Did caregivers seem to give sufficient time to hear concerns and explain items, rather than rushing to get to the next patient? The list goes on and may include non-medical indicators that are easily overlooked by an organization, too.
Do the televisions in the waiting room work? Are there a variety of magazines to read? Is there internet access for those waiting? Are the restrooms clean and stocked with supplies? Are coffee and refreshments available without having to venture far away from waiting rooms? Is there adequate and convenient parking available, and is the parking lot sufficiently lit to make people feel comfortable at night?
Unfortunately, we may be judged not only on the quality of medical care, but also with regard to non-medical indicators that relate to the overall experience. You can have the latest equipment and the most qualified caregivers in the world, but if the bathrooms are filthy, THAT is what people will recall and talk about with their friends.
The bottom line seems to be that each person is an individual and brings perceptions of quality that have been built from exposure to a host of messages. Our challenges are:
- Arm staff with our quality messages including our focus on continuous improvement as our never-ending journey.
- Continuously improve our processes to ensure that our quality measures will be positive as we begin to report them.
- Include not only caregivers in the quality message, but also individuals who have supporting roles, and make sure that they realize that their contribution has an overall impact on a patient / family interactions.
- Perhaps most importantly, assure that every single patient and their family has a very positive experience every single time and views us as the best healthcare partner they could have chosen.
References
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