Thursday, December 6, 2012

Public Hospitals Seek Patient Input for new Approach

A growing number of public hospitals are engaging their patients in a conversation on how to improve service. New committees and boards have been set up across the country, with membership comprised of patients or patients’ families. These committees seek the voice and the view of the patient as it relates to how care is delivered within the hospital.  The timing for this is not by accident.

Patient input and satisfaction have come back into the spotlight due to incentive programs recently put in place by the federal government. The Affordable Care Act carried with it both stick and carrot approaches to encourage hospitals and other patient care facilities to place patient care first.

The new Medicare Value Based Purchasing Program serves as the stick. The program focuses on the whole of patient care, including patient readmissions, shifting away from the traditional fee for service reimbursement model. Hospitals can lose from one to three percent of federal reimbursements for high readmission numbers. NAHAM News previously reported on this program here (Medicare’s new Value Based Purchasing program: Enough to inspire hospital change?)

The carrot, on the other hand, comes in the form of an Electronic Health Record (EHR) incentive program that rewards hospitals for utilizing the new technology. The program is still in its first stage, focusing on raw implementation of EHR systems, but the second stage will focus on meaningful use of the records. The program mandates that EHR technology must provide patients with an online means to view, download, and transmit selected data. More information on the EHR Incentive Program can be found here.

The Gordon and Berry Moore Foundation is also providing a carrot with their Patient Care Program. The program works towards eliminating patient harm with a two pronged approach. They emphasize meaningful patient and family engagement, and a reengineering of hospital processes. In turn, they believe that healthcare will become more cost effective and be more respectful to the patients and families they serve. To work toward the goal, they are planning to give out $500 million in grants to hospitals willing to alter their patient care model.

Ideas that come from these patient committees or boards can provide simple and effective ideas for hospitals. A hospital in northern California had a logical policy that all emergency patients had to be funneled through the emergency room. This included psychiatric patients who would be forced to have psychiatric episodes in the general ER. It was not until the hospital listened to advocacy from the mother of a mental health patient that the policy was changed to allow direct access to the psychiatric emergency department. This simple shift restored a sense of dignity and respect to an entire group of patients.

Another hospital in Oakland, California was shocked to hear about issues that patients experience when working with multiple hospital units. In this instance, physician rounds at 2pm meant that a nurse wouldn’t order a prescription until 2:30, which left little time for a patient to fill it in the discharge pharmacy before it closed at 3pm. This may delay a discharge and prevent another patient from getting an inpatient bed.
Still, other hospitals are requiring staff to attend patient care events that include patient panels and best practice discussions.

You can find the original article from here, but it requires a free subscription.

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