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 ModernHealthcare.com here,
but it requires a free subscription.
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