Move Family Satisfaction from the 7th to 75th Percentile in 12 Months

In 12 short months, Sharp Hospice Care—which is part of Sharp Healthcare, San Diego's largest health care system—has boosted family satisfaction from the 7th to the 75th percentile (Press-Ganey) and pain control from the 1st to the 88th percentile. Sharp Hospice Care has an average daily census of 250 patients, annual admissions of 1600 patients, and an average length of stay of 54 days. Employee turnover is just 2%.

"Sharp Hospice has been on a journey to service and operational excellence with the Sharp Experience for the last six years, but we recognized we needed to adapt the tools we were using to the needs of a more virtual hospice environment to get these gains," explains Suzi Johnson, RN, MPH and vice president of Sharp Hospice Care. "We struggled for several years to define the key pieces and really hardwire behaviors until they were used with every patient and family every time."

Hardwiring a Culture of Service
At Sharp Hospice, a culture of service starts with employee empowerment and accountability. When nurses said it would be helpful if printers were attached to laptops to print medication profiles for patients during home visits, Sharp delivered...improving patient safety and communication among interdisciplinary teams while also impressing patients and families with their responsiveness.

Likewise, staff are evaluated on areas they can impact. Performance expectations are aligned both vertically and horizontally. For example, since the hospice vice president is responsible for family satisfaction, accountability cascades to all hospice staff who are responsible for family evaluations on specific questions on family satisfaction surveys.

Each member of the team has responsibility for responses to specific questions on the family satisfaction survey. For example, nurses are responsible for answers to two questions: "How well the nurse taught you to care for the patient” and control of patient pain. Home health aides are responsible for "Aide’s concern for patient's comfort" and social workers are responsible for "Your rating of the social worker". Likewise, chaplains are responsible for "Your rating of the chaplain".

Using Key Words at Key Times
Key words at key times are a Must-Have for service excellence. Even though staff at Sharp Hospice were initially resistant to using "scripted" words, they have come to see the impact these words have on patient and family satisfaction. Key words also imprint a greater consciousness of service excellence by hardwiring consistency into each and every patient/family interaction. In a similar way, using AIDET—or the Five Fundamentals of Service—also raises patient and family satisfaction by communicating respect, communication, appreciation, and confidence.
 
 
 
 
 
   

"We want all our employees and volunteers to express an attitude of gratitude when they have contact with patients and families," explains Johnson. "In hospitals, patients know they aren't on their own turf, but in hospice we are guests in patients' homes. We want to honor the family structure and each family member as unique."



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