Decision aids are designed to educate patients about potential risks and benefits of preference-sensitive procedures and treatment such as which method to use to screen for colorectal cancer and treatment options for back pain.

Research has shown that decision aids help patients engage in shared decision-making. A study published in Health Affairs analyzed how decision aids were disseminated, if at all, in five primary care practices in California over a thirty-month period. The authors found that only 9.3 percent of patients due for colorectal cancer screening and 10.7 percent of patients experiencing back pain were given a decision aid.

We talked to Grace Lin, MD, one of the study’s leading authors, about the challenges facing hospitals and health systems to successful implementation of decision aids.

iTriage: What do hospitals and health systems have to gain from the successful dissemination of decision aids?

Dr. Lin: Decision aids have been shown in more than 80 studies to improve patient knowledge about treatment options, help patients have more accurate perception of the benefits and harms of treatments, participate more in the decision making process, and make decisions that are more consistent with their values.

Successful dissemination and use of decision aids could help hospitals and health systems provide better shared decision-making for patients and more patient-centered care, particularly for decisions where patient preferences are important in the decision-making process.

Engaging patients in shared decision-making in the appropriate context is becoming increasingly important. For example, hospitals and health systems that would like to participate in the Medicare Shared Savings Program as accountable care organizations must have processes to promote patient engagement and shared decision-making. Decision aids could be one way to meet the requirements of the program. 
In addition, some studies have shown that use of decision aids is associated with reduced rates of certain kinds of elective surgery and lower overall medical costs. Estimates show that implementing shared decision-making could save up to $9 billion over 10 years. Thus, there may be financial savings tied to successful implementation of decision aids and other programs to encourage shared decision-making.

iTriage: What metrics should hospitals and health systems follow in order to judge whether or not a decision aid dissemination program is successful?

Dr. Lin: There are many ways to measure whether a program designed to facilitate distribution of decision aids has been successful.

First and foremost, hospitals and health systems must ensure that the decision aids are reaching the right patients at the right time. One potential way to do this is to assess how many patients who were eligible for the decision aid actually received one. For example, if hospital or health system were distributing a decision aid about treatment options for hip osteoarthritis, one would want to know of the patients with hip osteoarthritis who visited the physician seeking treatment for this problem during a certain time period, how many received the decision aid? 

Another potential way to measure the success of a decision aid program from the patient perspective is to survey patients to find out how informed they were about the decision, how actively they were involved in the decision-making process, and whether the decision made was consistent with the patient’s preference. Such information would help hospitals and health systems understand whether or not they were providing patient-centered care.

iTriage: What barriers and challenges do hospitals and health systems face in the successful implementation of decision aids?

Dr. Lin: Currently, even though many effective decision aids exist, distribution and use of decision aids is low. There are a variety of reasons why, but probably the biggest challenge for hospitals and health systems is to establish a culture where facilitating shared decision-making through use of decision aids is valued and is the standard of care. When surveyed, physicians often cite a lack of time as a large barrier to routinely practicing shared decision-making. However, in our recent study published in Health Affairs, we found that physicians who used the decision aids regularly found that the decision aids actually saved time. Because those physicians saw the value of the decision aids, dissemination of the decision aids became their standard of care and they regularly distributed decision aids to their eligible patients. On the other hand, in clinics in our study where physicians either did not have easy access to decision aids, or did not see the value of the decision aids, distribution remained very low.

iTriage: What can hospitals and health systems do to address these challenges?

Dr. Lin: For successful implementation of decision aids, hospitals and health systems need to develop policies that facilitate distribution of decision aids, reward providers and/or clinics for using decision aids, and to build a culture where decision aid use is expected from all providers. For example, a health system could incorporate ordering of decision aids into the electronic medical record like other tests and treatments, so that it would be easy for physicians to incorporate decision aid distribution into their workflows. Non-physician staff could also be trained to offer decision aids to patients for certain conditions that don’t require physician diagnosis, such as cancer screening. Additionally, decision aid distribution could be incorporated into routine assessments of physician and staff performance, so that recognition could be given to those providers who successfully implement decision aids into their practice, and providers who are not as successful could be given feedback on how to increase their decision aid use. These are only a few suggestions – there are many other ways to encourage decision aid use.

iTriage: Can you name some hospitals or healthcare providers that have successfully used decision aids? What made them successful?

Dr. Lin: There are several institutions in the U.S. that have instituted successful shared decision-making programs with decision aids. For example, Dartmouth-Hitchcock Medical Center has established a Center for Shared Decision Making that includes both a decision aid library anddecision support counseling for many health conditions. Group Health Cooperative in Seattle, WA has also instituted a very successful decisionaid distribution program for surgical conditions. In both cases, there appears to be substantial institutional and physician support for such programs, both philosophically and financially. This allows for infrastructure to be built to encourage physician use of decision aids, and builds a culture supportive of decision aid use and shared decision making.

Grace A. Lin, MD, is an assistant professor at the University of California, San Francisco. She is an assistant professor in the Division of General Internal Medicine and at the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco. She also serves on the editorial board of the Archives of Internal Medicine. Dr. Lin received a master’s degree in clinical research from the University of California, San Francisco, and a medical degree from the University of Michigan. She served as chief resident for ambulatory service at the Washington University School of Medicine.

Check out iTriage’s patient education tools.

What do you think of decision aids? Share your success stories or challenges in the comments below!

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The ambivalence providers may have felt toward mobile health is gone. Half of Americans own a smartphone and there are more than 4.3 million mobile health app downloads every day. Patients use mobile apps to monitor their health, navigate the healthcare system and make more informed healthcare decisions. Even the most ardent mobile skeptics have realized mobile health is here to stay.

Mobile health’s ubiquity comes at an opportune time for providers, as reimbursement models increasingly value patient-centered care and outcomes over volume. If providers are to survive the transition from fee-for-service to pay-for-performance, they need to start acting like team players; they need to take steps now to control costs, improve care coordination and make sure that their patients have the right tools to manage their health. Providers have a vested interest in keeping their patients healthy regardless of whether they are in a facility, at home or on the road. Mobile health presents a myriad of opportunities for providers to help their patients live healthier lives no matter where they are.

Given mobile health’s ubiquity, providers are less concerned with whether they should get into the mobile health space than they are with how to get into the mobile health space. One of the most pressing questions they face is whether they should leverage an existing mobile health app or build their own. Here are three questions to address when making this decision:

1. What do I expect to accomplish?

Analyze the reasons you want a mobile presence. Do you want to increase patient volume, extend your brand, or drive patient satisfaction? If your goal is to increase patient loyalty and brand, then building a personalized app for your hospital might make sense. If your objective is to increase patient satisfaction, engagement and education, perhaps an existing app with multiple functions will better suit your needs.

Determine how useful the app will be to healthcare consumers and patients. Some providers build their own apps simply to be part of the mobile trend, and are then disappointed by low download rates. So ask yourself: Are you going to offer your app users something unique? Are you adding something new and valuable, or just reinventing the wheel? Why should healthcare consumers choose to download your app rather than your competitor’s?

Also, consider that Medicare patients have an average of five providers, and that these providers may be in different health systems and locations. Should consumers jump from app to app to navigate the healthcare system? Fragmentation and lack of care coordination have plagued healthcare for years. Will your app increase continuity of care, patient engagement and patient-to-provider communication? To put it concisely: will your app contribute to solving or exacerbating problems in the healthcare system?

2. What is the scope of my project?

Building and maintaining an app is a complex process: You’ll need a highly technical team or company to build the app, run updates, fix bugs, perform quality assurance, keep up with rapidly-evolving mobile technology, and support thousands of platforms and devices. Any mobile app you build will also have to maintain privacy and security standards and be HIPAA-compliant. If you choose to build your hospital’s app, you will need to invest a significant amount of time and money to manage all these moving parts.

3. What makes sense financially?

Depending on what you want your app to do, building an app can cost you anywhere from $50,000 to $150,000, plus the budget you’ll need to keep content current and accurate. Also remember that simple apps take generally take twelve weeks to develop and release. Realize that if you hire a company to build an app for your hospital, you will likely receive an “off the shelf” product. An app tailored to your market or customized exactly the way you want will cost additional time and money.

Also, consider the resources you’ll need to promote your app and drive downloads once it’s released in the crowded marketplace. How are healthcare consumers supposed to find you? There are more than 97,000 mobile health apps in the market, and consumers can not be expected to take the time to analyze each one. Once your app is built, you’ll have to invest considerable resources to break through the clutter and drive adoption.

The time, money and effort you spend building your own app creates a lot of pressure to be successful. Remember that it takes a lot of downloads and conversions to prove a ROI.

Healthcare is behind the times in providing consumers with convenience and consumer-centric service. Providers on the forefront of the pay-for-performance curve are taking proactive steps to anticipate the coming changes. They realize that healthcare and health are two very different things. Healthcare happens in facilities. Health happens in communities, at home, in schools, and in conversations with friends and family. The seemingly insurmountable wall that separates the two is disappearing, with the help of mobile health.

Whatever your final decision, always remember that mobile is about convenience to the consumer. If you put the needs and wants of your healthcare consumers first, you will succeed in the mobile health space.

Learn more about mobile health strategies for your hospital.

Does your hospital have a mobile strategy? What has worked, and what hasn’t? Let us know in the comments below!

The post Hospital Mobile Apps: To Build or To Buy? appeared first on iTriage.

In the approaching world of patient-centered care, putting patients first is no longer a nicety – it’s fast becoming a necessity. Considering patients’ preferences and engaging them in their own healthcare has been shown to lower costs, improve patient outcomes and increase patient satisfaction.

Patient engagement is a two-way street. As hospitals and health systems nationwide grapple with new payment models, incentives and regulations, many realize that engaged patients need engaged providers.

Enter the palliative care program. With its emphasis on patient preference, open communication between patients and providers, and team-based approach to care coordination, the palliative care program exemplifies what patient-centered care should be – a collaborative effort between patient and provider, with the patient making educated and informed decisions about their own health care.

Palliative care programs, a relative newcomer to the healthcare scene, help patients with serious illness manage their symptoms and improve their quality of life. Palliative care programs show that patient engagement matters, and that encouraging patients to be active partners in their healthcare is not only the right thing to do, it’s the smart thing to do.

What Is Palliative Care?

Palliative care, recently recognized as a formal specialty by the American Board of Medical Specialties, concentrates on the prevention and relief of suffering in patients. Unlike hospice, palliative care is appropriate at any age, at any stage of a serious illness, and can be provided alongside medical treatment. A palliative care team usually includes physicians, nurses, social workers and the patient’s family. Some palliative care teams include chaplains, massage therapists, nutritionists and/or pharmacists.

Palliative care has grown in popularity in the last decade: 66% of hospitals with over 50 beds have a palliative care program, a 148% increase from 2000, according to the Center to Advance Palliative Care.

While a growing body of evidence shows that palliative care programs have the potential to greatly benefit hospitals, patients and payers, some hospitals are reluctant to get on board.

Andrew Esch, MD, MBA, Director of Palliative Care at Lee Memorial Health System in Fort Myers, Fla., said palliative care programs face challenges because they defy how traditional care is delivered: “Now, care is not patient-centered. Switching to a more patient-patient centered approach, which takes into consideration the patient’s goals of care, wishes and needs represents a massive switch in philosophy. Most patient care is disease-oriented, care is usually complex and disjointed, and treatment involves many specialties, resulting in fragmentation of the patient’s care.”

Palliative care programs have been shown to ease the burdens Dr. Esch enumerated. He and Stacie Pinderhughes, MD, Medical Director of Palliative Care Medicine at Banner Health in Phoenix, Ariz., outlined exactly why hospitals should engage their most vulnerable patients through palliative care programs:

Improved Patient Satisfaction

Since palliative care always has the patient’s physical and emotional needs front and center, they are uniquely poised to improve patient satisfaction scores. Palliative care is designed to improve patients’ quality of life by treating pain, providing relief from anxiety, communicating with their patients, coordinating care, involving family in care decisions and providing practical support.

“Palliative care helps patients get the treatments they want by matching care to patient-centered goals,” said Dr. Pinderhughes. “This consideration of the patient has been shown to improve patient and family satisfaction.”

This patient-centered approach to care translates into higher patient and family satisfaction, a study conducted by the Agency for Healthcare Research and Quality found.

Improved Patient Outcomes

“Palliative care programs have been shown to improve symptom control, quality of life and length of life,” said Dr. Pinderhughes. “Palliative care programs enable hospitals provide quality care for their sickest and most vulnerable patients.”

A study published in The New England Journal of Medicine found that patients with metastatic lung cancer who received palliative care lived longer than metastatic lung cancer patients who didn’t. The palliative care patients also reported a significantly higher quality of life. Palliative care programs have also been shown to reduce hospital and ICU length of stay.

Lower Costs

Today, the sickest 10 percent of the population accounts for over 64 percent of healthcare expenditures, said Dr. Pinderhughes. As the population ages (government statistics estimate that the number of people over age 85 to hit 8.7 million by 2030), Dr. Esch said that hospitals will care for an increasing number of patients with serious illness, such as cancer, heart disease and kidney failure.

The writing is on the wall. As the aging population struggles with chronic disease, fragmented care and increasing medical costs, hospitals that have palliative care programs in place are more likely to experience lower overall costs of care in seriously ill patients.

These predictions are supported by a few studies: A study published in Health Affairs found that patients who received palliative care incurred $6,900 less in hospital costs than patients who received usual care. The study found that palliative care patients spent less time in the ICU, were less likely to die in the ICU, and were more likely to receive hospice referrals than patients who didn’t receive palliative care.

Another study, published in The Archives of Internal Medicine found that patients who received palliative care who were discharged alive had an adjusted net savings of $1,696 in direct costs per admission and $279 in direct costs per day. Palliative care patients who died had an adjusted net savings of $4,908 in direct costs per admission and $374 in direct costs per day. Both groups had significant reductions in pharmacy, laboratory and intensive care unit costs compared with usual care patients.

We want hear from you. Has your hospital implemented a palliative care program? If not, do you plan to incorporate one in the future? Let us know in the comments below.

The post The Palliative Care Program: Poster Child of Patient Engagement? appeared first on iTriage.

The emphasis on the relationship between primary care providers and mental health patients is understandable: one in four American adults, or 57.7 million people, suffers from a mental disorder, according to the National Institute of Mental Health (NIMH), and more than half of these cases are seen and treated by primary care physicians.

A study published in Health Affairs entitled “Patients With Mental Health Needs Are Engaged In Asking Questions, But Physicians’ Responses Vary” examined the relationship between primary care physicians and their mental health patients. It found mental health patients are engaged as the patients surveyed asked an average of 15 questions per visit.

Interestingly, the study also found that patients who ask more questions perceived their physician’s communication to be worse. This perception highlights an important component of patient engagement that is often neglected: engaged patients need engaged providers.

Challenges Facing Primary Care Physicians With Their Mental Health Patients

“Primary care physicians are concerned that their clinical skills and practice environment are inadequate to fully address the needs of patients with mental health issues,” said Ming Tai-Seale, co-author of the study. Primary care physicians’ concerns include:

Time:

Primary care physicians may struggle to fit mental health issues into what may be an already packed appointment. “Physicians perceive time as a major barrier to having discussions with patients about mental health,” said Tai-Seale. “Biomedical issues often take precedence over conversations about a patient’s feelings.”

While time constraints are often cited as a barrier to communication between primary care physicians and mental health patients, Tai-Seale said that overall visit length could be shortened if physicians fully respond to patients’ questions initially. “We found that a larger time cost is incurred due to fragmented conversations in which topics are brought up repeatedly,” she said.

“Primary care physicians are busy with the number of issues and preventative measures they need to cover,” said Tai-Seale. “Organizations can create a team-based care approach where logistical questions, such as where to go to obtain a lab test, are shifted to other clinic staff.”

Patients Aren’t Always Clear:

“Many patients do not explicitly tell their physicians that they are suffering from a mental health problem; patients tend to offer more subtle clues that require physicians to discern underlying issues such as depression,” said Tai-Seale.

Physicians Aren’t Always Prepared:

Even when patients are clear, physicians may not be prepared to answer their questions. “Some physicians are also frustrated because they may not have clear answers to mental health problems, which in turn leads to the patient feeling discouraged, resulting in a strain in the patient-physician relationship,” said Tai-Seale. “This may be due, in part, to traditional medical education not offering clinicians the training to respond to questions and concerns outside of the biomedical area.”

“Our study suggests that while question-asking is an important indicator of patient engagement in healthcare, communication is a two-way street,” said Tai-Seale. “Physicians must respond thoughtfully and adequately to mental health inquiries.” She noted, “The ability to respond to patients’ questions so that they feel heard is an art as much as it is a science, and clinical training should help primary care physicians become comfortable with such conversations.”

Improving communication between primary care providers and their mental health patients is imperative, but comes with challenges. How does your organization plan to combat these challenges and improve patient outcomes? Let us know in the comments below!

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“Shared decision-making in end of life care is not only the right thing to do, it’s the smart thing to do,” said Jessica McCannon, M.D., an internist and advisor to The Conversation Project, a grassroots public campaign dedicated to helping people talk about their wishes for end of life care. “A growing body of evidence shows that engaging patients in end of life care conversations improves patient experiences, health outcomes and lowers costs.”

Challenges Facing Providers: Why Are Providers Hesitant to Engage Patients in End of Life Conversations?

Dr. McCannon acknowledges that providers face many challenges when it comes to initiating end of life conversations with their patients: “It is almost impossible to engage in a discussion of preferences for end of life care without tapping into one’s deepest hopes, beliefs and fears — both for the healthcare provider and the patient. Obviously it’s a difficult conversation, which is why it doesn’t happen as often as it should, and as effectively as it should, in the healthcare setting.”

End of life conversations are not only intimidating, they require time, institutional support, and education — resources that are not always readily available.

• Time: “If we believe that there is no one-size-fits-all approach to screening recommendations, as in the case with screening for prostate cancer, imagine the complexity of approaching end of life care,” said Dr. McCannon. “Doing the right thing takes time — more time than is available in a 15-minute follow-up visit.” While addressing end of life care may seem like a burden to providers who are already time-constrained, Dr. McCannon noted that some providers are engaging their patients creatively; for instance, by offering patients a list of questions to consider and then going over the questions at the patient’s next appointment.
• Institutional Support: “Healthcare providers may believe that they already engage in shared decision-making, but that might not be the case,” said Dr. McCannon. “The workforce needs to be educated and investments need to be made in appropriate resources, such as tools, training and clinical information systems…as people express their wishes, hospitals and health systems need to have the people and processes to hear and respect what is being said.”
• Education: “There needs to be a culture shift within hospitals and health systems in order to engage patients in their discussions about their end of life care,” said Dr. McCannon. She noted that hospitals and health systems are starting to increase institutional support; some offer training programs for healthcare professionals that emphasize the importance of patients’ religion, culture, spirituality, and “what provides meaning to the lives of patients in general.” Without comfort in these areas, said Dr. McCannon, “healthcare professionals will be challenged in their ability to meet patients halfway.”

While end of life conversations may first occur outside of institutional settings, providers, especially primary care physicians, are uniquely positioned to play a pivotal role in end of life care conversations by encouraging their patients to plan for the inevitable.

Reasons to Engage Patients in End of Life Conversations:

1. Patients’ Wishes Are Respected, Loved Ones Are Spared:

If a patient has an advance directive, they are more likely to spare loved ones uncertainty, guilt and doubt as end of life care commences. “In many ways, those most affected by how someone dies are family and loved ones,” said Dr. McCannon. “By engaging in behaviors that enable people to die in the way that they choose, not only do hospitals and health systems do well by their patients in the most critical moment of all, but they also enhance the health and well-being of the survivors.”

2. Better Care:

Armed with advance directives, providers are better equipped to deliver care that is in line with a patient’s end of life wishes. Complying with these wishes can mean that patients receive less painful, expensive and/or ineffective interventions.

“Physicians can educate patients about best medical evidence, and discuss the risks and benefits of care options, and patients can share information about their needs and preferences,” Dr. McCannon said. “The combined learning and confirmation of understanding on both sides provides direction for a care plan that is right for each particular patient.” Dr. McCannon said that applying these principles provides necessary guidance for what is arguably, “the most critical decision of all.”

3. Lower Cost:

The Center to Advance Palliative Care notes that hospitals with palliative care programs (of which end of life conversations form an integral component) enjoy lower costs, since patients are transitioned to appropriate levels of care (reducing length of stay, especially in the ICU). Proactive care plans expedite treatment, since healthcare teams follow an agreed-upon care approach. Palliative care programs also encourage better use of daily resources by healthcare teams who avoid costs incurred from the ordering of unnecessary drugs and tests.

“It’s important to note that the objective of engaging patients in end of life conversations is not to increase the numbers of patients for opting for less aggressive care,” said Dr. McCannon. “The objective is to make sure that those who choose aggressive care or less aggressive care do so because they are well-educated when they choose.”

For providers who wish to learn more about how they can engage their patients in end of life conversations, Dr. McCannon suggests they start by having end of life conversations wit their own loved ones. “The Conversation Project offers a free starter kit that can help you gather your thoughts. Then you can share this starter kit with your patients. The hope is that it might enable an even richer first conversation.”

“People are motivated by stories, not numbers,” said Dr. McCannon. “On behalf of The Conversation project, I’d encourage medical professionals to share stories of patients and providers who engage in meaningful discussions about end of life care. The Conversation Project’s website is one way to share stories, but it’s also important to share these stories in the community, among colleagues. Not only will it encourage others to have the conversation, both inside and outside of the healthcare system, but it also helps preserve the love and joy that brings most people into the caring professions in the first place.”

About the Conversation Project: The Conversation Project, co-founded by Pulitzer Prize-winner Ellen Goodman and launched in collaboration with the Institute for Healthcare Improvement (IHI), is a public engagement campaign with a goal that is both simple and transformative: to have every person’s end-of-life wishes expressed and respected. Too many people die in a manner they would not choose, so The Conversation Project offers people the tools, guidance and resources they need to begin talking with their loved ones, around the kitchen table, about their wishes and preferences. Have you had the conversation? Learn more at: www.theconversationproject.org.

Dr. Jessica McCannon is board-certified in internal medicine, and is in her final year of Harvard’s Clinical and Research Fellowship in Pulmonary and Critical Care Medicine. After completing her internal medicine residency training at Massachusetts General Hospital, she began providing care to adults at the Mass General Hospital Down Syndrome Program. She received her BA from Cornell University. She has been an advisor to the Conversation Project since 2012.

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The program, designed to award hospitals for quality of care instead quantity, places high emphasis on patient satisfaction, which CMS monitors through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey.

Improving patient experience and satisfaction cannot solely originate from a strategic executive level priority, but must be engrained into an organization’s cultural foundation. This approach will ensure sustainability. As many in the healthcare industry struggle to improve their HCAHPS scores, a few prominent players have distinguished themselves on the forefront of this healthcare revolution.

Los Robles Hospital & Medical Center, located in Thousand Oaks, Calif., has taken drastic steps to improve their patient satisfaction scores, and their continued effort is paying off.

What is their secret to success? Greg Angle, President and CEO of Los Robles Hospital & Medical Center, said there’s nothing unique about the challenges they face in regards to patient satisfaction. “What has set us apart is our commitment to improving patient satisfaction and outcomes through enhanced culture,” said Mr. Angle. To improve culture, efficiency, and ultimately patient outcomes and experience, Los Robles staff say they concentrate on five areas:

1. Make sure everyone is on the same page

“The first step to implementing many of our patient satisfaction strategies is to ensure that everyone understands why we’re doing what we’re doing,” said Kris Carraway, VP of Public Relations and Service Excellence. “If everyone’s on board, then implementation is much easier.” Carraway’s emphasis on the importance of hospital culture is backed by numerous studies that link high employee satisfaction in the hospital environment to improved patient outcomes and high patient satisfaction.

2. Listen to employees

“Each year we have what we call an ‘Innovator Award,’” said Kaylyn Meredith, VP of Human Resources. Employees are encouraged to present ideas that will enhance patient care in three areas: service excellence, quality/patient safety, and financial impact.

3. Collaborate

Los Robles Hospital and Medical Center

When Los Robles decided that their ER wait times were too long, the hospital staff worked together to solve the problem. “We created a collaborative work group and formulated a rapid triage process,” said Lynn Tadlock, RN, Director of Emergency Services.

This process, now known as the Los Robles ED Rapid Medical Exam Process (RME), emphasizes fast triage. Patients are greeted by a registered nurse who does a very rapid assessment of ABCs, while eliciting the chief complaint from the patient or the patient’s family member. RNs triage patients immediately, even interrupting triages that are currently being performed if necessary. By abbreviating the initial intake information to the bare minimum needed to make sound judgments about patient acuity, Los Robles is able to get their patients into the system within minutes of their arrival. Patients, on average, are now triaged in under three minutes and seen by a doctor in under 12 minutes.

Before the implementation of RME, said Ms. Tadlock, patients could wait up to eleven hours in the ER to be seen. “By the time patients arrived to a treatment area, they were frustrated and disillusioned with our service and this negatively colored their experience of their treatment, no matter how good it was from that point forward.” Now, in addition to being able to rapidly diagnose patients and initiate early interventions for at-risk patients, Los Robles’s patient satisfaction scores have soared. “We no longer have a waiting room, because there is no waiting,” said  Ms.Tadlock. “That space is now simply referred to as ‘the ER lobby.’”

4. Realize that small things matter

While Los Robles’s “Innovator Award” and “ED Rapid Medical Exam Process” have both contributed to higher patient satisfaction scores, an important part of the hospital’s strategy is to make sure that all their bases are covered. “The small things matter,” said Irene Brennick, Director of Volunteers. “We try to make the patient feel as comfortable as possible, which is why we make sure we have free wireless Internet, volunteer patient advocates in the ER, pet therapy and Patient Pal volunteers who visit with patients to make them feel more at home.”

5. Reach out to patients

“We realize that consumers increasingly value convenience in their interactions with the often confusing healthcare system,” said Adam Blackstone, VP of Marketing. “To help them in their journey from home to hospital, we’ve implemented two programs: ‘Text ER Times’ and ‘iNotify.’” Text ER Times allows patients to instantly know Los Robles ER wait times by texting “ER” to a number. iNotify, an ER check-in functionality, enables incoming patients to check into the ER prior to their arrival, thus streamlining the patient ER experience.

What is your hospital doing to improve patient satisfaction scores? What has worked, and what hasn’t? Let us know in the comments below!

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“iTriage Appointment Setting is a great strategic initiative for FastER Urgent Care. It enables us to engage patients any time, any place at the patient’s convenience, not the doctor’s,” said Dr. Gluckman. “As a result, Appointment Setting has significantly increased new patient traffic, improved total patient volume and enhanced patient satisfaction.”

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“iTriage has really added value to our customer service. Patients have choices and want to feel as if they have some control over their healthcare. Patients who check in early using iTriage let us know that they appreciate being seen faster,” said Linda Ratner.

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