Observations on Operations

On May 4-5, 2009, I attended an ACHE Cluster called “Beyond the Silver Bullet: Ensuring Patient and Employee Satisfaction.”  Todd Linden, FACHE, President and CEO of Grinnell Regional Medical Center (Iowa), said:  “There are three things that patients judge hospitals on: (1) cleanliness, (2) food, and (3) courtesy.”

It is interesting if you think about this as it relates to HCAHPS, because HCAHPS does not measure satisfaction with food.   This thought prompted the following question from an executive at the ACHE Congress in March, “If HCAHPS doesn’t care about food service, why should I be concerned about our food satisfaction scores?  I’d rather put our hospital’s resources into areas that are measured.”

My friend at Press Ganey, Deb Paller, Vice President Physician & Employee Business Unit shared the following analysis of items with the highest correlation with “Likelihood to Recommend.”

Food did not make the list. Deb confided, though, that it appears that at the extremes … very bad food, or excellent food, seems to have an impact.

More clarification was brought by an April/May 2009 article in the Journal of Healthcare Management entitled Patient Satisfaction: Focus on The Excellent (note ACHE password required) by Koichiro Otani, PhD, associate professor, Division of Public and Environmental Affairs, Indiana University–Purdue University, and several executives at BJC Healthcare.

The purpose of this study was to find out what influences adult patients to rate their overall experience as “excellent.” The study used patient satisfaction data collected from one major academic hospital and four community hospitals.

“The increasingly competitive nature of the healthcare market makes it more important than ever for healthcare organizations to focus on “excellent” patient satisfaction ratings,” write the authors.

Furthermore, attribute importance is a relative concept.  Yes, nursing care and staff care were stronger than food and room attributes.  But this does not mean that food and room are not important.  Food and room are very important attributes to improve and were statistically significant components.

“Considering the nature of a hospital stay, it makes sense for patients to put a higher value on staff and nursing care than on room and food,” said the authors.  I agree – people don’t come to hospitals for the food and courtesy.  However, providing for the basic human needs of food and kindness, in a clean environment, in the most stressful of situations if done exceptionally, says much to patients and doing it in a way that earns excellent marks can make a difference.  I talked to Dr. Otani about the study.  He said: “When competing hospitals provide the same level of quality nursing care and staff care, food or room have a strong potential to make a difference in overall satisfaction.”

Which brings me back to the comment that started this thought from Todd Linden.  If satisfaction with your staff and nursing care, food service, and room is Excellent…you’ve got a better shot at being rated Excellent overall … and staying one step ahead of your competition.

So, “does food matter?” I believe that it absolutely does.