We focused on how Vancouver Coastal Health (VCH) improved patient safety and throughput in a time of increased governmental control and decreased reimbursement.

We provided a perspective of not focusing on the differences between the Canadian and U.S. systems, but how a Canadian organization adapted and succeeded under changing legislative imperatives. 

David presented how VCH improved patient throughput. With occupancy rates over 100%, VCH requires quick bed turnaround times. Through a process of using call centers, patient service cards, and enhanced bed management processes in housekeeping, VCH was able to bring turnaround times down to 48 minutes, despite increased volumes and complexity of care.

David then went on to describe VCH’s focus on patient safety measures. Using a standardized visual provincial cleaning audit tool, and observational audits enhanced with technologies such as glo-germ, thoroughness of the physical cleaning practice was ensured. Staff training, standardized cleaning practices, resulted in improved predictability of results. 98% of all sites passed a quality audit score, up from 29% in 2004.

Click here to see a copy of the presentation.

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.

I thought of this interaction and implications in healthcare.  At ARAMARK, we use the words “Key Words at Key Times” to describe how we educate our associates regarding their patient interactions.  Two sessions I attended were also related to the consumer experience.  What’s interesting is that although the speakers came from different perspectives, the process was very similar.  Gail Scott called it the “Act With TACT Model” — where TACT stands for:

- Take Ownership
- Acknowledge and Apologize
- Communicate and Correct, and
- Thank, Track, Trend and Learn.

Tom Tull and Candace Jennings of Mountain States Health Alliance (TN) defined a foundation for service excellence – called WOW – Values in Action.  This process involved:

- First Impressions
- Personal Appearance
- Caring Customer Service
- Communication
- Patient Information and Education
- Customer Interactions
- Respect
- Etiquette
- Commitment

The presentation that CHRISTUS VP Mike McBride and I did focused on Succeeding in the Patient-Centered Age of Healthcare.  It defined the AIDET (Acknowledge, Introduce, Duration, Explanation and Thank You) technique popularized by the Studer Group in guiding patient interactions. A copy of the presentation can be downloaded here.

Whatever the acronyms and approach, it appears that leading health care organizations are focusing on making a positive impact the customer experience which includes a scripted support staff interaction. These folks will succeed in the post-recession future! To kick off my first Blog posting … I’m interested in hearing about approaches that your health care organization has implemented, and affects they have had on outcomes.