17
May
2006
As promised yesterday on Hospital Impact, here is an update on the CAHPS survey, the standardized patient experience survey that will be collected by CMS and the results posted on the internet.
I started following the development of the CAHPS survey a few years ago. At first it was the major patient satisfaction survey vendors that were jockeying for particular questions and modes of survey delivery. In the end, there appeared to be a compromise on survey delivery (there will be 4 different modes of delivery), but it seemed that NRC Picker won the ideological battle over the questions. The 27 question survey asks about the patient’s experience during their stay rather than assess the patient’s satisfaction with particular aspects of care. Following the initial design, CMS conducted a 3 state pilot. The results can be found here.
Since I haven’t checked in on the CAHPS survey for a while, I had assumed I missed the first phases of the survey implementation. It turns out that we are at the cusp of the implementation. The deadline for signing up for the “dry run” is May 22nd. The dry run will allow hospitals and vendors to collect data for a few months without the data being published. Once that is finished a nine-month data collection period will follow and scores will be publicly released on www.hospitalcompare.hhs.gov in late 2007.
Alright hospitals, are your ready for the survey?
Posted: The Patient Experience
3
April
2006
Last week I introduced Baby Thomas and his truly brave and frank mother, Sara Bickle. Sarah shared some more comments with me about Thomas’s care. Their experience continues to reinforce how important it is for hospitals to attend to the total expereince of care.
Here are Sara’s comments:
I mentioned before that the Children’s nurses and doctors had been so motivated about pain and so proactive about preparing me to be the “care manager” for little Thomas. When we moved to the oncology floor Monday, I was disappointed by a difference in the way we were treated there, and this change brought to my attention the practices that had made my stay so positive on other floors.
The first change I noticed was that, out of about 14 people who came into our room in two days, just three of them introduced themselves and told us what they were doing (one was a housekeeper - I must say, Children’s housekeepers rock). I never realized what a gift this had been until I didn’t have it. Knowing someone’s name, department, and what they’re doing to your kid is particularly important in a teaching hospital like Children’s, where about 20% of the doctors and nurses you see aren’t allowed to do much for your baby without calling someone else in. Talking to the wrong person while your trached baby is wretching and writhing feels a lot like being put on hold when you’ve called 911.
The other big change I noticed was that people assumed I knew a lot of things that I didn’t know. Nurses would ask me if my son was on such-and-such a medication and a doctor looked miffed when I couldn’t tell her precisely what kind of medicine I was asking for on Thomas’s first night of chemo. I got pretty frustrated, but later I realized that on the oncology floor, all the families and patients really are professional patients. Thomas was the newest and youngest patient on the floor and we just didn’t have the comfort level and information that everyone else apparently had.
Those are really some of the only negative experiences we had with Children’s, and it didn’t seem like that big of a deal once I said to myself, “It’s just a different culture.” But I wonder how I would feel about it all if this wasthe beginning of our hospital expereince, and not the end. The good news is, at Children’s, I could probably talk to a floor manager and get a sign on our door telling staff to introduce themselves, and Lord knows, I am way more informed about meds today than I was three days ago.
You can read more about Baby Thomas at The Official Thomas Bickle Blog.
Posted: The Patient Experience
27
March
2006
Baby Thomas – The patient experience is one of the best tools we can use to measure the overall quality of the care we provide; but too often, the actual patient experience gets lost in patient satisfaction scores and graphs. That is why we should take a step back every once and a while and actually talk to our patients. In that spirit, I am pleased to share a very moving and insightful patient experience.
Some friends of ours told us about the Bickle’s and directed us to their website. The Bickle’s, of Dallas, Texas, are going through an incredible, and heart-wrenching, experience. They have a 6-month old son, Thomas, who was diagnosed with a brain tumor. You can read more about Thomas’s story and how he is doing on their website, The Official Thomas Bickle Blog. I recently got the opportunity to communicate with Sarah Bickle, the mother of Baby Thomas, and she agreed to share some of their experience with me.
What follows is a series of questions I asked Sarah about their experience in the hospital and with their care givers. Sarah was kind enough to offer some very thoughtful and candid responses. Due to the length of the questions, I will post the second half of the questions on Hospital Impact tomorrow.
Describe the hospital room that Thomas is in?
All of the rooms that I’ve seen in Children’s have a window and at least a couch for parents. One wall is painted a color like lavender in a wavy shape that goes around the room. There’s a wipe board where staff for the day writes their names and a sink and a computer for staff that folds away. Thomas’s crib has his name on a decorated piece of paper above it. The rooms are well-thought out; even in ICU we had a little shelf in the armoire that holds the TV to put our belongings in and there are 2 drawers under the bed/couch (in ICU, it doesn’t fold out, but it is wide enough to sleep on).
What has the hospital or nursing staff done to make you more comfortable?
Writing their names on the board each day and night makes a big difference - even if we know our nurse we may not remember her name at 3 a.m. When we first arrived, the neurosurgery floor made it a point to let us know where the family kitchen was, how we could store food, what the cafeteria and chapel hours were, and things like that. The floor manager and some kind of customer care representative also introduced themselves in the first day or so, so we felt like we knew where to go with questions or needs from the beginning. Finally, the staff was just great with our son. I can think of 3 people out of probably close to 70 staff members we’ve seen who didn’t seem genuinely thrilled to be with our son - and I include housekeeping in this list as well. There’s no way we would’ve been as stable and functional as we are now if we hadn’t had such an amazing staff and hospital system.
Do you feel like you are a part of the decision making process when it comes to the care and treatment of Thomas?
Definitely, especially when it comes to pain. I’ve never really had to defend a request for pain meds to anyone. They listen, but they take my word for the fact that Thomas is in pain. That was a big relief.
Posted: The Patient Experience
