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Pardee physicians push back on ranking issue

Pardee Hospital's physicians, other bedside care staff and staff members are working on several fronts to raise the hospital's patient satisfaction scores, physicians told the hospital Board of Trustees during its June meeting.

Dr. Peter Goodfield narrated a slide presentation that showed Pardee's scores on the patient satisfaction measures released by Medicare. Goodfield, chairman of the hospital's Performance Improvement Committee, made the presentation in response to recent coverage showing that Pardee ranked low in patient satisfaction.
The survey showed that Pardee ranked in the bottom third among Western North Carolina hospitals in overall patient satisfaction, at 67 percent, and last or next to last among 18 hospitals in doctor communication, nurse communication and getting help quickly.
The numbers come from the Hospital Consumer Assessment of Healthcare Providers and Systems, a national survey (known as H-caps) that asks a random sample of recently discharged patients about several aspects of their hospital experience.
While he emphasized that the hospital and staff offer no excuses for the poor showing, Goodfield said that the H-caps ranking failed to show just how close Pardee is to its goal of the top 25 percent.
"Patients are asked, do you get help as soon as you want it when you press the call button," he said. "You can answer always, usually, sometimes or never." The hospital gets one point if the patient answers "always." "If they say usually, even it's 99 percent, you get zero, which means you get absolutely no credit for what you've done."
"We all agree satisfied is not good enough. We want to be 'always' in all these parameters," he said. Goodfield also pointed out that the data released last month by the Centers for Medicare & Medicaid Services was based on survey collection that ended in June 2011.
"Any organization that tried to manage itself with data that was that old would be sunk in the water," he said. He said the performance improvement committee analyzes and acts on much fresher date from Press Ganey, a national patient satisfaction company that helps hospitals improve performance. The H-cap data is critical because bad numbers could jeopardize a hospital's ability to draw Medicare and Medicaid reimbursement for health care procedures.
"Fortunately we have the data immediately from Press Ganey, and we already know a year or two in advance what they're going to tell us, and we act on it," Goodfield said. "We are acting on it and we have been acting on it. This is something that has been going on since time immemorial. This is not something that just started because of recent publicity. There has been progress that has been made and there's going to be additional progress made. Again, there are no excuses. These scores must improve."
He said CEO Jay Kirby had underscored the hospital's commitment to improvement when he made sure that patients get a card with his cell phone number on it.

"I doubt there's many hospitals where once a patient gets admitted they're provided with a direct phone number of the CEO," Goodfield said.
"Another advantage is we have a captive population. These patients are here for some time. We're going to take advantage of that and have multiple levels of interviews while they're here, (asking) how are they doing, are they doing well, why are they not doing well."
Goodfield said local management is an important asset.
"I certainly hope the public understands that the board members live here, a lot of them are still working here" in the county, he said. "If I get sick I come here for medical care, if my wife gets sick, she comes here for medical care, my neighbors get sick they come here for medical care. This is not an exercise in theoretical corporate management. We want this hospital to be the best for ourselves and for the community."
Dr. Robert Kiskaddon, Pardee's chief medical officer, added: "The message we're bringing about is that there aren't any excuses and these scores are going to improve. There is an action plan, many of those items have been in place, and we're working in that direction. But part of the message we're sharing with the medical staff and the team members at Pardee is that we don't have that far to go."
With incremental improvement, he said, Pardee will reach its goal of placing among the top 25 percent of hospitals in the so-called H-caps survey results.
"I think a lot of what people see in the press has been that we're far behind the other hospitals in the area. The message that we want to get out to our medical staff and our team members is that we're not far behind," he said. "... There's a very tight cluster; it's almost a photo finish in terms of how close we all are. Again, we need to do better. The message is we are extremely close."
Charts and graphs notwithstanding, Kirby said Pardee has to improve its patient scores.
"The point I would like to make, (aside from) clusters, pie charts, we've got to move up, and we are lockjaw about doing that," he said. "We don't want to disincentivize or dishearten our team members for the work and the progress that they've made. The purpose of this presentation was not to create confusion but to create a picture of how close we are and how much further we need to go to cross to be the 25 percent in patient satisfaction of the United States of America. We're knocking at the door. These numbers will improve, and we will be back in 90 days to show you how much they've improved."