In spring 2010, Christian Health Care Center’s Ramapo Ridge Psychiatric Hospital made a dramatic decision.
“We had to improve our satisfaction scores; they needed to reach the 90th percentile ranking,” said Marianne Guerriero, RN, nurse executive for the 58-bed psychiatric hospital in Wyckoff, N.J. Despite various efforts, the scores continued to be below the desired target.
With two units, adult and geriatric, there was enough data to prioritize areas that needed to be addressed. Guerriero said it was easy to assemble a team. “We take seriously the feedback that is received from patient-satisfaction surveys and patient interactions,” she said. “Representation on this team was robust since members felt that the current scores did not accurately reflect the care that was being delivered in the hospital.”
Team representatives included nursing leadership and frontline staff, dietary, pastoral care, social work, unit secretaries, admissions, environmental services and staff from the organizational development and service excellence department.
During initial meetings, the team detailed an action checklist. Score trends were examined, weakest areas were highlighted and an improvement plan was formulated. The lowest scoring areas were prioritized, ranking those that were most easily addressed on top and ending with the most complex issues. This ensured a few quick wins, which reinforced team efforts.
The first priority was addressing early phase of treatment. This category measured patient satisfaction with program orientation delivered by staff. The team decided to develop a multimedia presentation to share with patients twice during initial treatment. The presentation includes information about what to expect during hospitalization, treatment team member profiles, unit activities, meals, scheduling, rules and visiting hours. Keywords that closely matched language in the survey were used in the presentation.
The second area of focus was on amenities of treatment. This category measured patient satisfaction with quality of food, meal choices and noise levels. The team decided to place a significant focus on creating a dining experience.
Patients and staff were surveyed about every aspect of meal service. Menus were changed to what patients frequently ordered. Paper menus were redesigned, beverages from carafes were served by staff, dining rooms were spruced up, place mats and centerpieces were added to tables and soft music played while patients dine.
As in many 24-hour care settings, noise levels at night can be hard to control. Patients reported they were kept awake by the mechanical sounds of doors opening with the use of staff electronic key fobs. Night-shift staff returned to using keys to open doors since it was quieter. Focus groups discussed ways to heighten awareness regarding noise levels. Conversations became quieter and staff was cognizant about not calling down the hallway.
Managers made it part of their routine to ask patients and families about noise levels, then addressing issues as they arose. During the daily community meeting, patients’ perceptions of noise levels were discussed.
Patient-satisfaction comments were posted throughout the units as acknowledgement of each individual’s contribution. The president and CEO sent thank-you notes to the homes of staff members who were acknowledged by name in patient-satisfaction surveys. The rewards and recognition service-excellence team held celebrations on each unit, posting a banner to display achievements.
These efforts resulted in significant improvements in satisfaction scores. Since the initiation of these processes, the adult unit has had a 32% increase in satisfaction for early phase of treatment, with a second quarter 2011 score in the 95th percentile. Amenities of treatment scores increased 22%, with a most recent score in the 95th percentile. The adult unit’s overall patient-satisfaction ranking was in the 95th percentile this past quarter.
The geriatric unit had a 23% increase in satisfaction for the early phase of treatment, with a most recent score in the second quarter of 2011 in the 100th percentile. Amenities of treatment satisfaction increased 14%, with the most recent score in the 100th percentile. The geriatric unit’s overall patient-satisfaction ranking was in the 100th percentile.