Patient- and Family-Centered Care: A 5-Star Experience at Johns Hopkins Hospitals

 

LisaAllenLisa Allen, chief patient experience officer for Johns Hopkins Medicine since September 2014, speaks on one of the institution’s strategic priorities, delivering safe, quality patient- and family-centered care that that is compassionate and respectful.

Click on the red Leave a Comment to submit a question.

What kind of feedback do we get from our patients about their visit or hospital stay?

Patient experience is measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for inpatients and Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for outpatients. These surveys are mailed to a random sampling of patients after discharge or a visit. The HCAHPS survey covers patients’ perceptions of their hospital stay, such as communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment and care transitions. The results are posted on Medicare’s Hospital Compare website.

On April 15, the HCAHPS survey will switch from reporting the results as a top-box percentage to an easy-to-understand, consumer-friendly five-star rating system, similar to what is used for hospitals, movies and restaurants. Our goal is to always deliver a five-star patient experience. View a brief video about how the HCAHPS survey works.

What resources do we have to enhance the way we care for our patients?

The service excellence and patient experience departments at each hospital are a tremendous resource.  The staff members there are available to help walk you through the survey data and comments to gain a better understanding on what our patients are looking for in their experience.

Some of you may also remember the Language of Caring training that was introduced a few years ago. We are reinvigorating this module-based program that teaches patient-centered caring communication. The topics are: Practice of Presence, Showing Caring Non-Verbal, Explaining Positive Intent, Acknowledging Feelings, Gift of Appreciation, Blameless Apology, and Caring Broken Record.  These modules teach us that even though we are caring people, we can utilize specific tools to help us make our caring known to those we are caring for and working with each and every day.

What are some other simple, practical ways we can help our patients and their loved ones?

When people are in the hospital, they are anxious and scared, and they need to feel listened to and cared for. When you help them feel connected, you can resolve problems earlier or stop them before they even start. Some simple things you can do:

  • Use the 3 W’s
    • Who are you? Smile, introduce yourself (by name and role) to the patient and family members, be courteous and attentive.
    • What are you there to do? Explain what is about to happen and why you are doing what you are doing.
    • Why do you care? Show empathy and partnership.  I want to help reduce your pain level.  I know you want to get home. I am here to help you prepare for discharge.
    • Don’t interrupt. Most providers interrupt within 18 seconds. Listen attentively.
    • Confirm patients understand what you have said; explain using words appropriate to their health literacy; use teach back.
    • Work as a team, always. Talk UP about your colleagues.  “I see you have Dr. X as your surgeon. She is fantastic.”  “This is Joe, he is the nurse taking over your care for the next shift.  I have explained how you are doing and he is a great nurse.”

How can employees find out how our hospitals and other hospitals are rated?

You can visit medicare.gov/hospitalcompare/, type in the ZIP code or name of the hospital in the “Find a Hospital” search box, indicate the hospitals you would like to compare, and hit the “compare now” button.

Johns Hopkins hospitals’ overall ratings ranged from between four and two stars. These scores are based on responses/data collected between July 2013 and June 2014. Five of our hospitals received four stars in one or more of the 11 key areas, with all hospitals receiving four or five stars on patients’ willingness to recommend the hospital.

What can we do to improve our scores?

The only way the scores will improve is if we change the experience. We believe that the efforts we’re making today will improve our ratings in the future. Since the most recent reporting period concluded, our hospitals have implemented several programs to improve our patients’ experience.

Questions?

We will be sharing more information about patient- and family-centered care with you. In the meantime, contact service@jhmi.edu if you have questions.

 

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10 Comments

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Comments

Michele Beanblossom April 15, 2015 at 4:14 pm

I was so excited when I saw that this initiative is being worked on at Hopkins. My name is Michele Beanblossom and I work at All Childrens Hospital, a partner of Johns Hopkins in St. Pete, FL. I have recently put together a team to work on family centered care from the ground up. We are very excited to implement a new culture for our hospital and are looking forward to seeing our patient satisfaction scores improve from this initiative.

Reply

Lisa Allen April 15, 2015 at 4:31 pm

Michelle,
I had the pleasure of visiting All Childrens Hospital in January. There are some great initiatives going on there, and so many family centered amenities. We are excited to be introducing Child CAHPS in the next couple of months. This will allow us to implement a standard survey throughout the system for our pediatric patients. While the survey is not publically reported at this time, it uses familiar concepts to the adult HCAHPS. It is about the experience- how often something happened, plus overall ratings. We look forward to communicating more about this survey as we prepare to launch it through our vendor, Press-Ganey. The goal of the standard survey is to be able to share best practices throughout the system, and set improvement goals based on the data.
Thanks for writing in.

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Mohammed Al-Taee April 15, 2015 at 2:41 pm

Thank you Lisa for sharing your experience and taking the time to answer the questions.

I agree that the only way the scores will improve is if we change the Patient Experience (PX)​. I think the change should always start from the care givers at the front line and it goes up.

I wonder if you can establish a PX lab where we as teams and departments gather and meet every quarter or 6 months to suggest and include interventions (process, resource, app, etc.) to find and measure how it will change the patient experience. The lab will create awareness about PX, discuss patient offline and online complains and suggestions to take action and make change, and finally this lab will serve as a unified PX resource for JHM. I think we need ongoing (not optional) coaching and training as PX is as marketing, continuously evolving.

Reply

Lisa Allen April 15, 2015 at 3:50 pm

Mohammed, this is a very interesting idea. Can you reach out to me at lallen29@jhmi.edu? I would like to bring you in to discuss this concept with the JHM patient experience team. That's what's great about working for Johns Hopkins Medicine- many out of the box thinkers that allow us to be the best.

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Susan (HCGH) April 15, 2015 at 10:21 am

I recently read an article in the Washington Post about hospital gowns (http://wapo.st/1ytDa2J). Is there any thought of changing gowns used in the John Hopkins System?

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Lisa Allen April 15, 2015 at 11:11 am

Thank you for highlighting this excellent article. We have started discussions with our vendors and buyers about looking at new patient gowns. Stay tuned!

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Janet April 15, 2015 at 10:14 am

Can you give us some examples of what would be considered good patient and family centered care?

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Lisa Allen April 15, 2015 at 11:50 am

Thank you for your question. There are many examples of great work in implementing patient and family centered care throughout JHM. Here are a few examples:

A visitation policy that benefits the patient; all of our hospitals have moved to a 24/7 visitation policy

Patient & staff rounding by our leadership

Seeking feedback from members of the Patient and Family Advisory Councils on proposed ideas and initiatives aimed at improving care

Nurse navigator roles

Inviting family members or identfied individuals in as partners (Health Buddy)

Bridge-to-home program

Pain relief and comfort menu

Language of caring

I invite others throughout the system to add in some of the great patient and family centered work you are personally involved in. Let's get a list going!

Reply

Cindy Walker April 15, 2015 at 9:59 am

Thanks for taking comments. I have often wondered about asking patients to rate their hospital experience on a 1-5 scale (like pain). If we routinely asked this question, we could obtain real time data, intervene, and demonstrate the - Practice of Presence, Showing Caring Non-Verbal, Explaining Positive Intent, Acknowledging Feelings, Gift of Appreciation, Blameless Apology, and Caring Broken Record. Just a thought that definately makes us present for patient/family engagement.
Respectfully, Cindy

Reply

Lisa Allen April 15, 2015 at 12:00 pm

Cindy, thank you for your thoughful question, and your knowledge of the key components to the language of caring. While we have to follow strict guidelines with our inpatients around not surveying them officially prior to getting their HCAHPS survey in the mail, I believe it is critical to check in with our patients to make sure we are addressing their emotional and personal needs.

Questions such as, "what is most important to you today?" " Is there anything that you are worried or concerned about that I can address?" "Is there anything I can do to make your hospital experience better or more comfortable?" are all great questions to ask our patients and families. Questions that show we care about the patient as a person are key to improving the experience.

I would be interested in others thoughts on ways to show our patients compassion, empathy, and a concern for them as people.

Reply

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