8 ways to improve patient satisfaction and the patient experience–and, as an aside, improve your HCAHPS scores.

1. If you want to stem patient dissatisfaction, stop giving off cues of indifference and uncaring. Such as: Healthcare professionals avoiding eye contact with “civilians.” Med students hurrying self-importantly down the halls, nearly running down the slow-moving patients who won’t get with the program. Patients ignored by nurses who haven’t yet clocked in and therefore don’t realize they are already (poorly) representing their institution. Doctors in the hallway loudly carrying on about the relative benefits of different Canyon Ranch vacations they’ve taken. Two radios playing at once from two administrative areas (with the waiting area for patients and their families located equidistant to both). Vending machines that are left out of service indefinitely. Vending machines that require exact change, but there’s no change machine. 2. Strive actively to experience your care the way that your patients do. Park where the patients do. See how easy it is/isn’t to get to the front door on crutches. Take a tour of your hospital with someone who hasn’t been there before, and let them show you whether they can really find where they’re going. You’ll be amazed how many mis-aligned, out of date, confusing signs you have. It all makes intuitive sense to you, of course, because you have been in your building enough times that you know your way around in your sleep (Literally, I suspect.) And, once a year, do a “full bladder exercise”: Everyone who works with patients should drink two or three liters of water–it is incredible how your perception of a “reasonable delay” between call button and response changes when you have a full bladder. 3. Get...

Recorded miTRAX webinar

http://mitrax.com/wp-content/uploads/2015/12/Webinar-12-9-15.mp4 This webinar hosted by EVP National Sales Director Jerry Whelan originally aired on...

How hospitals are prepping for Medicare’s mandatory bundled-pay test

Hospitals in dozens of U.S. markets are now cramming for a compulsory test of Medicare payment reform. The hardest part may be that their success relies on the work of partners they aren’t used to collaborating with. Hospitals in 67 metropolitan areas learned this week they have no choice but to accept a single sum for the cost of care during and 90 days after patients visit the hospital for hip and knee replacement surgery, a strategy known as bundled payments. (See the areas and hospitals included.) The mandatory initiative, proposed in June, is widely viewed as evidence of federal officials’ impatience with the industry’s shift away from charging Medicare for each visit, test and procedure. While many providers have signed up for one or more of several payment reform programs launched under the Affordable Care Act, the Obama administration has expressed an ambition to move much more quickly. The new bundled-payment program also clearly signals an expectation by federal officials that hospitals will do more to coordinate care after patients leave, said Robert Mechanic, executive director of the Health Industry Forum at Brandeis University. “It’s a push to start to change the culture inside of hospitals,” Mechanic said. “What they do can’t stop at the hospital wall.” Home-care and post-acute care providers such as skilled-nursing facilities are large expenses for Medicare joint replacement patients, and the cost and quality of that care varies significantly. “That’s actually where a lot of the significant cost reduction can occur,” said Dr. Michael McKenna, executive vice president and chief medical officer of McLaren Health Care. McLaren’s hospital in Flint, Mich., will have...

Joint replacement surgery made easier

Joint replacement surgery used to require a week-long stay in the hospital, and a long painful recovery. Not so any more. Enhanced recovery means walking into the hospital one morning, and walking out the next, with a new hip. Six months ago, after getting a total hip replacement, Dallas realtor Mary Cotroneo left the hospital the very next day and was back at work within two weeks. Cotroneo said, “Everybody’s jaw dropped when I walked into the meeting. They couldn’t believe it.” Jay Mabrey, MD, Chief of Orthopedics at Baylor University Medical Center, said, “We’ve gotten it down to where we can actually measure your length of stay in the hospital in terms of hours not days.” The breakthrough, called enhanced recovery, is a new approach to anesthesia. Patients can drink water two hours before surgery. They get a spinal block instead of a general anesthesia, a short-acting drug for sedation, and localized pain management, to cut down on the use of morphine and opioids. Ryan Hanson, MD, anesthesiologist at USAP, said, “And if we can avoid that class of medications or reduce their use, then we are potentially increasing the patient’s safety as well as reducing the complication rate long term.” Dr. Mabrey said, “Patients wake up with little if any pain, little if any nausea, and they are ready for physical therapy within an hour or two after their surgery.” Now that she’s been through it, Mary says there’s no reason to fear the surgery or put it off. “Here I am, I mean six months into it, and I feel like a new person. Still going...

Hospitals will have to risk financial losses for poor outcomes as Medicare changes how it pays providers.

Surgeons at Akron General Medical Center are rethinking their whole approach to hip and knee replacement surgery. The transformation underway in Akron will sweep through hospitals in 67 cities next year and eventually thousands nationwide. The stakes are high. Failure to get it right could cost the hospitals millions, as Medicare begins phasing in plans to pay hospitals not for the number of services they provide but for high-quality episodes of care provided at the lowest possible cost. CMS announced Monday that the most ambitious phase of the new program will begin April 1, 2016, when Medicare will begin putting in place a plan to put each hospital at financial risk for the cost and quality of each joint replacement procedure, including care provided outside the hospital for up to 90 days. Putting hospitals at financial risk for the cost of care is a powerful incentive to get it right. Unnecessary procedures, complications, hospital readmissions and extended care provided in costly “post-acute” settings such as rehabilitation centers all may drive up costs and increase the likelihood that hospitals will end the year owing Medicare money. Hospitals that reap savings will be able to reward physicians and other care providers, providing them too with an incentive to boost quality and cut cost. Hip and knee surgery is just the beginning. Goals set by Health and Human Services Secretary Silvia Burwell this year require half of all Medicare payments to be shifted into alternative models like the Comprehensive Care for Joint Replacement (CCJR) program by 2018, while 90 percent of payments will be tied to the quality of care. Dr. Patrick...