Chasing the numbers

I spent a good part of the day writing performance evaluations. I find it somewhat refreshing to think about a staff member and write wonderful words that reflect their performance during the last year. Of course not every word is, glowing, but for the most part all my staff are good, hard workers and each one has positive qualities that work together for the department, and the hospitals good.

A good portion of the rest of the day was spent chasing numbers. You know, the NRC Picker, or Press Ganey satisfaction survey results that go along with the HCAHPS survey results. I find I’m more and more often aligning strategies, scripting, and work teams to push these numbers up. It can become an obsession… the daily logging into Press Ganey, running the queries, reading the reports.

Hurray! +.5 % on the mean score for courtesy, oh sad, -.6 on cleanliness, but wait, the emergency room waiting area jumped up 7%. Lets go clean the furniture again, did we make enough patient room rounds today? It is not enough to manage by walking around (MBWA), we need to fill out some quality assurance checks and speak to a dozen patients as well, hold staff huddles, post the numbers, give more praise and recognition, re-train on high dusting, pass out more putty knives to scrape those corners, look into 55 gallon drums of floor finish, as we go through gallon jugs too fast and so on, so forth.

I find it rather exciting to push the numbers. Of course it is not smoke and mirrors. Behind those gains are many staff members and other hospital employees working hard, doing things right, taking care of the patients, guests and each other. That is why I am in this business, but we measure, measure and measure again to make sure we keep on doing those right things.

Chasing the numbers? Yes, it can seem that way. And those are moving targets, what with the hospitals we compete with doing everything they can to improve just as we are. I might achieve an increase in my cleanliness mean score but if other hospitals also increase, and higher than I do my percentile will go down. So we compete against ourselves, and against other hospitals. Makes it all just a little more complicated.

We have been doing patient rounding where we go see the patients and ask a few questions like, was your housekeeper friendly, was your room cleaned satisfactorily, is there anything we can do for you? We get good feedback and has helped our HCAHPS and Press Ganey scores.

Recently I’ve started using workers that have restrictions to the point where I can not work them, but they can walk, talk and write come in for ES Ambassador duty. I give them some scripting, a clipboard and the rounding questions and have them spend hours going to talk with patients. We talk about our goal of having their room always clean, how the survey works, and so on. I’ve had very positive feedback on this and it helps get the staff back to work with a better attitude.

I’ve increased our cross training and we all know how that helps. I’ve also moved staff more frequently to play to their strengths more than I have done in the past.

I put a large communication board in our common room. This happens to be our laundry and storeroom area where we check in and out the keys and pagers. During our standup meetings I share Press Ganey positive comments and other good comments and post them on our communication board. The increased focus on the score has helped I believe.

So far my HCAHPS score for the first quarter of 2009 is running 81%. This is a 10 point improvement over last years average, and higher over just November and December of last year.

What things have you all been doing to raise your scores and your staff satisfaction?