Featured Case Study:
Listening Leads to Action at
Tahoe Forest Hospital
(Truckee, Calif.)
Vitals
Tahoe Forest Hospital is the mainstay facility of Tahoe Forest Hospital District (TFHD), a not-for-profit, special district, patient-centered health care system in Truckee, Calif. The health system includes two rural critical-access hospitals, outpatient service facilities, specialized care centers and satellite locations that serve six counties in two states spread over approximately 3,500 square miles in the Sierra Nevada Mountains.
At TFHD, “Service – The Best Place to Be Cared For,” is one of five Foundations of Excellence, which are the basis for strategic objectives toward achieving the district’s organizational vision of being the best mountain community health system in the nation. TFHD was founded by the local community to provide top-quality care for its residents and those visiting the region.
Challenge
Delivering quality care and maintaining exemplary patient satisfaction are ongoing priorities for the leadership, physicians and staff at TFHD. To that end, patient satisfaction is a standing theme in the annual strategic planning process. Engaging with physicians and employees and understanding the factors that underlie their job satisfaction are key components of achieving that overarching goal.
However, TFHD was faced with two immediate challenges: 1) patients didn’t feel as if they were able to spend enough time with physicians or that physicians were sufficiently concerned about their questions or worries; 2) the hospital’s inpatient food service ranked at the 17th percentile nationwide on the Press Ganey database.
Solutions
“Our performance excellence journey reinforced our need to listen to the voice of the customer, and thus we selected Press Ganey to help us collect, analyze and benchmark our patient satisfaction. We also utilized Press Ganey to deploy our employee and physician satisfaction surveys,” says Virginia Razo, TFHD’s chief operating officer. “It's been a continuous learning process on behalf of the administration about how to use satisfaction data to inform improvement plans and then keep rechecking it to make sure we are focusing on the right things. I must say, Press Ganey has made it really easy for us.”
TFHD utilizes four solutions in the Press Ganey Satisfaction Performance SuiteSM – Ambulatory Surgery InsightsSM, Emergency Department InsightsSM, HCAHPS InsightsSM and Outpatient InsightsSM – as well as Employee PartnerSM and Physician PartnerSM in the Press Ganey Partnership Performance SuiteSM. HCAHPS Insights and Press Ganey’s Priority List were used to address patients’ perceptions about their time spent with physicians or lack of physicians’ concern about their questions or worries. From there, the physicians helped identify barriers that could be contributing to their patients’ feelings and suggested chairs be placed in each room, allowing physicians the ability to sit while discussing patient’s concerns.
When results didn’t improve as expected, hospital staff members utilized Press Ganey’s Solutions Starters® to benchmark what other organizations had done to address their patients’ concerns. They learned that placing pads and pens in the room marked “Questions for your doctor or nurse” may help patients remember what questions they had during their stay.
To address the hospital’s poor inpatient food service ranking, the hospital was already in the process of building a new café to replace its old cafeteria for patients and employees. However, the administration decided to expand the project to include a continuous quality improvement initiative, based on information from Press Ganey’s HCAHPS Insights. Next, focus groups were conducted with patients, employees, physicians and the community to identify issues of importance. The department also looked at benchmarks set by other hospital food service operations. The result: a new executive chef was hired. The chef, Matt Pierz, planned an entirely new menu and taught the staff how to develop flavorful selections that also met the various dietary needs of patients and residents. He also implemented a “sample table” process that brought in a variety of staff to evaluate food for taste, texture and other attributes before serving.
Performance and Outcomes
As a result of a strategic initiative that utilizes quality improvement techniques to target customer service, the facility continues to score above the 90th percentile for its integrated HCAHPS inpatient survey. Other significant performance improvements include:
- Creating an outpatient satisfaction improvement group titled the WOW team (Working on Wonderful) made up of managers and front-line staff.
- Posting performance excellence boards in each department so employees can see their progress on patient satisfaction and clinical, operational and financial performance.
- Compiling quarterly patient satisfaction performance reports (inpatient, outpatient, ambulatory surgery and emergency department) that are shared with the medical staff and the publicly elected board of directors.
“Tahoe Forest Hospital District’s Board of Directors’ focus on customer service has paved the way for physicians to buy into customer satisfaction,” Razo says. She adds, “Physicians like data, and the nice thing about Press Ganey is that the data are statistically analyzed and clearly displayed, making it easy to understand and take action on.”
Additionally, Tahoe Forest Hospital’s inpatient dietary department now ranks above the 90th percentile in the all-facility database and serves as a national benchmark for Press Ganey. The team was recognized by receiving the Achievement Award for the Most Sustainable Improvement in Quality and Excellence at the 2009 “Good to Best” Annual Healthcare Food Service Industry Conference.
TFHD continues its focus on patient satisfaction and utilizes Press Ganey as a performance improvement partner. It is now looking to achieve the same results at its second hospital – Incline Village Community Hospital (Incline Village, Nev.) – that it does at Tahoe Forest Hospital.
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