During the summer of 1995, Four Rivers Medical Center in Selma,
Ala., experienced tumultuous changes following its acquisition that spring by Columbia/HCA Healthcare Corp.
Management changes, layoffs and general uncertainty shook the confidence of employees and patients. Chief Executive Officer Robert Bigley, promoted from chief operating officer during the acquisition, said patient complaints were climbing even though the 150-bed hospital had not reduced the number of employees in caregiving positions.
"Clearly, we needed to do something," he said. The brainstorming session by Bigley and his management staff led to major changes and earned the hospital the Marriott Service Excellence Award for Internal Service.
The customer relations performance improvement program, or "PIP," was created to help reduce the number of "nontechnical" patient complaints. The gripes ranged from the length of time it took for someone to respond to call lights to patients feeling that nurses didn't have time for them.
The PIP program is directed by a 16-member team of volunteers. Each member is assigned a minimum of two medical/
surgical rooms. The volunteers make daily patient visits and try to defuse problems before they become formal complaints. Bigley believes one important PIP component is that the volunteers must come from nonclinical ranks.
"The nonclinical employees are the moderators because it is easier for them to relate to patient needs and view things from the perspective of a patient," he said.
Group volunteers commit to a six-month cycle and are educated about infection control, safety and health requirements, and what situations they might encounter on the floor.
Approximately 40 people have participated in the program since November 1995.
Despite the changes, patient-satisfaction surveys showed little change in the fourth quarter of 1995 and first quarter of 1996. That's when Bigley and his PIP team decided to become more ambitious and aggressive.
Instead of just listening and recording complaints, Bigley empowered the PIPsters to make decisions and take immediate action.
"For example, a patient complained about having a cold room, which occurred during (a change in equipment).*.*.*. So the volunteer told the billing department to not charge the patient for that day's room," Bigley said.
The clinical staff certainly has noticed the difference. Executives report that the program has reduced complaints by 30% since the end of the second quarter.
The program has broadened the perspective of nonclinical workers throughout the hospital who have participated in the program.
"Getting on the floors and interacting is important; it sheds light onto what (clinical staff does)," said Marienne Thomas, director of communications and a PIP volunteer.