New York City's public hospital system outlined an ambitious plan to improve how patients feel about their care, and, more important, to overhaul its corporate culture. The new five-point strategy to improve NYC Health + Hospitals' patient-satisfaction measures is expected to be announced by Dr. Ram Raju, the system's president and CEO.
Earlier this year, Raju laid out his "2020 Vision" plan for NYC Health + Hospitals (formerly HHC) to stop the system's red ink. The main goals are to boost the annual patient base from 1.4 million to 2 million, double MetroPlus Health Plan's enrollment to 1 million and increase the percentage of MetroPlus members who use NYC Health + Hospitals as their primary care provider to 80% from 50%.
But an improved patient experience, in Raju's view, is important to all three of those goals.
"Will it make a difference? The fact of the matter is our financial difficulty is big. We still need state and federal help. But we need to do our part, and the patient experience is a huge part," Raju said Monday.
Rather than turn to consultants, Health + Hospitals gathered about 300 employees—doctors, nurses, union members among them—to develop a Patient Experience Action Plan. It is not yet finalized, but Raju provided the plan's broad framework.
The five-year plan, he said, has five segments: Anticipating and meeting patient needs; engaging the workforce so employees feel supported and personally accountable; providing quality, coordinated care in a culturally sensitive way; expanding access so that the system can serve more patients; and investing in technology.
The hospital system will measure success in these areas by whether its patient-satisfaction scores improve, as measured by Press Ganey, the country's largest patient-experience consulting firm.
According to Press Ganey's measurements of Health + Hospital's inpatient and outpatient satisfaction, currently about 60% of hospital patients are satisfied, and 70% of outpatients are happy with their care. Raju's targets are 80% for inpatient care and 93% for outpatient care, if the 2020 Vision plan is successful.
Culture change is difficult, Raju acknowledges. He is making sure there is buy-in from his workers as they try to improve metrics for Health + Hospitals.
"There is enthusiasm and energy, because we asked for their opinions. They had a role in crafting this," he said. "I need to explain to my employees how everything, especially the patient experience, is connected to 2020 Vision, and moving toward being a goal-based organization."
Among the changes ahead for Health + Hospitals:
- Moving shift reporting to the bedside, with the patient and family present, to ensure effective communication between patients and clinical staff, and across staff shifts.
- Broadly adopting daily team huddles, where clinicians and the patient-care team meet about patients' care, and hiring "the right people to move the 2020 Vision forward by creating clear job descriptions and expectations."
- Expanding urgent care/primary care for treatment that does not warrant an ER visit.