Patient experience targeted with patient rounding

Five years ago, Joe Leggio at Lenox Hill Hospital in New York  City knew something needed to change for patients. Patient feedback on HCAHPS surveys continually noted that the hospital was too noisy, or the food wasn’t good, and other complaints that didn’t really deal with their actual health.

So Leggio, associate executive director at the Northwell Health-owned hospital, turned to patient rounding, which isn’t the first thing that springs to mind when it comes to innovation. The practice of checking in on patients clinically has been around perhaps since hospitals first started. Nurses pop in on a patient during their hospital stay to see how they are doing and make sure discharge plans and other clinical aspects of care are clear and to field questions.

Studies have shown that this version of patient rounding can improve patient safety and the patient experience. The dedicated time helps manage situations that can contribute to patient falls, and also prevent pressure ulcers by checking to see if a patient needs repositioning. Patient-experience survey firm Press Ganey said hourly rounding can increase HCAHPS scores up to 15%, and leadership rounds can increase scores by 30%.

“Rounding is a best practice that has a powerful impact on the patient experience when it is performed well and consistently,” said Press Ganey Chief Experience Officer Chrissy Daniels. “We see a definitive correlation between the patient experience, rounding and HCAHPS performance across all healthcare systems, regardless of bed size, type and region.”

But the thing Leggio wanted to get at was different. He and his patient experience team started looking at transitioning floor administrative assistants into taking on the role of collecting real-time patient experience data, like on the hospital food, or cleanliness of the bathroom, or how communication with their doctors was going—all things that can sway HCAHPS scores.

“The HCAHPS surveys that come back, it’s not so helpful to know that someone was upset eight weeks ago; there’s nothing I can do about it,” Leggio said. “It was a big shift for us to start to move from a reactive model to a very proactive approach of gaining feedback in real time.”

They brought on technology platform CipherHealth to digitize the endeavor. CipherHealth Chief Customer Officer Shawn Lemerise said many hospitals know these check-ins are important and can help improve all sorts of quality and experience scores, but many still use paper.

“Before you know it, someone has two feet worth of paper that they’ve got to go through,” Lemerise said, adding that the firm’s platform costs start at $30,000 a year for a subscription. “The reality is, if you identified something that you could correct, it’s too late, because by the time you’re going through that paper, a week later, the patient’s gone.”

Now these administrative assistants turned patient-service facilitators can see which patients need a check-in, log any complaints or questions, and triage those concerns to appropriate teams. When a patient is up for another round, the next patient-service facilitator can see all this history and check in to see how the patient is feeling about the way their issues were addressed.

“And we are actually talking to one another, which in a hospital is such a hard thing to do because we’re so busy,” Leggio said. “There’s so much happening with so many people—it is easy to miss the small things. And when you ask the patients, it’s the small things that matter.”

Last year Lenox Hill was able to compare the HCAHPS scores between over 1,000 patients who didn’t receive a patient round because of COVID-19 with the scores of patients who did, after the pandemic eased. In every category of the HCAHPS, there was a 3% to 20% higher score from patients who received a round.

“We’re spending money on this and we wanted to know, is the investment paying off? And yes, it is,” Leggio said, adding that the hospital’s CMS star rating this year was a 4, in part because of the increased HCAHPS scores.