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Mon Dec 24, 2012, 01:49 AM

Hospitals react as Medicare reimbursements influenced by patient satisfaction surveys

Source: Detroit Free Press

Hospitals react as Medicare reimbursements influenced by patient satisfaction surveys
December 24, 2012
By Zlati Meyer
Detroit Free Press Business Writer


At Providence Park Hospital in Novi, the artwork hanging on the walls isn't covered with glass, in an effort to absorb noise.

Special air-blowing vests keep patients warm pre-surgery. Private rooms are the norm. Staffers regularly check in with patients to anticipate their toilet and showering needs to cut down on call-light usage. Patients are given clear discharge instructions. Cleaning is no longer done at night. Patients are taught the difference between "pain-free" and "pain-controlled."

The reason for these changes at Providence Park and similar ones at other hospitals across the region is to ensure high scores on patient satisfaction surveys, the results of which will affect Medicare reimbursement rates, starting next year.

At issue are millions of dollars annually, all the more significant as the industry sees so many other dollars slipping away. In fiscal year 2013, for example, the pot is $964 million, according to the federal government's Centers for Medicare & Medicaid Services.

Amenities such as free lattes and valet parking are not new to hospitals. They began offering them years ago in a high-stakes fight to lure patients. However, what hospitals are doing now is, for the most part, tailored to the survey questions they know patients will be asked.


Read more: http://www.freep.com/article/20121224/BUSINESS06/312240089/Hospitals-step-up-patient-satisfaction-efforts-Survey-results-affect-Medicare-reimbursements?odyssey=tab|topnews|text|FRONTPAGE



Good!

15 replies, 2786 views

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Response to Bozita (Original post)

Mon Dec 24, 2012, 02:05 AM

1. Ditto to the Good!

My Mom was in and out of Emergency/Hospital several times over the last few years.

While there were some great staff, there were also some that were HORRID! One group on duty in ER one
time should have all been suspended or fired...the doctor and all nurses. Mom was in no condition to communicate
and they virtually ignored me...I've helped her for several years and know her history/meds inside-out. What a horrible
experience that was. I sort of just "took it" then...never, ever again.

I DO speak up now.

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Response to Bozita (Original post)

Mon Dec 24, 2012, 02:44 AM

2. Excellent.

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Response to Bozita (Original post)

Mon Dec 24, 2012, 03:16 AM

3. Hoping this focuses more on the quality of care than on window dressing. nt

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Response to patrice (Reply #3)

Mon Dec 24, 2012, 05:03 AM

5. Quality of care begins with prevention

I see some light at the end of the tunnel. The true meaning of what a health care organization means might be realized in some of our lifetimes. Until then though, i will keep trusting and using common sense in the attempt to be healthy as i can be on my own accord, keeping a vigilant eye and recognize some people are in it just for the bucks.

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Response to Bozita (Original post)

Mon Dec 24, 2012, 03:50 AM

4. Having spent most of the last two months in and out of acute care with my mother

I have to say there were places that glared at me for quality control. Watching this unfold will be interesting. Peace. LMSP

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Response to littlemissmartypants (Reply #4)

Mon Dec 24, 2012, 02:30 PM

10. You know, there are hospital accreditation organizations you can complain to.

In fact, simpy asking at the business office for the address of the accreditation organization of the hospital
will often be all the the "push" you need to get a problem solved or improved efforts by hospital staff.

Most hospitals are accredited by JACHO.
"Obtaining JCAHO accreditation is important for hospitals, as the Medicare Act of 1965 decreed that accredited hospitals were deemed to have satisfied federal health and safety requirements necessary to Nat participate in Medicare.
Hospitals also have considerable incentive to become accredited for marketing purposes, often using JCAHO accreditation as a "third-party endorsement of quality.
As a result, approximately 80 percent of the 6,000 U.S. hospitals have sought JCAHO accreditation."

Here is how to complain about a hospital:
http://www.jointcommission.org/report_a_complaint.aspx

FWIW, I have found, when I am trying to solve a problem with a company or provider, that casually mentioning that I am writing the contents of the conversation onto "the internet organization I belong to " ( meaning DU) really makes a difference!

Yes, in case you have not noticed, I am firm believer in squeaky wheel practice, and have found it does work when one picks the right place to complain.

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Response to Bozita (Original post)

Mon Dec 24, 2012, 05:19 AM

6. The heck with lattes and valet parking, get me out without an infection, medication errors, etc.

But people do tend to judge the "quality" of care by that kind of jun

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Response to Hoyt (Reply #6)

Mon Dec 24, 2012, 06:47 AM

7. +1

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Response to Hoyt (Reply #6)

Mon Dec 24, 2012, 08:58 AM

8. We're working everyday to assure SSI's are as rare as possible.

That's half my job because all the Washing and Sterilization equipment is my responsibility. Every week we're hit with new questions and changes in techniques to make surgery safer and better.


All those total hips and total knees are just infections waiting to happen. Under the new rules re-admittance for SSI's are going to be eaten by the hospitals. It makes for good business sense and obvious good patient outcomes to address every point of care.

The hospital just replaced every bed in the place (and moved our better beds to day surgery) Currently installing TV's and nurse call. There are 100's of projects going on across our two facilities to make for a better patient experience.





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Response to Hoyt (Reply #6)

Mon Dec 24, 2012, 04:26 PM

11. Well, I agree but I had one of those air blowing warming vests before my outpatient surgery

last week and I thought it was a nice touch. The valet parking was wonderful since my husband has limited mobility due to spinal surgery even tho he can drive and the friend who drove both of us to my surgery and took us home had had knee surgery 6 weeks earlier. Valet parking was extremely helpful to us and by far the least expensive parking option...

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Response to Hoyt (Reply #6)

Mon Dec 24, 2012, 09:58 PM

13. Staffing adequately should help with that.

i hope this finally leads to safe staffing in hospitals.

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Response to Mojorabbit (Reply #13)

Mon Dec 24, 2012, 10:08 PM

15. It will be a long time before hospitals increase staffing, those days ended in the early 1980s.

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Response to Bozita (Original post)

Mon Dec 24, 2012, 11:32 AM

9. Yes, and this is only a part of it. . .

The rest of it allows the public to "compare" hospitals regarding surgical infection rates, nosocomial infections, % of hospital-acquired bedsores, urinary tract infections via urinary catheters, etc. It also looks at readmission rates to hospital within 30 days of discharge.

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Response to Bozita (Original post)

Mon Dec 24, 2012, 06:09 PM

12. But I bet none of them will improve bed side staffing

Something that would definitely improve the satisfaction rate.


Instead, the staff will be scolded at every staff meeting, pencil pushers will drop in on units and point out things that should and shouldn't be laying around the units, or ask "why haven't you done this and that"...easy to pop in and do that when YOU are not the one trying to care for 5 or 6 patients, half of which are "total care", the other half who are not total care who are upset that the nurse is not in their room in a nanosecond of pushing the call button to fill their water jug or get them a blanket or get their pain medicine BECAUSE the nurse has been with those total care patients since there is no additional help on the unit (techs, etc...).
Or she/he is also doing the work of dietary (clearing trays out of the room), unit secretary (making arrangements for patients to be escorted to a procedure or answering phones), or trying to get a moment to look at orders on the computer because she/he has not been able to sit down and look at a computer for the last 3 hours and when she/he does, each patient has a page and a half of new orders that the docs wanted down, oh, an hour ago (and, yes, those docs are calling the unit wanting to know if those orders have been done yet).

Gets quite depressing at times as you are running nonstop trying to meet everyone's needs and you have family members standing in the patients' doorways staring at you as you fly back/forth trying to get stuff done and you seem them with a hating/angry look on their face as they mumble sentences you cannot quite make out but you hear them using a bitter tone when it comes to the word "nursssssse" as if it is the most despised word in the English language.

And then when you get a new admission whose family is appalled that they have to share a TV with their room mate and THAT is all you hear about for the rest of your shift. Never mind that the patient has a looonnngg list of potentially life endangering problems that the nurse is trying to stay on top of...the family (and, hence, patient's) main uproar is sharing a TV ("but we saw a PRIVATE room down the hall right there"....yes, you did..THAT is for our isolation patients and your spouse is not in isolation).

Last night I overheard a spouse upset that the hospital is "spending all their money to make the lobby look nice but now my husband has to share the room with TWO other people?". Yes, he does...you want a private room, go down the street to the shiny, private hospital where you will no doubt will get a nice shiny BILL after his hospital stay...instead you came here to a federal facility that will NOT be sending a bill no matter what he has done or how long you stay...

And don't even get me started on the number of "loss of caregiver" admission diagnosis that we have seen in the last week...consistantly happens before major holidays...drop dad/grandpa off at the local federal facility and not show up again til, oh, 3 or 4 days after the home celebrations are over. But when you do show up, you ride the nurses' ass and are pissed because you don't "know" what is going on with your dad/grandfather..well, had you bothered to stick around the last few days instead of dropping him off like a hot potato and running home, you would KNOW what was going on!


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Response to rainbow4321 (Reply #12)

Mon Dec 24, 2012, 10:00 PM

14. Testify!!!

I retired decades ago and it was like that then too. Looks like nothing much has changed.

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