In the course of a day, I frequently hear stories about the care we deliver and the occasions when we exceed expectations and the instances where we fall a little short. Recently, I heard two stories that are so extraordinary I’d like to share them with you.
The first takes place at a registration desk at The Miriam Hospital. Kevin Guinea, a patient representative in the admitting department, was registering a patient who had come to the hospital for a vascular test. As she was responding to his questions, he noticed that she was slurring her speech and had other symptoms that made him think she was having a stroke. He stopped the registration and spoke to the patient and her husband about going immediately to the emergency department. He then escorted the couple to the ED. He’d been right: the woman was having a stroke and was treated successfully.
The second story takes place in the parking lot at Newport Hospital. A young couple had planned when and where they would have their baby—but the baby had other plans. They rushed to Newport Hospital but arrived too late—the baby was born in their car in Newport Hospital’s parking lot. After the mother and her baby were brought to the Drexel Birthing Center, Tony Aguiar, an environmental services group leader, was notified about the car in the parking lot—and he took it upon himself to clean the car, and in doing so, removed a reminder of the traumatic part of the day, allowing the family to focus on the joy of a new life. Can you imagine how this family told the story of the untimely delivery? I’d be very surprised if the story didn’t end each time it was told with “and when I left the hospital, the car was clean as a whistle.”
Both of these stories remind us that so much of the experience our patients have with us extends well beyond the care we deliver at the bedside. And both of these stories lead me to share some very good news regarding one of the metrics we use to track the experience people have when they come to our facilities: In June, for the first time ever, Lifespan met its target for the patient experience, system-wide. Our target was having about 74% of our patients rate their overall hospital care as a 9 or 10 (on a scale from 0-10, with 10 being the best) or provide an overall rating of their experience as good or very good. In June (again, for the first time ever), slightly more than 75% of our patients described our hospitals that way. Congratulations are in order to all whose hard work and compassion for our patients contributed to this success. If medicine is a team sport, then the patient experience is the best indication of our success individually and as a team! This rating shows the impact we are having on our patients as we bring to life our mission each and every day—Delivering health with care.
A new program that is being piloted on certain units at our hospitals may have helped contribute to our recent success. The program is designed to ensure that the rounding effort of our nurses and CNAs is both consistent and effective. It is called purposeful rounding. The concept is that once every hour, every patient will be checked on by an RN or a CNA in a manner that actively involves the patient to see whether:
1. the patient needs anything, 2. the patient’s pain is well controlled, 3. the patient needs to be repositioned or positioned more comfortably, 4. the patient has personal belongings within reach, and 5. whether there are any safety concerns (such as whether the call light is working and within reach). Every patient is told to expect purposeful rounding which will continue throughout the night but will not disturb the patient’s sleep. Patients are also told that while they are in the hospital, a member of the nursing leadership team will visit them at least once to make sure we are keeping patients informed, that we are responsive—in short, that we are providing the best experience possible and delivering health with care.
We began the project in April at The Miriam Hospital and Newport Hospital; Rhode Island Hospital began its pilot in June. We know from our own data that rounding, when done deliberately and when patients are aware that we are doing it, makes a difference in the way patients rate the hospital, in their perception of our staff’s communication with them and our staff’s responsiveness to their needs. Coupling this effort with a variety of strategies to improve physician-patient communication (another critical element in how patients view and rate us) holds the potential to move our patient experience scores even higher. Again, it is a team approach and all members of the caregiving team are important for these metrics and for continuously improving the patient experience.
I hope you were able to enjoy a little time off this summer. I’d like to close with a final thought, which is that delivering health with care is essentially this: really seeing our patients, truly listening to them, and responding to their needs. Any of us can do these things and in doing so can, as Kevin Guinea did, save a life, or, as Tony Aguiar did, save the day.
In the steadfast pursuit of excellence, I remain,
Timothy J. Babineau, MD
President, CEO of Lifespan
President, Rhode Island Hospital