How TriHealth’s Bethesda North Hospital Learned to “WOW” Patients 

TriHealth is the integrated healthcare system that formed as a partnership between Good Samaritan Hospital and Bethesda Hospital, Inc. TriHealth is a full-service, nonprofit health system that provides a wide range of clinical, educational, preventive and social programs.

Established in 1995, TriHealth is one of the top integrated health systems in Greater Cincinnati with approximately 820 adult beds and 190 newborn beds currently in use. In July 2014, U.S. News & World Report named Bethesda North Hospital the best hospital in the Cincinnati metropolitan area and the third best hospital in Ohio. Good Samaritan Hospital was named the second best hospital in the Cincinnati metro area and seventh best hospital in Ohio.

In addition to the U.S. News & World Report recognition, Bethesda North and Good Samaritan Hospitals have received numerous recognition and awards for quality, forward-thinking medical education; been named the top hospitals in the country for diabetes and endocrinology care; and been named the top heart hospital in the country, among others.

The problem 

Despite all these accolades, Earl Dalton, Medical Surgical Services Director at TriHealth’s Bethesda North Hospital, couldn’t help but look at the scores on the patient satisfaction Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Report Card and wonder what could be done to move the Med/Surg scores from the 80% range into the high 90% range. In the past, Med/Surg had tried to implement various improvements such as toileting in advance of needs and responsiveness to call lights only to discover the efforts did not have a significant impact on improving patient satisfaction.

The vision 

Dalton solicited the help of TriHealth’s Performance Improvement Consultants to do some research and collaborate on how to improve the patient experience. His marching orders were to think “out of the box” and find an innovative way to “WOW” patients. “Let’s not focus on typical improvements, thinking we’ll get better results,” said Dalton. We’ve tried that and the HCAHPS scores didn’t improve. Patients expect certain services as a standard and we already provide those services. We need to find a new way to enhance the patient experience.

Research was completed and presented to Dalton. After discussing the research, a vision was formed. Bethesda North Hospital would borrow concepts from the hospitality industry to develop a new model of care. The model would include all the typical services provided by hospitals but would add a concierge to perform customer service duties to “WOW” patients and families.

The plan

A team was formed with the purpose of piloting concierge services in two units at Bethesda North Hospital. The team selected a name for the pilot, “At Your Service,” and outlined the role and responsibilities of the concierge. The following is a summary of the job description: This position performs customer service duties to WOW patients and patient families. The person filling this position should be well groomed and dress in business casual attire. They should be customer-service oriented, have an outgoing personality, and be articulate, forward thinking and flexible to handle an array of different requests. This position will be responsible for rounding patient rooms to see if patients or their families desire any non-clinical services.

Examples of services to be performed include canceling patient appointments, delivering prescriptions upon discharge so patients don’t have to stop at a pharmacy, delivering morning newspapers, providing phone chargers, obtaining items from other areas of the hospital (such as Starbucks and gift shop items), and obtaining the services of a hair dresser. In addition to these tangible services, the concierge should be cheerful, caring and helpful, listening to patient/family needs and fears.

The team determined two staggered shifts would be required to take care of patient needs during peak patient admission and discharge hours (7:00 a.m.-3:30 p.m. and 1:00 p.m.-9:30 p.m.).

Existing Patient Care Associates were selected to perform the role of the concierge. They were equipped with a mobile phone (so patients could contact them directly) and a concierge cart stocked with newspapers, snacks and beverage items. They were also provided budget guidelines and the authority to purchase items for patients as needed (outlined in the guidelines).

Results

The model was piloted for three weeks (from March 20-April 9, 2014) on two Med/Surg units to determine the feasibility of the program. The team debriefed on a weekly basis to share success stories and to discuss/implement components of the program that needed to be changed.

A patient satisfaction questionnaire was provided to all patients at the time of discharge. Patients were asked to evaluate the concierge program using a Likert scale and to rate the concierge services from strongly disagree to strongly agree on the following questions:

1. The concierge made your hospital stay more pleasant.
2. You were able to focus on healing when the concierge took care of your requests.
3. Your satisfaction as a patient at Bethesda North Hospital increased because of the concierge services provided.
4. You are more likely to refer someone to Bethesda North Hospital because of the concierge service you received during your stay.
5. This service makes me feel valued as a patient of Bethesda North Hospital.

Results from 107 respondents are shown below. All respondents agreed or strongly agreed that the concierge program positively affected the patient experience.

Patients were also asked for comments on how the hospital could have further enhanced their stay. Some of the comments received are outlined below:

• Concierge service added a positive personal touch to patient and family care. A pleasant surprise.
• It was so nice to be able to feel “normal” and have items available to me that I would normally have at home. It was also nice knowing that my husband’s comfort needs for sleeping while staying overnight at the hospital were met as well.
• The program is a wonderful extra benefit to coming here. Did not intend to stay overnight with the patient, but ended up staying. This program was so helpful and beneficial. Kate was awesome! What a wonderful personality for this program.
• My stay was great. To be sick and have staff members that listen and also someone to just poke their head in the door and ask if you need anything was so helpful. Sometimes a patient’s needs don’t include a nurse. A smiling face to listen is just what a patient needs sometimes. Thank you 
• Since I wasn’t expecting to be admitted when I went to the ER, I did not have anything with me. I was worried how to get things since I came by myself. My cell phone was losing charge and the charger was in the car. After I was admitted, I had arranged for friends to run and pick up supplies from home and to get my charger. Along came Michelle — what an angel. She had a charger for me to use and offered to go get mine from the car. On her way back to my room she checked with security if my car would be okay in the ER parking lot. Then she stopped and helped an elderly couple get where they had to go. What a great person, who sees something that needs to get done, owns it and solves it. It was assuring to know that if I needed something I could call and I could get help solving it.
• I was able to get an hour of complete attention from the concierge to pack my belongings and shampoo my hair before I left. Then she took me straight to the lobby and loaded my car for discharge. What a great service!
• I was shocked but happy to learn I could cut my hair. Katie walked me to the ATM and was so kind and full of energy. Very nice service.
• Our stay was during a very stressful time, and having this service became something we waited for. We knew when we needed something she was who we could turn to.
• My stay was good. I love the individual, personalized feeling the concierge program provides. It was a comfort to have her come in and provide light pastries, fruits and snacks and paper! I hope you continue the program! Thank you for everything you did Michelle! You went over and above!
• The person who came around in the morning was like a fresh sunshine of medicine. Always bubbly and a smile on her face — makes a person feel good.
• I would highly recommend that you keep the concierge service. The “extras” really do matter!

In addition to the Patient Satisfaction Questionnaire, HCAHPS Report Card scores were trended over time to see if the concierge pilot program had a positive effect on patient satisfaction. Below are the results:

The future 

As the results clearly demonstrate, in a budget neutral fashion, Med/Surg was able to repurpose a full-time equivalent with the right skill set to positively affect customer experience scores. In the ever changing world of customer experience and consumerism in health care, this innovative approach is an excellent way to meet the challenge.

The future is bright for the concierge program at TriHealth. All results have been positive, and TriHealth has decided to expand the concierge program to other units at both Bethesda North and Good Samaritan Hospitals. Additional concierge positions have been added to the budget for 2015.

— Earl Dalton, MHA, MSL, BSN, NEA – BC, is the Medical Surgical Services Director for TriHealth Bethesda North Hospital, and Regina Fitzsimmons, MBA, is the Senior Performance Improvement Consultant for TriHealth Bethesda North Hospital. For more information, go online to www.trihealth.com.