Patient experience and outcomes help drive the value equation
Most consumers say they can recognize a good value when they see one, yet this seemingly simple concept becomes far more complex and subtle in the realm of health care.
“At Saint Francis, and across all of Trinity Health Of New England, we are focused on delivering the value component of health care by providing the best outcomes with regard to quality of care and the best patient experience, at a reasonable cost,” states hospital President John F. Rodis. “It’s a strategic priority for us to improve the overall patient experience.”
These comments reflect “Triple Aim,” a health care framework developed by Don Berwick, founder of the Institute for Health Improvement (IHI). The IHI Triple Aim states that the U.S. health care system must pursue three distinct objectives simultaneously: to improve the experience of care (including quality and satisfaction), improve the health of populations and reduce per capita costs of health care. According to Berwick, “The best changes are synergistic; each is a piece of the greater whole, aimed at integrated, patient-centered care.”
Saint Francis and its sister hospitals in Waterbury and Stafford Springs, Connecticut, and Springfield, Massachusetts, are progressing on all three fronts.
“The patient experience begins well before a person enters our doors,” according to Dr. Rodis. “It includes every patient touchpoint along the continuum of care—from the experience navigating our website for directions and parking information to discharge and post-hospital care. Our work is to optimize each and every step along the way.”
“The primary metric used to measure patient experience is how likely patients are to recommend their hospital,” says Anne York, regional director of patient experience for Trinity Health Of New England. Following their discharge from Saint Francis, patients are asked to participate in a national survey that asks about their experiences during their stay. According to recent HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) results, when asked if they would “definitely recommend Saint Francis,” 83 percent of patients responded “Yes;” compared with a state average of 71 percent and a national average of 72 percent.
“Over the last decade, Saint Francis has moved from being in the middle of the pack to being consistently in the top two hospitals in the state,” notes York. “We’re delivering on our promise to be high quality at a lower cost.”
Another aspect of this success, according to Regional Chief Quality Officer Jim Tucker at Trinity Health Of New England, is the hospital’s focus on improving quality, safety and efficiency by becoming a high-reliability organization.
Saint Francis recently became one of almost 100 hospitals across Trinity Health’s national system to implement a Balanced Scorecard dashboard that focuses on a shared set of objectives around three quality and safety components: reducing and eliminating hospital-acquired infections (HAI), reducing readmissions and improving the patient experience.
“Overall, our objective is to be very people-centered. We want to keep people safe,” says Tucker. “We want them to get the care they need and not be re-admitted. The dashboard is a very people-oriented way of framing the measures and setting targets for us to reach.”
While achievements in patient experience and clinical outcomes are both significant and noteworthy, they are only part of the picture. The final element of the value equation is cost.
“Value is all about delivering excellent clinical outcomes and patient experiences at a reasonable cost,” according to David Bittner, senior vice president and chief financial officer for Trinity Health Of New England, “It’s about putting what people truly value at the center of the discussion.”
According to Bittner, the desire for high-value health care is shared by many constituents—from employers, to insurers, to government and most importantly, individual consumers.
“As individuals and families—the people we serve—continue to be more responsible for paying a greater share of their health care expense, they are paying closer attention. People want to know what they are getting for their money, and they are seeking value for their health care dollar.”
“We advise patients and their families to consider all the information available to help them make their hospital selections,” says Dr. Rodis. “There are many important considerations that go into deciding which hospital might be best for a particular person and they should all be considered carefully. It’s not about being the least expensive choice; it’s about getting the greatest value.”
Saint Francis is a strong choice. The hospital has received an “A” rating Hospital Safety ScoreSM eight times since the survey’s inception in 2012 from The Leapfrog Group, a national hospital quality watchdog organization. Healthgrades, which aims to help patients make informed choices when seeking health care, named Saint Francis a Distinguished Hospital for Clinical Excellence three years in a row and recognized its superior outcomes in joint replacement and pulmonary care.
Most recently, Healthgrades placed Saint Francis in the top 5 percent of hospitals in the U.S. Saint Francis is also one of only four hospitals in the state to earn a 4-star rating from the Center for Medicare and Medicaid Services.
Saint Francis was also recently named a Top 100 Hospital for Patient Experience by the Women’s Choice Award.
“Saint Francis was awarded because it is one of the best at treating their patients the way their patients want to be treated,” said Delia Passi, founder and CEO of the Women’s Choice Award. “Hospital choice is a critical decision, particularly for women, who make over 80 percent of health care decisions. Our designation makes it easier for them to choose a hospital where they and their families are more likely to have a better experiences and outcomes”—which sounds an awful lot like value.
