Radiology and the Patient Experience: Oxymoronic or Exigent?

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 - Patient Experience

The Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, survey—now driving a portion of hospital revenue—touches radiology only tangentially, so it would be convenient to leave the patient experience to someone else. That was not the path of the University of Michigan Medical Center (Ann Arbor), which began exploring the idea of patient experience about five years ago, under the leadership of Ella Kazerooni, MD. The radiologist became interested, at the time, in the idea of service excellence, but discovered that the subject of patient satisfaction became controversial very quickly, in the setting of radiology.

“It’s easy to put in questions to patients (and their families and visitors who come with them) about the operations of the experience and the way that they were treated,” she notes. “There are other elements of the patient experience, though, that the radiology community may feel less comfortable with, such as the availability of radiologists to speak
to patients if they have questions about an exam.”

The medical center was considering an institution-wide service-excellence initiative and investigated bringing in an outside company to train all employees, but was moving forward slowly, at the time. Subsequently, Kazerooni and her colleagues developed a service-excellence group composed of hospital staff, representatives of all imaging modalities and each physician-specialty division, and house officers—as well as support services such as IT, engineering, and media services: all in all, a large group.

The group began by discussing the concept of service excellence as a term for everything from employee engagement to patient satisfaction and the patient experience. Members read The New Gold Standard: 5 Leadership Principles for Creating a Legendary Customer Experience Courtesy of the Ritz-Carlton Hotel Company (McGraw-Hill, 2008) and considered which principles resonated with them, as leaders in the health-care enterprise.

The group built its program from the ground up, learning from others within the institution, developing a service excellence-statement and attestation that resonated with what people in the radiology department thought was important, and coordinating with the strategic plan and goals of the health system. “It took between 12 and 18 months, and there were lots of skeptics at the time,” Kazerooni recalls—people who asked what the group was doing, why it was meeting, and why it needed to do this. She says, “Others simply said that they knew what was good medical care, and this was just superficial fluff.”

She continues, “Taking our time and making it our own made it that much more an embraceable program. When we launched it, it felt like it was us. It was our program; it was something that we believed in and wanted to do.”

Platform and Planks

The program was based on core service statements that resonated with staff about how to treat patients; how to smile through the phone and on email; and how to close out each encounter (whether on the phone, in person, or by email) when it relates to a patient-care experience. “It’s about treating each other well; treating our colleagues well, across the health system; treating our referring physicians well and exceeding their expectations; and, certainly, meeting (if not exceeding) the needs of our own patients,” she says.

A gold card printed with the belief statements was developed, and staff members carry it behind their ID badges. A one-page attestation of the belief statement must be read, discussed with a manager, and signed by all newly hired personnel and by all staff and faculty members at their annual reviews. A thank-you/closure card also was printed, with a radiology motif on one side and a note thanking the patient for choosing radiology at the University of Michigan on the other. The card bears the name of the last person to speak with the patient (technologist, staff person, or physician); the date when the patient can expect to get his or her results; and a reminder to the patient to ask any unanswered questions.

“It wasn’t a very expensive program,” Kazerooni reports. “I think some of the misconceptions about a patient-experience program are that it has to be expensive, that you have to spend a lot of time putting it into place and training people, and that you can’t do this by yourself. I disagree with all of those myths. It’s really more of a mental and emotional commitment.”

Having a champion with the energy, passion,