Joanne's Journal - Thursday, January 25, 2018
At Dartmouth-Hitchcock, transparency is a key ingredient to improving the care we provide, and I am pleased to share that beginning next week, we will be joining a small but growing handful of nationwide organizations that have taken the initiative to publicly post their patient satisfaction ratings online.
We know that patients have choices on where they go for care. We also know that many patients today go online to research health information as well as seeking out information on primary care physicians, specialists and hospitals where they may choose to get their care. According to an editorial in the New England Journal of Medicine, Yelp has more than 102 million customer reviews to date with 6 percent of them about health care providers or organizations. Dr. Vivian Lee, the author of this editorial, looked at an analysis of Yelp health-care reviews and how the comments related to patient satisfaction scores. Dr. Lee asked many of the same questions we asked ourselves: What are the goals of transparency when it comes to patient feedback? And what’s the best way to share this kind of information so that it is relevant and accurate?
Many of the consumer ratings websites provide ratings based on a limited number of reviews. This small sample size can deliver an incomplete or distorted perspective of a physician’s actual performance and rating. We believe that results from our patient satisfaction surveys, which are conducted by Press Ganey, will offer a more relevant picture of provider satisfaction for patients and their families.
Recognizing these factors, we carefully reviewed best practices from other health systems and industry leaders to develop our own initiative to provide a greater level of transparency for our patients and families. We will be launching our own provider ratings on our website next week. These ratings will appear for 400 providers in specific specialties at D-H locations in Lebanon, Concord, Manchester and Nashua.
Here’s how it will work:
- The Dartmouth-Hitchcock provider ratings will be based on questions from the Press Ganey Patient Perception of Care survey.
- A star rating will be generated, which converts each response from the “Care Provider Domain.” Scores will be converted to a five-star rating similar to those found on consumer sites.
- Stars will be placed on individual provider web pages.
- We will also post survey comments unless they contain patient health information (PHI), profanity or libelous claims.
- Providers need to have a minimum of 30 returned surveys. (This ensures that we have a large enough sample size to provide an adequate representation of patient experience and one that cannot be skewed by one or two negative reviews).
- Provider ratings will be updated monthly.
- We will roll out star ratings to all other providers in 2019.
- For more information about this initiative, visit our Frequently Asked Questions webpage.
Dr. Lee made other good points about transparency in her editorial that are important for our initiative:
- Reviews of physicians or hospitals can help patients make more informed and more confident consumer decisions.
- Patient reviews offer clinicians valuable performance feedback for learning and improving, both individually and across a system.
- Health care systems and physicians who voluntarily share patient-review data visibly foster a spirit of trust and transparency with patients and the community.
I think this last point is an important one – to help foster a spirit of trust and transparency with our patients and the communities we serve. And I’m curious to know more about your thoughts on this topic. Please either reply to this email or send a message to Office.of.the.CEO@hitchcock.org.
An Unexpected Collaboration
It’s not every day that Dartmouth-Hitchcock (D-H) Radiology Department Chair Jocelyn Chertoff receives an email from a National Park superintendent. So, she was intrigued when Rick Kendall, superintendent of Marsh-Billings-Rockefeller National Historical Park in Woodstock, VT, and Saint-Gaudens National Historic Site in Cornish, NH, asked Chertoff last winter if she and her radiology team could help with a Saint-Gaudens project. Visitors to Dartmouth-Hitchcock Medical Center’s (DHMC) Winter Art Exhibit, which will be on display through spring 2018, can now see the result of this unique collaboration.
Kendall wanted to know if a D-H CT scan machine could be used to identify the carvings inside 16 historic plaster molds. All they knew was that the molds had been sculpted by Augustus Saint-Gaudens, renowned for sculpting Boston’s Shaw Memorial, the “Standing Lincoln” monument in Chicago’s Lincoln Park and designing the 20 and 10 dollar gold coins. Part of the process of making bronze sculptures is to create plaster molds from which the sculpture is cast.
“These molds have been sealed for over 100 years and nobody had any idea what was in them,” says Henry J. Duffy, PhD, curator of the Saint-Gaudens Museum. To prevent damage to these historic artifacts, the Park Service did not want to break the seals; thus, a CT scan machine seemed like the ideal solution.
Chertoff agreed. “I was immediately taken with the idea and I was pretty sure we could do it and do it pretty quickly, without impacting patient care and with virtually no impact on our Radiology workflow,” she says. “I just had some technical questions, such as how heavy the molds were and whether they contained metal that can create interference in a CT scan.”
Daisy Award Winner: Jackie Bennett, RN
Jackie Bennett, RN, a clinical nurse in the Emergency Department (ED), thought she was headed into an early morning meeting with ED Unit Nurse Manager Moriah Tidwell, RN, on January 17. But instead she was greeted by a roomful of her colleagues and D-H CEO and President Joanne Conroy, MD, who all applauded when Karen Clements, RN, BSN, MSB, FACHE, chief nursing officer for DHMC, told Bennett that she was being presented with the DAISY Award for this quarter. “Thank you for the many differences you make every day,” Clements said as she presented Bennett with the award.
The DAISY Award is an international nursing recognition program, in which D-H participates, that honors extraordinary nurses. Bennett was nominated by Nicole Lafrance, LNA, a member of D-H’s Staffing Resource Team. Lafrance wrote, “Jackie always puts her patient and their family first, even when she has six patients and patient families. She always takes the time to discuss in detail their discharge or next step. Jackie is upbeat, energetic, knowledgeable and ready to teach at any moment. Her communication with the staff is spot on, and she is able to communicate other things in a hectic environment without the patient becoming concerned. She never leaves a room without asking one more time if she can do something for someone.”
Bennett has been an ED nurse for the past three years after initially joining D-H’s Medical Surgical unit four years ago. “Jackie is just phenomenal. She takes great care of our patients,” said Tidwell, who noted the Bennett works the 3 am to 3 pm shift. “They all love her. I’ve never had a single patient who didn’t. She’s a wonderful nurse.”
“Now you’re going to make me cry,” Bennett joked, as she reached for the tissues that Clements offered her. “I like the diversity of my job, my supervisors are really supportive, and I have fun at work,” she said.
She said she makes a point of coming to work every day with a good attitude and tries to brighten the days of her co-workers and patients. “When you spend your time focusing on their sickness and not trying to lighten things up, it can often be more stressful for the patient. So, I try to make things a little lighter while I’m here because sometimes joking around with my patients helps them relax.”
After the ceremony, Clements commented: “I’m so proud of all of our nurses. And it’s exciting for me to be able to recognize nurses who really do go above and beyond to make a difference for our patients every day.”
Anyone may submit a nomination for the DAISY Award— patients, visitors, physicians, nurses and all D-H staff and volunteers—at this D-H web page. All nurses who are nominated are recognized at an annual D-H celebration. Bennett was presented with a certificate, a DAISY Award pin, a hand-carved stone sculpture entitled “A Healer’s Touch” and a DAISY Award banner, which will be displayed in the ED for the next four months.
Next Facebook Live with Dr. Joanne Conroy and a Special Guest
The next in a series of Facebook Live sessions, Dr. Joanne Conroy, CEO and President of Dartmouth-Hitchcock (D-H), will talk about the patient experience with Carol Majewski, Director of the Office of Patient Experience at D-H. This Facebook Live session will be held on Monday, January 29, at 12 noon. For those who want to tune in, go to the D-H Facebook page at the above date and time. To comment on or share the video, you will need to have a personal Facebook profile, but you can view the D-H Facebook page even if you are not logged in. On that day, if you are logged into your Facebook account and already "like" the D-H page, you will likely see a notification that the session is live. Submit questions in advance to firstname.lastname@example.org.
For those who are unable to tune in live, you can view an archived version on the D-H Facebook page. If you have a comment or question you would like to ask Dr. Conroy, please send a message to email@example.com.
Dr. Conroy will host four more Facebook Live sessions throughout 2018, featuring special guests to discuss topics of interest to the D-H Community (see schedule below). If you have suggestions for upcoming guests, please send your suggestion to: firstname.lastname@example.org.
- April 3, 12 noon to 1 pm, guest to be determined
- July 9, 12 noon to 1 pm, guest to be determined
- October 2, 12 noon to 1 pm, guest to be determined
- December 5, 12 noon to 1 pm, guest to be determined
First Video Featuring Staff from D-H and Affiliates
More than 600 staff in 12 locations throughout Dartmouth-Hitchcock and at affiliate hospitals and clinics were filmed for a new video series meant to celebrate the year ahead with the title song “This is the New Year” by A Great Big World. The videos feature employees smiling, waving, caring for patients and enjoying the song, representing departments and units from the following locations:
- Visiting Nurses and Hospice of New Hampshire and Vermont (VNH)
- D-H Nashua
- D-H Bedford (including Bedford Call Center)
- D-H Manchester
- D-H Concord
- New London Hospital (including Newport Health Clinic)
- Mt. Ascutney Hospital and Health Center
- Alice Peck Day Memorial Hospital
- Cheshire Medical Center
- D-H Lebanon
The series include versions for each affiliate hospital with only their staff in the video so that each location can show internally to their teams and externally on their social media platforms.