HealthStream Research has provided physician satisfaction survey services to healthcare systems and individual hospitals across the U.S. since 1990 and has accumulated the nation’s largest comparative database for physician satisfaction. We recently took a closer look at four hospitals that scored high when physicians were asked to rate the hospital’s efforts to maintain a high quality of care which is consistent across all shifts and floors. This is part three in a four part series that features best practices of hospitals that score high in this area.
Consistency of Care: Part of Hospital Philosophy and Culture Carolinas Hospital - Florence, SC
HealthStream Research recognizes Carolinas Hospital as a top performing hospital in delivering consistent care. Carolinas Hospital is a 375-bed facility located in Florence, SC, with more than 1,800 highly skilled medical professionals, including over 260 specialized physicians in every major specialty on staff. After speaking with Jim O’Loughlin, CEO, and members of his administrative team, it is easy to see why Carolinas Hospital consistently delivers quality medical care.
Building on a Strong Foundation of Consistent Care
Carolinas Hospital believes that consistent care begins as a foundation. Consistency of care is part of the philosophy and culture of the hospital. The value of delivering consistent care has been hardwired into the organization. Carolinas has built on this foundation of consistency of care by implementing several programs. The Physician Recruiting Plan was developed to support physicians both before and during the on-boarding process. Administration makes sure to have lunch with new physicians once every quarter for the first year, and once every six months after that. New physicians are assigned a nurse manager as a mentor. The support of well-established nurse managers helps make new physicians feel at home in the hospital.
The Physician Relations Committee is another important program at Carolinas Hospital. This committee is made up of eight senior leaders from various departments in addition to the CEO. This group meets monthly to review the admitting statistics of all physicians and to discuss any high-admitters or low-admitters. Every month, members of this committee are given three or four physicians to visit. This gives physicians an opportunity to discuss problems or concerns, as well as successes. This feedback gives administration the ability to fix problems quickly, or avoid them altogether. Carolinas Hospital also uses a ‘Lunch and Learn’ program to increase consistency of care. Once a month physicians educate other staff members. For about thirty minutes physicians and staff discuss expectations for patients, new procedures, and preferences for care. Lunch and Learn demonstrates that nurses and staff are eager to please physicians, which contributes to consistently delivering quality care.
Collaboration Between Physicians and Nurses Creates Consistency of Care
Carolinas Hospital has also formed a Physician Leadership Group as well as a Nurse Leadership Group. The physician group has monthly dinners with administration at a local restaurant. This gives physicians the opportunity to discuss problems, provide input for strategic planning, and even discuss financial issues. Carolinas Hospital also shares the results of HealthStream Research’s Physician Insights Satisfaction Research with the Physician’s Leadership Group. Hearing from physicians concerning survey results helps Carolinas Hospital improve physician satisfaction and deliver consistent care.
Collaboration between the Physician Leadership Group and the Nurse Leadership Group also creates consistency in care delivery. Twice a year Carolinas has the two groups meet together. This allows nurses and physicians to coordinate procedures for care. One actual example occurred when physicians were receiving what they perceived as ‘unnecessary’ phone calls. The Nurse Leadership Group got together with staff RNs and created a formula to educate staff about calling physicians. They developed a checklist of five things to do before calling. This checklist is posted at nursing stations throughout the hospital. The number of unnecessary phone calls has been reduced, and necessary phone calls are more efficient. The collaboration of the Nurse Leadership Group and the Physician Leadership Group really allows the entire hospital to offer consistent care.
Problem-Solving Enhances Delivery of Consistent Care
Problem-solving is key for delivering consistent care at Carolinas Hospital. Physicians know that their problems are listened to because these problems get solved. From simple problems, such as a lack of Diet Coke, to more serious problems, such as the transfer of information across shifts, the administration at Carolinas Hospital is always working to solve problems. One creative solution for keeping physicians up-to-date is the ‘Round Report’. This is a report that is printed off and placed in the front of each patient’s medical record every morning before rounding. The Round Report is a summary of the patient’s care for the previous 24 hours, including medications, labs, and radiology reports. This gives physicians the most recent information and allows physicians to offer consistent care to their patients.
Availability of Administration is Key to Consistency of Care
The atmosphere created by administration and managers at Carolinas Hospital enhances the consistency of care. Administration and department managers are visible and available throughout the hospital. Every morning, Monday through Friday, managers and administrators deliver newspapers to patients. Physicians know that administrators and managers see what is going on in the hospital. This also provides opportunities for physicians to discuss problems and get feedback quickly. Managers have also embraced the concept that physicians are the hospital’s customers. With strong competition, Carolinas must make it easy for physicians to practice there. Administrators, managers, and staff want that physician business, so they go out of their way to make Carolinas Hospital a consistent, stable environment for providing medical care.
Maintaining a high quality of care consistently across all shifts and floors takes a total team effort, as demonstrated by Jim O’Loughlin and his team at Carolinas Hospital. They use a variety of tools to ensure consistent quality care. Programs that enhance physician-staff communication, in addition to an atmosphere of problem-solving and communication, augment these efforts. Congratulations to Carolinas Hospital—a top performing hospital continues to deliver consistency of care!