Juggling Responsibilities

The top challenges chosen by healthcare administrators in surveys conducted by two major industry sources are listed on the next page. Crothall is focused on tailoring solutions to meet clients’ specific needs and address 8 of the 9 major healthcare challenges.

Jump to:

• Governmental Mandates/Challenges
• Capacity
• Patient Satisfaction

Governmental Mandates/Challenges

Recent moves by the Centers for Medicare and Medicaid Services (CMS) make it clear that the government is changing its role from passive payer to active regulator of quality within healthcare. At the recent “Chasing Zero” infection prevention summit in Washington, D.C., former CMS Administrator Mark McClellan commented that CMS policy would be to “create accountability for quality outcomes.”

As of October 1, 2008, certain surgical site infections have been added to the list of “never events,” inexcusable outcomes that will exclude a procedure from reimbursement. An April draft of proposed “never events” went even further, to include all C-Diff related illness. Although this item was not adopted, it signals that CMS favors a zero-tolerance approach to hospital-acquired infection. Crothall is dedicated to maintaining a healthy environment and has partnered with Infection Control to ensure client facilities are clean and safe for patients.

The Joint Commission, which accredits hospitals for compliance with a long list of regulations, has “deeming” authority for CMS, meaning accredited hospitals automatically meet Medicare conditions of participation. Crothall partners with clients to ensure the hospital meets all Environment of Care and Life Safety Code requirements of Joint Commission. Crothall even uses an external auditor to make sure programs pass muster.

Regulations governing support service departments can be vexing to hospital administrators focused on delivering quality clinical care. As support service specialists, Crothall can better adapt to changes.

Capacity

Hospital administrators faced with capacity issues—long Emergency Department wait times, walkouts, and diversion—may look to hospital expansion as an answer. While Crothall can help with everything from safety compliance to post-construction cleanup, construction is not always the best way to solve capacity issues.

Often, the real problem is the hospital’s inability to meet patient demand efficiently. Patient throughput and flow challenges cause bottlenecks in the delivery of patient care, preventing hospitals from making the best use of existing capacity. Before breaking ground, administrators should study the logistics of how patients move through the system from entry to discharge.

Crothall’s patient throughput solution involves the technology-driven collaboration of Environmental Services with centralized Patient Transportation. Crothall’s proprietary TeamThroughput software allows managers to visualize all patient throughput and flow tasks, track productivity, and produce dashboards and reports that clients can use to monitor the program. This allows patient throughput to take priority over other tasks, expediting discharge requests and reducing bed turnaround times.

Crothall works collaboratively with clients to be a key part of any larger initiative to address capacity challenges. As discussed in the recent Celebrations article “Reducing the Patient Flow Bottleneck” (Feb 2008), Crothall has partnered with many client hospitals, finding innovative ways to improve throughput. These facilities have seen impressive reductions in turnaround times while discharge volumes have increased.

Patient Satisfaction

HCAHPS is the main focus of patient satisfaction concerns now that patients can look online to see scores for any hospital. CMS will soon begin withholding up to 2% of Medicare reimbursement for hospitals neglecting to publicly report HCAHPS data. But publicly reported scores appear long after patients are cared for, much too late to address any problems. For example, HCAHPS scores posted in the September 2008 update represent patients discharged between January and December 2007.

Crothall has invested time, talent, and research into pioneering a program over the last year and a half to improve HCAHPS scores by introducing new patient satisfaction strategies in Environmental Services. Immediate Strategies for Driving HCAHPS is a systematic educational, training, and coaching initiative fully in place at all Crothall accounts nationally. The second phase of the program, The Crothall Way: Driving HCAHPS Scores for Success, is currently underway. Comprised of 7 Key Drivers and over 40 proven strategies, it will create happier employees, satisfied patients, and more successful programs.

The results have been encouraging since implementation of the Immediate Strategies in June 2008. Laredo Medical Center (Laredo, TX) has increased from 66% of patients responding their room and bathroom were “Always” kept clean in March 2008 to 84% in August 2008. North Mississippi Medical Center (Tupelo, MS) has increased from 75% to 80%. Mount Sinai Hospital of Queens has increased from 65% to 79%. Presbyterian Hospital Matthews (Matthews, NC) has increased from 63% to 81%. And Scotland Memorial (Laurinburg, NC) has increased from 68% to 84%. Crothall expects many more success stories resulting from the industry’s first and most comprehensive program to address HCAHPS.