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Satisfaction Soars on 4 South
At HCGH, doctors aren’t the only ones making rounds

How happy are patients? Nurse Patty Walter checks in twice a week to find out.
Anyone who’s ever been admitted to the hospital can tell the same story: A nurse comes in to assist you. Seconds later, her pager goes off. “I’ll be right back,” she says. A half hour later, she returns, apologizing for the delay.

“Patients understand that staff are pulled in 10 different directions,” says Judy Siegelman, nurse manager on 4 South at Howard County General Hospital, “but we can do better.”

They already have. Eighteen months years ago, Siegelman’s 30-bed medical/surgical/oncology unit launched patient satisfaction rounds, modeled after a similar effort at Johns Hopkins Bayview Medical Center. Four to five times a week, a nurse stops by to see if patients have any concerns. “Be-right-back” still is on the list of complaints—but not as much anymore. Maybe that’s because the 4 South nurses now tell patients how long they think it will take to deal with an interruption.

Simple strategies like these can make a patient happy, observes nurse Patty Walter. “Patients begin to understand that their opinions are valued,” Walter says. Increasingly, she explains, hospitals are bringing in marketing professionals to conduct satisfaction surveys. “But we—here on the unit—actually manage these patients, so we know first hand what patients want.”

On satisfaction rounds, Walter begins with an open-ended question. Then she listens and takes notes. If it’s a minor problem, she can usually deal with it swiftly. Otherwise, she’ll record the complaint and turn it over to Siegelman.

Complaints are addressed at monthly team meetings led by night-shift nurse Stacey Shumway, head of the patient satisfaction team. The team identifies opportunities for improvement and then tackles them. With help from Siegelman, Walter and the four other R.N.’s who make patient satisfaction rounds, Shumway hammers out solutions to problems ranging from simple (salt and pepper are missing from the dinner tray) to complex (a certain phlebotomist always has trouble finding veins on some oncology patients).

“We do have patients with unrealistic expectations,” “but we’re here to do the best we can to meet those expectations,” Siegelman says, adding that the satisfaction rounds have pleased even these patients.

Just how effective is this new strategy on 4 South?

Survey results from an outside firm indicate that for the quarter ending March 31, 2003, the unit’s overall patient satisfaction rating was 75.3. Three years later, the score jumped to 83.3, a statistically significant gain.

Patient satisfaction rounds have helped bring about not only rising scores, but also a flood of testimonials from patients and their families. “I’m picky about care. The staff on 4 South eased our uncertainty. They were very helpful and attentive and made us feel like family,” wrote Jean W., wife of a former patient.

“My wonderful nurse on 4 South is one of the most patient people on earth,” another patient remarked.

For Siegelman, the most fulfilling aspect of patient satisfaction rounds is seeing how much those comments buoy staff. With it all, the 4 South nurses know there’s still room for improvement. The hospital’s goal is to reach the 90th percentile for patient satisfaction. That would put HCGH in the top 10 percent of hospitals nationwide.

Judy Minkove



Johns Hopkins Medicine

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