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Making Up Ground
Halsted 8 improves its patient satisfaction scores using common-sense techniques.

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From left, Michael Harris, floor technician; Siobhan Hensley, R.N.; Yacob Yisrael, support associate; Kathy Pretl, R.N.; Latesha Heyward, clerical associate; Ricardo Ramos, R.N.; Roland Champane, clinical associate; Miriam Lee, R.N.; Mercy Brown, clinical associate; Michelle D'Alessandro, nurse manager; Dorothy Holt, inventory control manager; Shana Counts, R.N., surround a Halsted 8 patient.

Although Michelle D’Alessandro never buys donuts when she regularly picks up coffee at the Boston Street Dunkin’ Donuts shop—and the folks behind the checkout counter know that—each of them nevertheless always asks as she’s paying for her coffee, “Is there anything else I can do for you?”

D’Alessandro, nurse manager on Halsted 8, likes such routine attentiveness. She decided it was one method her 32-member staff could use to improve the disappointing results they were receiving on patient satisfaction surveys, despite the excellent care and quality service they provide.

Beginning last fall, she and her staff adopted what D’Alessandro calls “The Dunkin’ Donut Approach” to patient care. She advised the 23 nurses and 15 support personnel on Halsted 8: “Before you leave a patient’s room, always ask, Is there anything else I can do for you?”

That initiative, along with several other imaginative efforts to improve not only their performance but the perception of it, so energized the staff and dramatically improved their patient satisfaction results that the 18-bed unit won this year’s Linda Arenth Award for service excellence from the Department of Nursing.

Arenth, first director of nursing for the Hopkins Oncology Center from 1973 to 1987, and the Hopkins Hospital’s vice president for nursing and patient services from 1987 until her death from cancer in 1992, was renowned as a mentor and visionary leader who encouraged innovations in nursing practice. The Arenth Award recognizes the nursing unit that has demonstrated a strong service-oriented environment.

As recently as last December, Halsted 8’s ranking in the quarterly, nationwide Press Ganey survey of patient satisfaction was a rock-bottom first percentile. That means it was deemed inferior to 99 percent of nursing units across the country.

“My staff felt that the scores really weren’t representative of the care we give and the quality of service we deliver,” D’Alessandro says. She and Jodi Burke, one of her staff nurses, launched a series of innovative moves to improve the unit’s performance.

The results have been substantial. By the end of the first quarter of 2008, Halsted 8’s satisfaction rating had jumped to the 35th percentile. The results for April, the first month of the 2008 second quarter, indicate the unit has soared to the 65th percentile.

Out of the Hopkins Hospital’s nearly 70 nursing units, Halsted 8 now is “one of our most improved, despite being in a very old building” with fewer amenities, notes Rebecca Zuccarelli, senior director of patient satisfaction.

Among the problems D’Alessandro and her staff faced was that many of the patients on Halsted 8, a general medicine unit, simply never responded to the Press Ganey survey. 

So Halsted 8 began giving patients a four-question exit survey of its own, “just to get them thinking that they’re going to be getting another survey in the mail,” D’Alessandro explains. Their survey posed a few simple inquiries, such as whether the staff had addressed their concerns. The patients’ responses—the negative as well as the positive—are posted on a huge bulletin board in the nurses’ breakroom.

Additionally, the unit created laminated business cards for all of the unit’s support staff to hand to patients. Each member of the unit’s nursing staff also received a promotional lapel button proclaiming “Halsted 8: Committed to Patient Satisfaction.” And every month, the nurses’ assignment board features a new “Question of the Month” (such as, “Was your room kept clean and free of clutter?”) that the staff is encouraged to pose to patients. The unit also has a supply of coupons for meals and parking spaces that it gives to patients or their families in response to delays.

D’Alessandro, an 11-year veteran of Hopkins who became a manager in 2005, also tries to meet every new patient personally, making the rounds to “curtail any problems or issues before they escalate. That’s helped a lot.

“Patient satisfaction is a marathon, not a sprint,” D’Alessandro says. “I think we’re going to have blips on our radar when we’re going to go up or down, but we’re trying to be consistent overall.”  

—Neil A. Grauer



Johns Hopkins Medicine

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