According to the country's most widely used measurement and improvement researcher, Madison County Hospital's Obstetrics (OB) department is in the top tier of all OB departments in the country in four key areas.
In the first half of 2008, obstetrics patients, who rated Madison County Hospital through Press Ganey surveys after returning home, catapulted the department to a rating better than all other hospitals in the country. When it comes to patient satisfaction, the department outranked the competition in the following categories: likelihood to recommend, staff addressed emotional needs, staff kept you informed, staff response to concerns and complaints.
According to its web site, Press Ganey works with more than 7,000 health care organizations to measure and improve their quality of care with research-based and –tested surveys. Press Ganey is the health care industry's most widely used approach to collecting stakeholder perspectives.
"The goal is to be in the 99th percentile – that's the best you can get," said Patrick Baker, Vice President and Chief of Nursing at Madison County Hospital. (Baker is also a Major in the U.S. military serving as Healthcare Administrator for the 179th Medical Group in Mansfield, Ohio.) "Being in the 99th percentile says our OB department did a better job in regard to those questions than 99 percent of the other hospitals in the country regardless of size."
The ranking didn't come without hard work, Baker said. It took a commitment from all levels of staff to see improvement in the rankings. In 2007, the department ranked only in the 19th percentile on the survey's question "likelihood to recommend."
"That wasn't good," said Baker. "So we adopted a new approach to customer service that has helped our OB department rise to the top."
The hospital's new Service Excellence Program is called MCH CARES and has nurses, doctors and aids in the OB department excited to come to work. In fact, the department hasn't had to enlist the help of a nursing agency in 208 days.
"It's common practice to use nursing agencies to fill staffing needs, but we have not needed to do that in seven months," Baker said. He attributes that to a different work environment where nurses feel valued, that their input matters and that they're part of the decision-making.
MCH Cares is based on Quint Studer's book, Hardwiring Excellence, in which three principles are key to creating an environment truly focused on customer satisfaction. The three key principles are: 1) creating an environment where people have a purpose for work, 2) worthwhile work, and 3) a place where people feel they're making a difference.
What has started in the OB department as a result is something called "hourly rounding." The nurses are committed to visiting patients at least every hour to proactively ask about the "3 Ps". By asking about position, pain, and "potty," the department has reduced the number of nurse calls and patient falls. It also helps improve the patient's comfort and alleviates pressures.
Jackie Call has had three children at the hospital in the last six years, and said her experience giving birth to her two youngest children – one 18 months and one 3 months – was like a "maternity day spa."
"You press a button and a nurse is there in seconds," said Call. "You feel like they really, really care about what's about to happen to you and make sure your experience is as comfortable as possible."
While the entire hospital is implementing MCH CARES, the OB department has become the model for the rest of the hospital to emulate. Baker attributes this to the enthusiasm and involvement of Karen Uhrman, Director of OB at MCH, and the commitment by every employee in the department.
"I think the general attitude of the staff has really improved," said Karen Uhrman, Director of Obstetrics at Madison County Hospital. "There's a real sense of teamwork."
The day-to-day changes have translated into patient satisfaction thanks to the staff using one of Studer's concepts of "key words at key times" that help reinforce patient satisfaction and make their patient's experience memorable. This has resulted in higher ratings when patients return home and fill out their post-stay survey from Press Ganey.
"For example, instead of simply pulling a curtain, we now say 'I'm pulling the curtain to give you some privacy,'" Baker said. "It helps patients understand why we do the things we do."
Call agreed that Madison County Hospital would get high ratings from her in the 'likelihood to recommend' category.
"I have been trying to tell my friends and family who go to larger hospitals farther away that Madison County Hospital is not the 'hospital of old' anymore," she said. "It just felt like I was being really, really watched-after and the most comfortable I could be. The nurses are not just clinicians, they really care about your emotional needs."
In addition to the hospital, Call recommends her obstetrician Dr. Mitchell Spahn to her friends and family.
"He is a great coach," she said. "He really listens when you have concerns and takes you seriously when you ask a question. He understands that none of us practice medicine for a living."