A hospital’s built environment can shape its patients’ experiences. Grainger Insights’ Kym Orange recently sat down with Lynn Kenney, Director of Industry Relations for The Center for Health Design, to discuss how hospitals can improve patient satisfaction by paying attention to the built environment.
Kym Orange: Lynn, how did you get into the profession?
Lynn Kenney: After starting my career at the National Fire Protection Association, I moved to ASHE, the American Society for Healthcare Engineering, a non-profit advocacy organization that works to improve the health care environment.
I enjoyed working to resolve conflicting codes and regulations within the healthcare industry. After joining ASHE’s patient experience taskforce, I knew I had found my passion. My mom has had health challenges her whole life, and the patient experience has become part of the fabric of my family’s life.
At The Center for Health Design, I work on the connections between health and the physical environment.
Kym Orange: If you could go back in time and give yourself any advice based on what you've learned, what would it be?
Lynn Kenney: I have two teenagers, and I encourage them to pursue volunteer opportunities. ASHE and The Center for Health Design are two wonderful examples of organizations were young people can get involved. Volunteering can provide great networking, education, and leadership opportunities.
Kym Orange: What are some of the biggest challenges healthcare is facing?
Lynn Kenney: Everyone wonders what will happen with regulation. You can't pick up a newspaper without reading about the changes to the Affordable Care Act, and that will have huge implications for the patient experience.
The people, process, and place framework is also important. We really want to see interdisciplinary teams coming together to share their knowledge and discuss their challenges and work to improve patient experience.
Kym Orange: Tell us about the people, process, and place framework.
Lynn Kenney: Sure. For example, the top environmental issue cited by patients on CMS Hospital Compare surveys is noise. We can address that issue from the perspective of people, process, and place.
We could start by improving the built environment, installing noise-absorbing materials--anything from ceiling tiles to acoustic wall panels or even sound-absorbing artwork. Another example would be lighting. Adjustable lighting in the corridor can have a significant impact the noise.
From the people perspective, workers need to understand the importance of improving the patient experience. So training needs to be part of the solution.
People, process, and place should come together to address the facility’s issues.
Kym Orange: Could you explain the importance of HCAHPS to healthcare leaders?
Lynn Kenney: HCAHPS is the survey tool implemented by the Affordable Care Act, linking reimbursement to value instead of volume. Two percent of a hospital's CMS reimbursement is now based on patient surveys.
The surveys ask patients to rate their experience. For example, one survey question is: “During this hospital stay, how often was the area around your room quiet at night?” If the patient reports “always”, the hospital gets credit. We’re striving for top line scores, which are tough to achieve.
The other part of reimbursement is based on continuous improvement, so scores have to go up year over year. It's a challenge for healthcare leaders, and that's why it's so important to have these tools.
Kym Orange: Tell us about lighting and the perception of cleanliness.
Lynn Kenney: Cleanliness is another challenge. For example, one hospital we worked with had older bathrooms, and their surveys showed low scores for cleanliness. The EVS team worked diligently to keep these areas sparkling clean, but they still looked dingy and old. The hospital didn't have the money to renovate.
As part of a sustainability initiative, the hospital installed LED lighting in the bathrooms. In the brighter light, the older bathrooms looked brighter, and their cleanliness scores went up.
You can imagine how happy the EVS team was. They knew the bathrooms were clean, but they had struggled to change their patients’ perception.
Kym Orange: Why is it so important that hospitals receive an "always" score on patient surveys?
Lynn Kenney: The CMS reimbursement models are based on the number of "always" scores on surveys. If a patient reports the hospital was "sometimes" quiet at night, or the bathrooms were “usually” clean, the hospital doesn't receive the funding bonus. Hospitals have to strive for "always" scores.
Kym Orange: Where can patients and healthcare professionals learn about their scores?
Lynn Kenney: The CMS Hospital Compare website has really evolved since the implementation of the Affordable Care Act. These scores are now on social media and consumer reports websites.
Healthcare has become a more consumer-driven marketplace. Patients post about their experience on social media like Yelp and Facebook. I always tell clients to know their scores, check them regularly, and always know how they compare regionally and nationally.
Kym Orange: What are the next steps facilities can take to start improving the patient environment?
Lynn Kenney: Make sure you're having those interdisciplinary conversations, and really look at the facility through the eyes of a patient. ASHE has this really funny video we produced, where we put staff members on a gurney and wheeled them through the facility. All of a sudden, they’re seeing the stained ceiling tiles. Staff should try to see their facility the way that their patients experience it.
It’s really important to know your survey scores and understand what the hospital’s leadership is dealing with. Understanding the people, process, place framework can help you address complex variables and come up with innovative solutions.
Find more healthcare-related articles on the Grainger KnowHow.