On the Journey towards a Patient-First Culture

With patient satisfaction tied to CMS reimbursement, practices are increasingly focusing on how to better own the patient experience.

Perhaps the first step in the transition to patient-centered care is to define patient care. Jason Jones, vice president of patient experience at the Laser Spine Institute (LSI), an outpatient surgical center in Tampa, Fla., in a presentation at this year’s Medical Group Management Association (MGMA) Conference, held in Nashville, Tenn., said the journey toward patient-centered care is costly but critical. Today, as a result of LSI’s efforts in this area, 98 percent of patients say they would refer a friend or family member to the surgical center  

In addition to their Tampa headquarters, LSI has seven regional surgery centers total (Philadelphia, St. Louis, Cleveland, Cincinnati, Oklahoma City, and Scottsdale, Ariz.). LSI sees an average of 1400 patients per month at their seven centers.

Last month, LSI’s Philadelphia facility became the first ambulatory surgery center in the world to achieve gold-level Planetree Designation for Excellence in Patient-Centered Care. Planetree is a Derby, Ct.-based nonprofit that works with healthcare providers to institute patient-centered care.

LSI had noticed that their patient satisfaction scores had dipped across the board in 2013, when it first began to transition to patient-centered care. Jones said the surgical center was also experiencing a cultural resistance at that time. Quite often, the journey to patient-centered care will result in some employees deciding to leave.

“What we have learned during the process of moving to a patient-centered approach was that great customer service and patient-centered care sometimes have nothing to do with one another,” Jones said during his presentation. “We learned we had put processes in place for efficiency that valued efficiency over experience. We had excluded the patient voice in the decision-making process.”

One of the first steps LSI took was to assess the cultural roadblocks to change. “This required a cultural movement for us to really assess where we were in the process, to assess how much were we weighing efficiencies over experience,” Jones said.

Jones said LSI started the training process utilizing sessions of 25 teammates at a time. Sessions were mixed to ensure diverse views in each meeting. “It’s a significant cost,” Jones said. “We broke up the cost over six months and factored in training into our budget for the year.”

One of the important changes LSI made was putting a patient family advisory council in place to make sure the patient voice is heard. The council is purposefully made up of former patients who provided the most forthright feedback.

Jones said LSI utilized the Planetree designation (for Excellence in Patient Centered Care) criteria as a guide and for best practices. However, much of the information and examples were built for hospitals and didn't translate to their practice. “So we had to try many innovative initiatives to reach the criteria we used,” Jones said by email. “There isn’t much of a road map for executing patient-centered care in an outpatient setting. Many organizations are trying to figure it out and we believe we can serve as an example of how to deliver patient-centered care in this setting.”