When patient satisfaction scores were less than satisfactory at the Copper Ridge Surgery Center in Traverse City, Mich., LoAnn Vande Leest, RN, MBA-H, CNOR, CASC, CHSP, the facility's CEO, helped develop a graphic called the "Infiniti Loop." It displays every step of patient care, from the moment cases are scheduled straight through to the follow-up phone call.

Patients see the roadmap of care posted in the center when they arrive and are comforted in knowing exactly where they are on the perioperative pathway — and where they're heading next. Do you see those green hash marks between the billing experience and diagnosis circles? They represent the time when patients are out in the community telling friends and family about how they were treated at the facility. ?It's the chart's most important element.

Treat patients like they're the only case of the day and watch your satisfaction scores soar.

"We're always striving to make those stories better by design through excellent patient care," says Ms. Vande Leest. "We talk constantly about the big picture, about the importance of getting patients to speak well about the care they received by treating each patient like they're the only one who matters."

The Infiniti Loop chart hangs in strategic areas throughout the facility so every staff member who sees it is reminded that they're part of an effort to provide excellent patient care that's bigger than their individual roles. They also know they're empowered to hold colleagues accountable for delivering on that promise.

If you're not positive patients will have positive things to say about how well they were treated at your facility, remind your staff about the impact every patient interaction makes on satisfaction scores and reemphasize the importance of treating patients like the most important people in your facility. Before long, they'll be singing your praises to anyone who will listen.

Setting the tone

Laying the groundwork for excellent care on the day of surgery demands connecting with patients long before they enter your facility, says Cynthia Shashaty, RN, BSN, CAPA, clinical director at the Lakewood (N.J.) Surgery Center. Her staff e-mails pre-admission information and post-op satisfaction surveys to patients, who are more likely to respond to directives and requests for feedback if they show up in inboxes instead of mailboxes. The center also uses e-mail to provide patients with a link to the facility's website and access to a secured portal through which they submit health histories and pre-op information. Patients prefer to register for surgery through the portal, according to Ms. Shashaty, because they can fill out the online forms — which take about 30 minutes to complete — at their convenience.

Patients who schedule surgeries at Copper Ridge Surgery Center in Traverse City, Mich., receive packets that contain key facility information and a timeline of their surgical care that spells out what they will go through from 2 weeks before procedures to 3 days afterward. The timeline also includes an hour-by-hour breakdown of what will happen on the day of surgery.

"One of our goals is to give patients as much certainty as possible about their surgical experience," says Tricia Wollam, RT(R), BSHCS, total joint program coordinator and chief patient experience officer at Copper Ridge Surgery Center. "It's important to standardize every communication that they receive, whether it's verbal, written or face to face."

Hardcopy updates are helpful and useful, but sending automated text message reminders and updates directly to patients' cellphones in the weeks and days leading up to surgery can be a definite satisfaction booster. Whether you rely on paper packets or electronic platforms to reach patients, the key is to remain in constant touch and keep them informed and engaged in their care.

"Detailed pre-op communication takes away the uncertainty patients might have about what goes on in your facility," says Ms. Wollam. "That reduces the anxiety they feel when they arrive for surgery. A patient who is a well-informed consumer is ultimately more satisfied with their care." ?

Warm welcomes

There's only one chance to make a first impression, so front desk staff at Lakewood Surgery Center are required to undergo customer service training, which includes lessons on acknowledging patients and their loved ones with direct eye contact, proper ways to introduce themselves, setting realistic expectations about how long patients will wait for surgery and how long procedures are expected to last. The center also designated a room adjacent to the waiting area as a private place where patients can work on registration forms with assistance from a front desk staffer.

Don't forget to focus your attention on the friends or family members who are waiting anxiously for their loved ones to emerge from surgery; enhancing their experience often translates into higher patient satisfaction scores. Make sure the waiting area is clean and organized, and filled with snacks, refreshments and current magazines.

Lakewood Surgery Center created a secondary waiting area known as the "quiet room," where televisions are turned off, lights are dimmed, and talking and distractions are kept to a minimum. The room features a charging station with several brand-specific attachments people can use to charge their cell phones and handheld devices.

Keeping friends and family informed of how their loved one's case is progressing with preprogrammed text messages sent by the surgical team is a nice touch. Posting HIPAA compliant updates on a monitor in the waiting room is also an effective way to keep patients' escorts informed, but don't ignore the importance of the human connection.

"The front desk staff should act like the hosts of the waiting area," says Ms. Shashaty. "They should constantly work the room to ensure patients and people there are comfortable and having their needs met."

Ms. Shashaty is also actively involved in connecting with patients' escorts. She takes turns with the center's administrator and the business office manager to conduct hourly rounds, during which they walk through the entire facility to get a feel for the day's vibe, touch base with patients and their family members, and to ask if anything can be done to improve their experiences. ?

Controlling the narrative

Patients at the Lakewood Surgery Center had noted on satisfaction surveys that they wanted to receive more information about their procedures and details about what was happening on the day of surgery. When patients arrive in PACU, they now receive a report that reviews every aspect of the care they received throughout their stay. The report serves as a written reminder of the patient-centered care initiatives the facility implemented — ?remember those warm blankets we applied in pre-op ?— and the education they provided about such things as expectations of post-op pain and the potential side effects of surgery. The report also includes a polite request to fill out the patient satisfaction survey they will receive via email after discharge.

Patient-centered care demands attentive listening and supportive communication, according to ?Kathleen Ranne, MSN/Ed, CNOR, core measure analyst at St. Lucie Medical Center in Port St. Lucie, Fla. ?Every member of her clinical team, from pre-op to PACU, is trained to advance the patient-centered care narrative by constantly talking to patients about what staff has done to enhance their care, from applying active warming measures in pre-op to reviewing the many safety initiatives they implemented.

"Staff members aren't supposed to ask patients specific questions that appear on satisfaction surveys or feed them the answers you want them to jot down," says Ms. Ranne. "But that doesn't mean they can't reinforce the elements of excellent patient care that your staff delivers."

It's essentially a way to soft sell satisfaction. "Every conversation with patients has to follow a consistent narrative," adds Ms. Ranne. "Your staff must constantly reinforce the concepts of patient-centered care that you want to emphasize." OSM