Background and Objective: 

The purpose of this quality management study was to demonstrate how one hospital made a journey from average patient experience to become a regional leader in the experience of patient care for nationally recognized quality and safety metrics.

Methods: 

Saint Francis Hospital & Medical Center (SFHMC) located in Hartford, Connecticut, serves a diverse sociodemographic community as part of Trinity Health. “Recommend the Hospital” (RTH) has been the main marker of patient experience at SFHMC and Trinity Health across the United States as part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). From 2010 to 2019, SFHMC implemented unit-based rounding hospital-wide, adopting charge nurse and executive leadership rounding as standard work. The intense support from senior leadership spurred the implementation of these changes across middle management and all frontline workers. The t test was used to determine differences between the mean RTH scores between SFHMC, Connecticut, and the United States.

Results: 

Patient experience at SFHMC was regularly assessed by Press Ganey surveys and HCAHPS, which demonstrated higher scores than averages for the state of Connecticut and the United States between 2010 and 2019 (both Ps < .001). SFHMC was the top performer with an RTH score of 83%, with the state average being 71% and the national average being 72%. In the years following the implementation of a multipronged low-cost strategy, hospital RTH scores rose linearly from the state and national average. SFHMC observed gains in patient safety and quality scores as measured by national benchmarks, including Leapfrog patient safety scores of 7 A's and 1 B over a 4-year period. SFHMC was the only hospital in Connecticut to receive an A grade 4 years in a row.

Conclusion: 

A combination of nurse-led, unit-based rounding and executive team rounding with a consistent focus on patient experience resulted in significant improvement in RTH scores for a busy teaching urban hospital, with only a modest investment of resources. There was also improvement in quality and safety outcomes, which together with patient experience of care drove fiscal stability in an increasingly value-based health care environment.

中文翻译：

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城市三级医院十年来改善患者体验

背景和目标： 

这项质量管理研究的目的是展示一家医院如何从普通患者体验转变为患者护理体验方面的区域领导者，达到国家认可的质量和安全指标。

方法： 

圣弗朗西斯医院和医疗中心 (SFHMC) 位于康涅狄格州哈特福德，作为 Trinity Health 的一部分为多元化的社会人口社区提供服务。作为医疗保健提供者和系统医院消费者评估 (HCAHPS) 的一部分， “推荐医院”(RTH) 一直是全美 SFHMC 和 Trinity Health 患者体验的主要标志。2010年至2019年，SFHMC在全院范围内实行科室查房，以护士长、行政领导查房为标准工作。高层领导的大力支持促使中层管理人员和所有一线员工实施这些变革。t检验用于确定 SFHMC、康涅狄格州和美国之间的平均 RTH 分数之间的差异。

结果： 

Press Ganey 调查和 HCAHPS 定期评估 SFHMC 的患者体验，其得分高于 2010 年至 2019 年间康涅狄格州和美国的平均水平（P s < .001）。SFHMC 表现最好，RTH 分数为 83%，州平均分数为 71%，全国平均分数为 72%。在实施多管齐下的低成本战略后的几年里，医院 RTH 分数较州和全国平均水平呈线性上升。SFHMC 观察到按照国家基准衡量的患者安全和质量评分有所提高，其中包括在 4 年期间 Leapfrog 患者安全评分分别达到 7 A 和 1 B。SFHMC 是康涅狄格州唯一一家连续 4 年获得 A 级的医院。

结论： 

由护士主导、以单位为基础的舍入和执行团队舍入以及始终关注患者体验的执行团队舍入相结合，使得一家繁忙的教学城市医院的 RTH 分数显着提高，而仅投入了少量的资源。质量和安全结果也得到了改善，再加上患者的护理体验，在日益以价值为基础的医疗保健环境中推动了财政稳定。