Medical Staff e-Update

John Mogerman

John Mogerman, MD

Medical Director, Allegiance Behavioral Health & Chief of Staff

Ray King, MD

Senior Vice President, Medical Affairs & CMO

Issue 17 - December 6, 2014

Setting standards for customer service is essential to improving patient satisfaction, says Joan Hablutzel of MGMA

There are at least 30 ways to grow patient satisfaction at your healthcare facility, but 10 key service standards should do the trick.

Joan Hablutzel, senior industry analyst with the Medical Group Management Association, told attendees at the MGMA 2014 annual conference Monday that increasing patient satisfaction was challenging, but necessary to the success of a medical practice in an increasingly competitive healthcare marketplace. "Identify low patient satisfaction scores and work as a team to design, implement and maintain solutions," she said. "But focus on the patients, not the scores."

Setting standards for customer service is essential to improving patient satisfaction, Hablutzel noted. The standards may be simple, but can transform the way in which staff interact with patients, as well as boost patient perception of the practice. Hablutzel walked MGMA 2014 attendees through 30 steps to increasing patient satisfaction, but emphasized that there are actually 10 "top" standards on which practice staff should focus.

  1. Smile and say 'hello' when patients arrive. This seems basic, but may be overlooked in many cases, if it is not established as an expectation of all staff. "Everyone likes to be acknowledged," Hablutzel noted.
  2. Answer the telephone in three rings with a consistent greeting. And "no blind transfers," Hablutzel said.
  3. Use the patient's name at least once during each conversation. Calling a patient by name emphasizes that the practice views them as an individual, not simply another generic patient, Hablutzel said. Of course, calling a patient by name must be done only when and where appropriate, so as not to violate confidentiality.
  4. Observe the patient's communication style and respond in a manner that will make the patient feel comfortable. Empathy is critical. It affirms to the patient that you are listening, and care about what she has to say.
  5. Explain to the patient what is going to happen next. It might be the patient's first time at the practice, or the first time for a particular procedure. As Hablutzel says, "forewarned is forearmed."
  6. Listen to the patient without interrupting them. Hablutzel says practice staff can often learn more from listening to patients than from asking questions. "Silence is OK," she said.
  7. Look for cues that may indicate that the patient is not satisfied or is concerned about something. Be proactive in responding to situations. If a patient has a problem or complaint, answering 'I don't know' is not acceptable. Find someone who can answer a patient's question.
  8. Respect patient confidentiality at all times. "HIPAA is for real," Hablutzel said. Many, if not most, topics surrounding a patient's visit are of a sensitive nature. Thus, staff need to understand the surroundings in which they are speaking with a patient, with an eye to preserving confidentiality.
  9. Do what you say you will do, when you say you will do it. Set time estimates for patients and update them on any changes. Apologize for any delays.
  10. When a patient leaves, say good-bye warmly and wish them well. If applicable, say that you look forward to seeing them again. This "closes the loop," affirms respect and gives staff an opportunity to acknowledge the patient once again by name.

The MEC approved the use of online education for physicians and advanced practice professionals (APPs).  Computer-based learning modules (CBLs) are available in NetLearning, the same software used by hospital staff to complete online education.  Advancing to online education is consistent with expectations to optimize technology including making access to information as efficient for you as possible.

The MEC approved two topics: Compliance Education and Target Zero. 

These CBLs are available to you in NetLearning and must be completed by December 31, 2014

The CBLs approved by MEC are mandatory, as they are essential to our mission of providing the most up to date and safest medical care to our community.  We need everyone informed and actively participating in our transformation from good to great. 

The Medical Staff Office created NetLearning user accounts on your behalf and user names and passcodes were sent to providers as recently as November 6. 

If you need to have the information re-sent, please contact the Medical Staff Office at (517) 788-4946 or MedicalStaffOffice@AllegianceHealth.org.

Over the past two and a half years the staff and providers of the Allegiance Women’s and Children’s Health have undergone an amazing transition in how they care for and support new mothers and their babies. As a result of their efforts, Allegiance Health is hoping to become the next hospital in Michigan to be designated as “Baby-Friendly.” This international designation signifies that a hospital provides optimal care practices and support to breastfeeding families during their hospital stay and beyond. Additionally, a Baby-Friendly hospital supports parents who have made an informed decision to use breast milk substitutes or formula. Through the Baby-Friendly Hospital Initiative, Allegiance Health is doing its part to:

  • Improve the health of the Jackson community
  • Achieve the national Healthy People 2020 goals to increase breastfeeding in the US
  • Perform well on the new Joint Commission Perinatal Care Core Measure on exclusive breastfeeding.

As a result of these efforts in the Labor and Delivery and Mother/Baby Unit, providers will have noticed a greater number of patients choosing to breastfeed.  A breastfeeding mother makes many providers nervous about the effect of various tests (e.g., IV contrast), procedures (e.g., general anesthesia), and medications on a baby who is nursing. Too many times, nursing mothers are told unnecessarily to stop breastfeeding or “pump and dump” their breast milk for a period of time. In response to such instructions, some mothers abandon breastfeeding altogether as they feel that their breast milk is dangerous for their baby. For others, their milk supply may decrease if baby is not nursing. The vast majority of the time these instructions are not necessary.

There are excellent resources available to providers about the compatibility of breastfeeding and various contrast agents, anesthetic agents and medications. These resources examine not only the impact of these agents on the nursing baby but also on a mother’s breast milk supply. Both resources are available as apps and can be downloaded to a smart phone or tablet:

  1. U.S National Library of Medicine - The LactMed® database contains information on drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate. All data are derived from the scientific literature and fully referenced. A peer review panel reviews the data to assure scientific validity and currency. Learn more and get the free LactMed app: http://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm.
  2. Infant Risk Center - Developed by the Texas Tech University Health Sciences Center’s Infant Risk Center, this app gives health care providers fast, convenient access to up-to-date and evidence-based information about prescription and non-prescription medications. Learn more by calling (806) 352-2519 and visiting www.infantrisk.com.

If you have any questions about breastfeeding and your patient population, please contact the Allegiance Health Lactation Consultants at 788-4940 or the Pediatric Hospitalist at extension 6378.

The Centers for Medicare and Medicaid Services (CMS) expanded coverage for Cardiac Rehabilitation service to patients with stable, chronic heart failure, effective February 18, 2014.

Medicare beneficiary patients with stable, chronic heart failure who meet all of the following criteria may be referred to Cardiac Rehabilitation:

  1. Left ventricular ejection fraction (EF) < 35%
  2. NYHA class II-IV symptoms despite being on optimal heart failure therapy for at least six weeks
  3. Medicare defines stable as:
    1. Not having a recent (<6 weeks) major cardiovascular hospitalizations or procedure
    2. Not having had a planned (<6 months) major cardiovascular hospitalization or procedure

The following information is needed when referring a patient with chronic heart failure to Cardiac Rehabilitation:

  1. Cardiac Rehab referral
    • Any patient diagnosed with stable, chronic heart failure on or after February 18, 2014 can be referred.
      • Proper diagnosis needs to be placed on referral
      • The patient must be medically stable in order to be referred to Cardiac Rehabilitation
  2. Proper documentation that meets all CMS criteria for entry into Cardiac Rehabilitation. Indication of proper NYHA classification, along with EF is needed.
  3. Documentation on how EF was obtained (e.g., echo, catheterization)
  4. An indication of any restrictions or limitations (e.g., fluid restrictions) the patient may have

If you have any questions, please contact Allegiance Cardiac Rehabilitation at (517) 788-4908.

Voting initiated at the September 23rd General Medical Staff meeting has concluded and the results are as follows: 

Chief of Staff:Mark Smith, MD
Chief of Staff-Elect:Andrew Caughey, MD
Secretary/Treasurer/Communications Officer:Ryan Beekman, MD (incumbent)
MEC Member-at-Large:Cathy Glick, MD (incumbent)

Quarterly General Medical Staff Meetings

The quarterly General Medical Staff meetings present an opportunity for physicians to meet new physicians, participate in medical staff governance, and work together to set the direction of healthcare in Jackson.  The Medical Staff Bylaws require members to attend two General Medical Staff meetings per year. 

The 2015 meeting dates are as follows:

  • Tuesday, March 24
  • Tuesday, June 23
  • Tuesday, September 22
  • Thursday, December 17

All meetings are held in the Anderson Building Auditorium. Dinner is served at 5:30 p.m. Meetings are from 6 - 8 p.m.

Additionally, every Clinical Service holds regular meetings. The meetings provide an opportunity to discuss topics of interest and importance to individual specialties.  Please do not hesitate to contact Medical Staff and Credentialing Services at 788-4946 if you would like a copy of the meeting dates.

Are you caring for (or do you know) patients with elbow and shoulder muscle tightness (spasticity) due to damage from a stroke? Allegiance Health Neurologist John Wald, MD, is conducting research to evaluate the safety and effectiveness of Botox for relieving this tightness. Study treatments are free and involvement will not exceed 20 weeks. Male and female patients between the ages of 18 and 80 and dealing with upper limb spasticity will be considered. Please contact Dr. Wald at 817-7620 or Allegiance Health Research at 841-1416.

Welcome New Physicians

  • Sameer Ahmed, MD – Internal Medicine (Hospitalist)
  • Tibero Frisoli, MD, Internal Medicine (Hospitalist)
  • Mohammad Hajjar, MD – Internal Medicine (Hospitalist)
  • Shraddha Jatwani, MD – Rheumatology
  • David Werho, MD – Pediatrics

Welcome New Advanced Practice Professionals

  • Noah Britton, PA – Emergency Medicine
  • Jessica Hull, NP – Psychiatry
  • Hillary Kast, PA – Occupational Health
  • Allison LeDuc, PA – Internal Medicine
  • Kelly Lufkin, PA – Emergency Medicine
  • Marta Metz, PA – Geriatrics
  • Megan Spicer, NP – Urology
  • Phillip Villanueva, PA – Emergency Medicine 

Washing your hands is the best and easiest way to help you stay well and prevent the spread of germs that can cause colds and flu.