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Improving the Patient Experience

San Mateo Medical Center (SMMC) began its patient experience journey in October 2011, when it joined the Safety Net Institute/California Association of Public Hospitals Patient Experience Transformation (PExT) initiative. After consulting with patients, an SMMC team targeted five key areas for improvement, which led to five consecutive quarters of improved patient satisfaction scores.

Through focus groups and one-on-one interviews, SMMC patients identified the top five areas for improvement in patient experience:

  1. patient/nurse communication;
  2. care coordination;
  3. shift-to-shift communication;
  4. patient/physician communication; and
  5. staff recognition.

To address gaps in these areas, the SMMC team implemented “always events,” including:

  • shift huddles;
  • “hellos and goodbyes,” when all nurses make the rounds immediately following shift huddles to greet their patients and review goals;
  • a communications binder, which augments the information shared during huddles;
  • improved nurse/provider communication; and
  • “Walk in Their Shoes,” where leaders shadow clinical staff to identify front line challenges.

These strategies not only led to a 4.6 percent improvement in patient satisfaction from the first quarter of 2012 to the second quarter of 2013, but they also fostered a culture that emphasized teamwork, patient and staff engagement, quality, and safety.

According to SMMC’s clinical services manager, convening shift huddles impacted quality and safety most because they ensure the team is aware of potential safety events and prepared to respond if a patient’s condition changes. The manager adds that quality, safety, staff experience, and patient experience go hand in hand, noting that heightening staff’s situational awareness might improve their job satisfaction, which in turn might lead to improvements in patient experience.

Although SMMC saw its first decrease in patient satisfaction scores since October 2011 in the third quarter of 2013, the organization continues to make patient experience a priority and is working to identify possible reasons for the decline. For example, unit coordinators visit patient rooms and conduct mini surveys so they can address patient needs — which often include quality and safety concerns — immediately, allowing staff to prevent possible harm events.


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