provided. Patient expectations are about
individual, personal situations and are
looking for the “event” of healthcare.
Creating a “WOW” moment for the patient in healthcare should be the goal. It is
not necessarily about give-a-ways or free
coffee. Finding ways for sustainability of
the experience and the creation of new
ways to implement an experience is never
ending. It is about the behaviors of staff,
the smooth process, and the consistency
of both which will create that event for
Methodist Willowbrook Hospital in
Houston, Texas aggressively adopted
“Intentional Tools,” which are a combination of specific scripting and man-age-up techniques addressing questions
on the Press Ganey survey used during
patient hand offs. These combined tools
are used to improve patient satisfaction.
Using the Six Sigma DMAIC (Define,
Measure, Analyze, Improve, and Control)
process, opportunities for improvement
were identified. A two week focus pilot
was conducted specifically on areas identified through the Six Sigma process.
UHC Peer Group
2012 2011 2010 2009
Figure 1 • Outpatient satisfaction metrics.
To ensure initiatives were focused, a
retrospective review of outpatient imaging Press Ganey data was conducted
for the time period of January 1, 2012
through June 30, 2012 (Figure 2). Each
element captured on the survey was up-loaded as variables into an SPSS statistical
software program. Once loaded, correlational analysis was performed to identify
variables which could predict the overall
score with some statistical certainty.
While many hospitals have dedicated
outpatient imaging centers to separate
service lines, the imaging department
at Methodist Willowbrook is a hospital
based outpatient imaging department.
This means it shares both staff and room
resources for outpatients with the hospital
inpatients and emergency room patients.
Table 1 shows a breakdown of volume by
modality and patient type.
Press Ganey is the service used to
measure patient satisfaction. For the
last two years, the imaging department
(consisting of MRI, CT, ultrasound, nuclear medicine, and x-ray) had a mean
outpatient score of 91.2, placing them in
the 37th percentile ranking with University HealthSystem Consortium (UHC
is an alliance of 116 academic medical
centers and 276 of their affiliated hospitals representing approximately 90% of
the nation’s non-profit academic medical centers). Mammography and bone
density are considered a separate service
line and, due to their dedicated outpatient service type, were not included in
Methodist Wilowbrook has been able to
make improvements in outpatient satisfaction metrics (Figure 1), but with the bar
continuing to rise for superior scores there
was a need for a more focused approach.
TABLE 1. Volume by modality and patient type.
What was discovered was that a single
question could predict the overall score
of the survey with statistical significance
in three categories. The question was:
“Minutes after appointment before called
to test area.” The patient could select one
of six options: 0-5 minutes, 6-10 minutes,
11-15 minutes, 16-30 minutes, 31-60
minutes, or 61+ minutes.
Patients who selected 0-5 minutes
scored the department a 94.36 with a
standard deviation (SD) of 2.136. Those
who selected 6-10 minutes scored the
department an average of 94.98 with an
SD of 1.609 and those who selected 31-
60 minutes scored the department 85.32
with an SD of 12.9255. See Figure 3. It is
also important to note that the findings
of both the 0-5 minutes and the 31-60
minutes were statistically significant to
.001. The selection of 6-10 was statistically significant to .05. These findings
were consistent with a 2010 study where
long wait times were defined as greater
than 15 minutes delay. 2