Hospital will be paid more next year for satisfied customers

Laurens County Health Care System's renewed emphasis on customer service pays off.

Six years ago, the Laurens County Health Care System began a renewed emphasis on customer service and it's paid off with the hospital's ranking in annual customer service surveys soaring. Beginning next year, the payoff will be real.

CEO Rich D'Alberto told the hospital board last week that, starting in 2013, CMS (the federal Center for Medicare and Medicaid Services) will withhold a portion of every hospital's Medicare reimbursement payment and hospitals will earn the money back based on scored given for customer service and patient outcomes.

If a hospital does poorly, they won't receive any of the money back. If they do well, they can earn all their money back and even part of the money withheld from a hospital that does poorly, the CEO said.

"In the future, we'll be paid based on how well we do in quality scores and customer service scores," he said.

CMS will withhold $67,000 from LCHCS next year, D'Alberto said, and by 2017, the amount will be as high as $200,000. He said, based on a trial run of LCHCS's scores, the local hospital will receive some, but not all, of the $67,000 back.

The scores will be based on national benchmarks (the highest achievement levels nationally) and national thresholds (the minimum achievement levels).

"I think it's a good idea," D'Alberto said. The new procedure is part of the Affordable Care Act.

D'Alberto made a presentation to the board on customer service and quality reporting and the internal changes that have been made at LCHCS.

The hospital has begun a new service excellence program this year as the sixth year of emphasis on customer service.

The first year, employees taught each other basic customer service ideas, while the second year emphasized ways to make the patient experience more positive.

The third year dealt with how employees can control stress, followed by a fourth year review.

In the fifth year, the hospital implemented the LEAN program to identify and remove waste.

This year's program is JUST Culture designed to make it easier for employees and physicians alike to report mistakes.

"There's not anyone here who would make a mistake on purpose," D'Alberto said. "But mistakes are made and we want to correct them as quickly as possible. We want things reported without fear of reprimand.

"If a procedure need to be changed, let's find out the cause and fix it," he said. "If someone needs to be retrained, let's retrain them."

D'Alberto is holding CEO Roundtable meetings to hold managers accountable and to give them the opportunity to listen to each other. "We can help each other learn from each other," he said.

Each department head is looking at the department's top three areas of "dissatisfied" scores in the most recent Press Gainey customer survey.

The board's Quality Committee has also been restructured and will receive standard reports quarterly.

D'Alberto said Dr. Michelle Hagenbuch, chief of the medical staff, has been leading the physicians through their role in the process.

"They shouldn't be afraid to report something wrong if the staff makes mistakes, but like the staff shouldn't be afraid (to report it) if the doctor does something wrong," D'Alberto said.

The parameters of peer review are set by the medical staff and not by the hospital administration, he said.

Just as the physicians take a detailed look at every death in the hospital, the medical staff is conducting a root cause analysis of every incident when a mistake happens.

"If something happens, we look at every step to see if something went wrong and how to fix it," D'Alberto said. "Usually when something happens, it's (because) a number of little things that went wrong."

This story first appeared in Clinton Chronicle.