Arkansas Hospitals Association Health & Science

Rural Patients’ Superheroes: Critical Access Hospitals Earn 5-Star Ratings

Brian “Superhero” Lee (front) joins the CAH Workshop attendees, along with AFMC, AHA and ADH staff.

By Michelle Sharp, MSN, RN, CPPS, and Mandy Palmer, RN, CPHQ, CPPS, Arkansas Foundation for Medical Care

The Medicare Beneficiary Quality Improvement Program (MBQIP), overseen by Medicare’s Rural Hospital Flexibility Program (Flex), focuses on improving quality of care in critical access hospitals (CAHs) in four domains: patient safety, patient engagement, care transitions and outpatient care. All 29 Arkansas CAHs participate in the MBQIP program by reporting data and actively working to improve care in rural areas.

The patient engagement domain includes the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, a standardized survey that measures patients’ perception of their hospital experience. The survey is important because it demonstrates the patients’ voice. There is growing evidence of a positive association between patient experience and health outcomes, quality of care, and adherence to treatment and preventive care.

The Arkansas Foundation for Medical Care (AFMC), under contract with the Arkansas Department of Health’s Office of Rural Health and Primary Care, recently hosted an annual CAH workshop. Bringing together Arkansas CAHs, the workshop provided an opportunity to gain knowledge and share experiences that reflect the MBQIP program and focus on HCAHPS.

The event featured nationally recognized speaker Brian Lee, CEO of Custom Learning Systems. Mr. Lee presented his innovative approach, which weaves together the patient experience and patient engagement to change hospital culture. It focuses on three cornerstones of engagement: engage, empower and transform. CAHs were inspired to push through the challenges that small, rural hospitals face.

Attendees left the workshop with several key ideas and interventions, including:
• Appoint a patient experience council to make patient experience a top priority; be sure it’s supported by management.
• Know your HCAHPS scores and share results with all staff, including reading patients’ comments at staff meetings.
• Educate staff about HCAHPS, recognizing that all staff are caregivers and patient experience is everyone’s job.
• As leaders, empower staff to impact HCAHPS domains.

Some specific innovative ideas to empower staff include:
• Issue a “License to Silence,” expecting everyone to speak in gentler tones and report noise.
• Create a “No Pass Zone,” expecting any staff to offer assistance with call lights.
• Issue “Freedom to Clean” cards, empowering everyone to be housekeepers.
• Implement a rewards program, “Pain Care Angels,” recognizing staff for compassion, recognition and pain treatment.
• Allow staff to “own” recovery by developing patient advocates.
• Wear vests during medication pass that signal “do not disturb me,” to prevent errors.
• Use the best quality folders with your hospital logo for discharge packets.

Sit down with patients and talk to them daily. “When you sit, you’re heart to heart,” Mr. Lee said.

Arkansas CAHs perform as well or better than the nation in HCAHPS. Over the past few years, several Arkansas CAHs have achieved a Five-Star HCAHPS rating, placing them among the top 6% of hospitals in the nation. Most recently, this included CrossRidge Community Hospital in Wynne and Mercy Hospital Berryville.

Representatives of Mercy Hospital Berryville’s patient engagement team are (left to right) Kathy Brown, Tyler Tanner, Delano Richardson, Tony White, Suellyn Fry, Dr. Richard Taylor, Joyce Eggert, Sherry Cooper, Laura Farmer, Dr. William Flake, Keresa Phillippe, Cindy Kendrick and Vickie Allen.

CrossRidge Community Hospital has strong community support. Active leadership engagement is reflected in the staff’s attitudes and beliefs. Pat Hamilton, quality director, says, “Our CEO is so eager to use data that he frequently asks for it before it’s even available.”

CrossRidge’s successful patient-centered processes include purposeful hourly rounds, communication white boards, bedside reports, discharge phone calls and patient thank you cards. Additionally, the hospital focuses on HCAHPS comments for improvements, including stoplight noise meters for noise reduction and upgrading patient amenities like vending and cable services. The hospital displays quarterly HCAHPS scores and celebrates with pizza and ice cream parties. Most recently, they created a banner picturing all employees. It hangs in their main hallway for all to see, stating, “We are ALL the Patient Experience.”

At Mercy Hospital Berryville, leadership places a strong emphasis on exceptional care and the importance of a great patient experience, recognizing that patients have a choice of where they receive care. Leadership routinely makes rounds to all departments and holds roundtable discussions where all staff are invited to meet and share ideas or concerns regarding the patient experience.

The culture at Mercy is rooted in a focus on process improvement, recognizing that patient perception may not always match the intention. Because of this, front line staff in every department are expected to play a role in improving the patient experience and carrying out Mercy’s mission.
Staff appreciation is demonstrated during “Spirit Days” and “Opportunities for Fun” events throughout the year. A staff-developed program allows peer recognition of excellence through selection of a monthly “Shining Star.”

Leadership is fundamental to improving the patient experience and improving quality outcomes. Mr. Lee said it best: “Your people can’t care about what they don’t know about. Your role as a leader is to educate your people to know and inspire them to care.”

Janet Perry (left), Outreach Services Director, and Pat Hamilton, Quality Director, are proud of CrossRidge Hospital’s patient engagement banner.

Michelle Sharp is an Outreach Specialist and Mandy Palmer is Manager of Outreach Quality at the Arkansas Foundation for Medical Care.


The above article is from AHA, a custom publication of Vowell, Inc., which also produces Arkansas Money & Politics.

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