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Patient Experience Case Study - St. Joseph’s Medical Center
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Treating Every Patient Like a "VIP" through Daily Senior Leader Rounds

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What was the challenge, opportunity or issue faced?

At. St. Joseph’s Medical Center in Stockton, California, we have worked for many years to improve our patient satisfaction scores with the results being relatively flat. We tried staff based teams, weekly management patient experience meetings, implementation of the nursing bundle, posting scores monthly, patient experience coaches… all with little success in making significant improvement to our patient satisfaction scores.

From 2008 - 2014, scores overall remained stagnant. Administration and the interprofessional leadership recognized that we needed to do something drastically different to change the culture and transform the experience of the patients who come to our facility. St. Joseph’s Medical Center needed a solution to drive consistency throughout the organization, giving the opportunity to gain the full-intended benefits that hourly rounding brings to nurses, patients, and family.

What did you do to address it?

Senior Leader Rounding is a team approach to touching and connecting with every patient, every day in the inpatient units, PACU and Emergency department at St. Joseph's Medical Center. This includes approximately 200-250 patients per day.

Thirty six leaders (including the entire executive team, all directors and select managers) have team assignments in one of the 15 clinical areas in the hospital. There are 10 designated substitutes. Every weekday from 9-10 AM is established as the "Golden Hour" and no meetings are held.

Leaders gather in their assigned units and divide the patients among their team so that every patient is visited. The leader welcomes each patient, sits down with them and asks how their stay is going. The leader encourages the patients to share their perceptions to improve care and elicits concerns. If issues or problems are brought up, the leader writes notes and lets the patient know what the follow up will be.

At the end of the visit, they thank the patient for the honor of providing care and give their business card. The leader makes a "connection" and the goal is that every patient feels like a "VIP" and has access to a senior leader.

We have seen leaders pray with patients, sing to them and assist in physical care. At 9:45 AM the entire group comes together every day for a short debrief and discusses each unit with specific patient issues, comments or suggestions. Staff and/or safety issues are also addressed. Assignments are made for follow-up and leaders are asked to "close the loop” with their patients.

What were the outcomes?

The outcomes of doing rounds this way is that the staff sees leaders focusing every day on what is most important—THEIR PATIENTS! Leaders are taught to be a member of the team—to help in any way they can — even a warm blanket or getting ice chips is appreciated.

Golden Hour Senior Leader Rounds have been incredibly transformative for the organization. For clinical and non-clinical leaders alike, going in to touch and build relationships with patients and families has been very fulfilling. After the first month, the director of Pharmacy, who has been with the organization for 30 years commented, "Wow, this is absolutely the best part of my day now!” This connects leaders back to our core mission.

The daily debrief has become an active, interdisciplinary forum to focus on patient and environmental issues and work on immediately fixing the problems. Inconsistencies with practice issues have been identified and specific patient or family issues brought up and problem solved. Leaders have solved countless individual patient and family concerns, from small things like dissatisfaction with the food, to larger issues such as a patient not understanding his or her plan of care from the physician.

This process has connected leaders to the organization's core values, has reinvigorated the patient and family advisory council and has been seen positively by staff. Positive compliments from patients are immediately addressed with staff in the form of a "Star Buck” (which can be used at the coffee cart or cafeteria) plus a hand written note acknowledging the staff for their wonderful care.

Scores for all eight domains of HCAHPS have improved in 2015, with statistically significant improvements in: overall satisfaction, communication with doctors, communication with nurses, and cleanliness and quietness.

> View St. Joseph's Medical Center's Patient Satisfaction Scores

About St. Joseph’s Medical Center

St. Joseph’s Medical Center is a not-for-profit, fully accredited, regional hospital with 337 beds, a physician staff of over 400 and more than 2,000 employees. St. Joseph's specializes in cardiovascular care, comprehensive cancer services and women and children’s services including neonatal intensive care (NICU). St. Joseph’s Medical Center is the largest hospital, as well as one of the largest private employers in San Joaquin County. In addition to being nationally recognized as a quality leader, St. Joseph’s is consistently chosen as the "most preferred hospital” by local consumers. Founded in 1899 by Fr. William O’Connor and administered by the Dominican Sisters of San Rafael, St. Joseph's continues to lead the region in medical innovation as well as ongoing clinical research, developing tomorrow's advancements, today.

St. Joseph’s Medical Center is committed to delivering compassionate, high-quality, affordable healthcare services with special attention to the poor and underserved. In 2014, St. Joseph’s provided over $38 million in charity care, community services and unreimbursed patient care. St. Joseph’s Medical Center is a member of Dignity Health, a system of ancillary care sites, medical foundations and acute care hospitals serving California, Arizona and Nevada. For more information, please visit our website at

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