Patient experience: Personal philosophy, leadership drive improvement


Improving the patient experience is more than a business mission for Michael Macht-Greenberg, Ph.D. It's personal.

As a trained psychologist, the vice president of patient access services at Lahey Hospital & Medical Center in Burlington, Massachusetts has a unique perspective about what his organization can and should do to provide care based on the patient's point of view.

"I think first as a provider, healthcare administrator, a patient and father of patients," Macht-Greenberg said during an exclusive interview. "On some level we are grateful that we have these wonderful providers to take care of ourselves and deal with our healthcare needs, but sometimes feel frustrated as to what we perceive as the bureaucracy of healthcare and we figure there is a better way to run things."

As a result, Macht-Greenberg (pictured left) urges Lahey employees to put themselves in the patient's shoes to give all patients and their families the best experience possible.

He joined the physical-led, nonprofit group practice two years ago when the organization decided to create the position and focus on improving patient access. The organization includes 500 physicians and 5,000 nurses who work in the Burlington ambulatory care center, 317-bed hospital and Level II trauma center, as well as a medical center in nearby Peabody that includes a 10-bed hospital and 24-hour emergency department.

And he has the full support of the executive leadership who provided his department with necessary resources and backing to make necessary changes. The leadership suppport, he says, is essential to success of the intiatives.

"What I found when I first got here was there were a lot of people dedicated to the tasks they were hired to perform. Lahey has a wonderful culture of retaining colleagues for many years. But in many ways they were focused more singularly in an area, without guiding principle or a philosophy, or overarching management structure to bring more welcoming business processes," he said.

Lahey's new guiding principle is, "It's a relationship; not a transaction."

Under his guidance, Lahey revamped its patient access services department to ensure that staff greet patients at the hospital and over the phone in the friendliest, most helpful and most responsive manner. The hospital's call center now has less than a four percent abandonment rate and less than a 30 second wait on average, compared to a call abandonment rate of 20 percent and two minute wait just a few years ago.

The patient access department offers staff members continual training and ongoing feedback. Lahey also developed an etiquette program within its call center and created an assessment team that explains to the frontline staff exactly what the organization expects in terms of patient engagement. "In the past year we've recorded phone calls for quality monitoring to hear how they engage staff [and] we've had a secret shopping program in clinics where staff less known to each other can observe how staff welcome and engage folks," he said.

The organization has made good progress on the etiquette initiative since it launched the program more than a year ago, according to Macht-Greenberg. "When we first developed it, we had a baseline measurement of staff compliance at 45 percent. Now we have compliance rates of middle to high 80 percentile on our telephone scores and in our reception areas. We have a target to exceed 90 percent compliance," he said.

Another key component of the patient access overhaul was to improve the interpreter services offered through its ambulatory clinic. In the last 18 months, Lahey has shifted from a model using contracted agencies for translation services to hiring its own team of 25 interpreters that can offer face-to-face translation in 16 languages.

In addition, the interpreters are now translating documents that are part of patient-family documentation and becoming involved in staff education and diversity awareness training.

"What's exciting is by having a vibrant group of staff interpreters we've reduced cost of interpretation services per visit by 30 percent," he said. "I feel very strongly that interpreter services is a key part of patient access. If you can't talk to your healthcare provider or understand what your healthcare provider is saying, you can't be patient centered [organization] ... It's not only a business win of cost savings, it a really putting the patient first by going to the extra trouble to hire staff who understand what the patient is talking about. That's what I'm the proudest of." --Ilene (@FierceHealth)

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