Undercover Patient: Checking Your Practice’s Vital Signs

Written by on July 1, 2013 in Practice tips - No comments

PatientWEBThe patient experience should always be top priority.   Seeds are planted prior to the patient ever seeing the physician face to face.  You may be the most qualified, experienced and reputable physician however if your support staff does not reflect the same, the patient experience suffers.

As an EMT, I learned quickly just how important patient’s vital signs are.  As a practice administrator I learned the importance of vital signs within a hospital and practice.  As an “Undercover Patient” and “Patient Shadow” I’ve learned exactly what it takes to make a positive difference for each patient.

It can be as simple as a phone call to schedule an exam or a procedure that will make or break a first impression.

Recently I sat among a group of health care professionals and listened as they explained to me the pros and cons of the Pediatric Practice their children attend.  They shared that the physicians within the group are absolutely wonderful however they have to overlook their negative, resistant and unhelpful support staff.  They have considered changing practices all because of those employees but truly love the physicians.

Do you know how your patients are treated?   Well now, in the age of digital and social media, everyone can know almost immediately.

Patients can record their health care experience by going to www.CMS.gov and taking the HCAHPS: Patients’ Perspectives of Care Survey.

The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients’ perspectives of hospital care. HCAHPS (pronounced “H-caps”), also known as the CAHPS Hospital Survey, is a survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience. While many hospitals have collected information on patient satisfaction for their own internal use, until HCAHPS there was no national standard for collecting and publicly reporting information about patient experience of care that allowed valid comparisons to be made across hospitals locally, regionally and nationally.

Checking Your Practice’s Vital Signs

Heart Beat – compassion driven care

Breathing Rate – just as our heart and lungs must work together, the care team must work together to do what is best for each patient

Temperature – maintaining a consistently pleasant environment

Blood Pressure – keeping a positive attitude circulating throughout the facility even under pressure.

To obtain vital signs, a health care provider observes the patient, notates results and continues to monitor the patient.   The same technique is applied during an Undercover Patient Assessment.

When there are signs of distress, we need to take note, take the necessary measures to correct any issues before a negative patient experience occurs.   We should continue to monitor, making certain the same mistakes are not repeated.

By taking the straight A approach we:

  • Assess
  • Accept
  • Act upon

As an Undercover Patient, I will sometimes appear to be lost within a facility.  It is always interesting to see if and when someone asks if I need help.  Will they point me in the right direction or personally LEAD me to the next location?  That is what makes the difference.

I can sometimes be a difficult patient.   I doubt anyone has ever had to deal with one of those in real life.  Patients are nervous, afraid of the unknown as well as having financial concerns and other uncertainties.

I’ve witnessed patients arriving for their procedures, being NPO since midnight and yet are greeted at the registration by the smell of coffee being enjoyed by the patient representative.

When nurses start taking their lunch orders and the patient overhears, “the special today is chicken and dumplings” and they have not had anything to eat preparing for a procedure, one really begins to understand just how important the “little things” are.

I am happy to say that I have experienced many positive situations as an “UP,” unfortunately there have been numerous negative encounters as well as some very humorous occurrences as well.   In fact, prior to an exam before a colonoscopy, while the physician was washing his hands, I decided it was time to reveal myself as the Undercover Patient.   I also couldn’t believe my eyes as I watched a receptionist greet a new patient with a “crumby clip board” – the receptionist was enjoying her breakfast when a new patient interrupted, walking up to check in.  The receptionist handed over the clipboard, dusting the crumbs off while explaining, “those are crumbs from my breakfast, I’m sorry.”   There are plenty more stories that are teaching moments.  I do not share the names of facilities or employees but use these situations when teaching with a bit of humor.   In fact, I have been told that my alter ego “Gladys Friday” kicks off many staff meetings with her YouTube videos.  She paves the way with humor to open the eyes of employees and get them thinking about the way they may look from the other side and ways to improve.

Most times the physicians and management team are fully aware of the Undercover Patient however most do not wish to know my name, when I will arrive and which physician I will be seeing.  Most facilities want to obtain a true picture from the patient side.

Through experiences with my Daddy on the “Other Side of Health Care” – we could not measure the clinical skills of health care professionals but we could measure the way we felt when we were around those who truly cared.  We learned very quickly that the things that cost the least really mean the most.

By Denise Price Thomas

Denise Price Thomas brings with her 34+ years experience in healthcare.  She is Certified in Healthcare Management and was a surgical practice administrator, retiring after being employed there for 32 years. 

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