Monday, July 24, 2017

A Leader's Role in the Patient Experience

Healthcare is a highly regulated and in some cases, a highly competitive environment.  Healthcare delivery is changing at a rapid pace. Healthcare leaders are learning how to adapt and lead their hospitals into the future.  The center for Medicare services over the last few years adapted the Hospital Consumer Assessment of Healthcare Providers and Systems; better known as HCAPHS patient satisfaction scores to tie patient satisfaction in the calculation of reimbursement for patient stays (CMS, 2015).

Hospitals in competitive environments focus on how to deliver care and stand out from the competition. Additionally, social media has changed how patients share their healthcare experiences.  Patients can praise or complain about their hospital experiences on Facebook, Twitter, Instagram and the like.

Leaders are in a great position to help staff understand the importance of patient experience to an organization, whether it be to improve overall scores or patient perception. Quality care is increasingly linked to efficiency, cost reduction and optimal utilization of resources. Healthcare quality care programs and metrics are increasingly influenced by financial incentives and measured by state of the art scientific tools and sophisticated methodologies. (Belasen, Eisenberg & Huppertz, 2016 p 144)
Patients and families view their experience of care in its entirety: The clinical treatment, the interactions with staff, and the physical and ambient environment all tie together as one, overall impression and journey. Leaders and caregivers who commit to observing and learning in detail about this journey quickly identify what needs to improve to create a better experience. (IHI, 2011)

How can you as a leader showcase the importance of patient experience in your workplace? Interpersonal relationships can go a long way to helping organizations improve scores. Effective leaders practice with conviction, and demonstrate the importance of the caregiver/patient relationship.

 An important leadership quality is social intelligence. “Socially intelligent leaders have strong conversation and listening skills, a keen understanding of social roles and rules, confidence in interacting with different types of people and a fine-tuned ability to understand other’s thoughts and feelings.” (Sowick et al, 2015) One of my favorite quotes is from Maya Angelou “I have learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”  This statement holds true not only to the patient’s we serve but also how we as leaders serve our teams.

 Leaders of today must use both transactional leadership skills and transformational leadership skills to be an effective leader in today’s workplace.  Being the vison setter to bring new ideas forward, to have the courage to lead by example and advocate for employees and patients will go a long way toward improving not only the patient but staff experience.


Balik, B. (2011, July). Institute for Healthcare improvement, Patient Safety Reprinted from
Belasen, A. T., Eisenberg, B, Huppertz, J. W., (2016). Mastering Leadership: A Vital Resource for Health Care Organizations, pgs.
Sowick, M, Andenoro, A, McNutt, M, Murphy, S.E (2015) Leadership 2050: Critical Challenges, Key Contexts, and Emerging Trends; Emerald Group

Provided by Robyn McDevitt, Graduate Student, Saint Joseph's College

Tuesday, July 18, 2017

There is Hope!!

Lately, I pondered the question of “….how would the retiring Boomer Long-Term Post-Acute Care (LTPAC) leaders be replaced….?"  With the average age of administrator’s being in their 50’s, this is a real challenge for licensure boards, employers and educators.  Public policy makers will need to find some solutions to this complex problem.

I had the opportunity to work with a number of students who are majoring in healthcare administration and are going out on a one-year practicum.  I found them to be a delight to teach, but also to learn from.  They are bright, focused,  passionate about the LTPAC sector and were excited to learn about the profession.

It was enlightening and heartening to interact with this group, as they progressed in their studies.  They asked great questions, researched many of the challenges facing our sector, and suggested innovative methods to approach some of the difficult issues facing the LTPAC sector. 

What has been encouraging to me was that the students were from the millennial generation and very interested in an aging services career!   There have been some articles and suggestions about the characteristics of this coming generation that were considered to be negative, when compared to Boomers.   I did not find the “generalities” about millennials that have been suggested to be true nor accurate.  They were serious with their studies, willing to learn, and excited about working in the sector. 

It gave me considerable comfort that these students will make great leaders in the LTPAC sector.  Now the question is how do we find more of the millennials that will be willing to prepare to learn and enter this profession?

Submitted by Steven Chies, Faculty at Saint Joseph's College

Friday, July 07, 2017

The New Moon in Healthcare

The Medicare Outpatient Observation Notice (MOON) came out earlier this year and this is something that always comes up as a question and not many know where to find the answers.

Medicare put out a MLN article in February for Critical Access Hospitals (CAHs) that provide observation services to Medicare Beneficiaries. The main point of this article was to identify and drive home a clear and concise message covering how providers in CAH facilities should utilize the MOON to educate Medicare beneficiaries. CAH providers should use the MOON to inform any Medicare beneficiary who is an outpatient in their facility that happens to be receiving observation services and are not an inpatient in the CAH or hospital.

Hospitals and CAHs must provide the MOON to beneficiaries who receive observation services in a CAH or hospital for more than 24 hours. This form must be provided to the Medicare beneficiary no later than 36 hours after observation services begin in the outpatient setting. Now, this is not only for the traditional Medicare Part A and Part B patient, but those beneficiaries that do not have Part B coverage, as this is optional, and when a patient is admitted prior to the required delivery of the MOON.

Now, one may think, let’s give these to all of our Medicare patients receiving outpatient services. This will not work as the MOON should not go to all beneficiaries receiving outpatient services. It is intended only for patients that exceed 24 hours of observation services. But here is a good twist, the CAH or hospital can deliver the MOON to Medicare beneficiaries that are receiving observation services in a CAH or hospital, but have not exceeded the 24 hour rule. As long as they are receiving observation services the CAH or hospital can deliver the MOON to the patient, but no later than 36 hours after observation services have started.

Some other points:
  • The MOON must remain two pages
  • Additional information may be attached, per individual state regulations
  • Hospitals and CAHs can put their logo on the top of the MOON
  • In completing the MOON, hospitals or CAHs must type or write (clearly) the patient name, patient number, and reason for outpatient in the blanks of the MOON.
  • CAHs and hospitals must provide, not only the written MOON, but an oral notification as well. This must consist of an explanation of the standard written MOON.
  • To show proof of delivery, the patient or representative must sign and date the MOON to show delivery and understanding of the information contained in the form.
  • An electronic form of the MOON is permitted with an electronic signature capture pad.
  • With an electronic form of the MOON, the patient must receive a paper copy as well.
If a patient or their representative refuses to sign the MOON, the facility representative can sign the document, state their title, date and time presented to the patient, and the staff member will note in the “Additional Information” portion of the MOON that the form was delivered and the patient refused to sign, then date and time of refusal will be noted as well.

This is very similar to other forms for CMS, such as an Advance Beneficiary Notice (ABN), and the same care must be taken to remain in compliance with CMS and to make sure you are keeping your patients educated.
Submitted by Kevin Harrington, MS, RHIA, CHP, Faculty, Saint Joseph's College