University of Wisconsin–Madison Medical College of Wisconsin

Optimizing Inpatient Patient Experience

Precious Anyanwu, BS; Sparsh Jain, BS; Sushma Raju, MD; Sanjay Bhandari, MD; Jeanette Carreras, MPH; Pinky Jha, MD, MPH; Barbara Slawski, MD

WMJ. 2024;123(1):3.

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Dear Editor:

Quality of patient care, service, and communication is critical for patient satisfaction. This is tied to several benefits for the health system, including increased patient compliance, loyalty, referral to new patients, and improved clinical productivity. The efficacy of a hospital is often dependent on the admitted patients’ experiences with different clinicians. These experiences factor into the patients’ likelihood to refer the clinician to other potential patrons. Patients are likely to refer a clinician when they feel heard and included in the decision-making process. When patient satisfaction is low, it is reflected in the percentage of the “likelihood to refer.” A below-average score indicates a need to address departmental practices and potentially change how clinicians interact with their patients. A cross-sectional study by Leow and Liew noted that the length of time a physician spends with their patient is one of the strongest determinants for patient satisfaction.1

At Froedtert Hospital in Milwaukee, Wisconsin, the 9NT medicine floor continuously reported a likelihood to refer score between 50% and 67% from July 2022 through January 2023, with 76% being the desired goal. To improve likelihood to refer parameter, we started a project in February 2023 focusing on improving clinicians’ scores by interventions to promote the communication between clinicians and their patients. We implemented 3 focused intervention strategies to target patient satisfaction improvement. First, physicians should press the “Provider in room” button on the Rauland’s panel upon entering a patient’s room, which alerts the bedside nurse to come into the room. The physician then discusses the plan of care (POC) with the patient and nurse, utilizing this time to address any questions or concerns intentionally focused on shared decision-making and collaboration. Next, the clinician should update the whiteboard with the patient’s POC for the day and the expected discharge date and place. Then, at the end of the day, the physician will re-connect with the patient either in person or via the patient’s in-room phone. During this time, the physician will share potential POC updates and ask if any changes occurred and if they can assist with anything before departing for the day.

Prior to introduction of these interventions, “the likelihood to refer” percentage consistently remained below 67%. Within the first month of implementation of this pilot project, this rate increased to 75%. Throughout the study span, the “likelihood to refer” for 9NT reached 78%, surpassing the desired target.

With 3 targeted intervention tactics, an increased “likelihood to refer” percentage demonstrates improved patient satisfaction. Based on the successful pilot project, we are implementing this on all medicine units at the hospital. This initiative will enhance the efficiency and productivity of the institution, improve patient retention, and foster trust between patients and their medical care team.

  1. Leow HT, Liew SM. A cross sectional study on patient satisfaction and its association with length of consultation at the University Malaya Medical Centre Primary Care Clinic. Malays Fam Physician. 2022;17(2):71-80. doi:10.51866/oa1339.

Author Affiliations: Medical College of Wisconsin, Milwaukee, Wisconsin (Anyanwu, Jain, Bhandari, Carreras, Jha, Slawski).
Corresponding Author: Pinky Jha, MD, MPH, Section of Hospital Medicine, Division of General Internal Medicine, Medical College of Wisconsin HUB for Collaborative Medicine, 7th Floor, 8701 W Watertown Plank Rd, Milwaukee, WI 53226; phone 414.955.0356; email; ORCID ID 0000-0002-7893-188X
Financial Disclosures: None declared.
Funding/Support: None declared.
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