ASC earns Outpatient Surgery Magazine’s OR Excellence Award for Patient Satisfaction

November 20, 2009

The Orthopedic and Sports Surgery Center in Appleton, Wis., features a hotel-like recovery room and unparalleled service for patients and their families.

— Kent Steinriede

E-mail [email protected].

The secret to keeping patients and their families happy is personalized attention, from their first contact with the surgery center staff until long after they're back at home recuperating, says Angela Laux, RN, BSN, MSOLQ, director of quality for the Orthopedic and Sports Surgery Center in Appleton, Wis.

Indeed, patients in the center's total- and partial-joint program meet with Ms. Laux and other staffers 2 weeks before their scheduled operation. If necessary, Ms. Laux and her team go to patients' homes. They've traveled as far as 60 miles away. Family members are always at the first visit, and they get nearly as much attention as the patients. From that day on, patients and their families have cell phone numbers for Ms. Laux and the center's liaison between patients and the home healthcare agency that will help care for patients as soon as they get home. At the meeting, Ms. Laux discusses how to prepare for the procedure and also gathers information that will help make the day of surgery as pleasant as possible for patients and families. She asks them what magazines they like to read and what type of music they like to listen to, and gets recommendations on films to rent for family members who will be waiting during surgery and recovery. The day before surgery, someone from the center goes shopping for the patients and families, rents movies and downloads music from iTunes.

When a patient at West Hartford (Conn.) Surgery Center showed up for a reconstructive procedure with an infection that caused the case to be cancelled, she was disappointed. Not by the cancellation, but in not being able to have a chocolate frosted donut in the PACU. "So one of the staff ran out to Dunkin' Donuts and we turned a negative day into a few laughs for her," says Administrator Louise DeChesser, RN, BSED, CNOR, MS. Just a small example of the ASC's mantra: "We will do anything for our patients. Our patients are like family." ' At discharge, patients at the St. Joseph's Candler Health System eye surgery center get a satisfaction survey with a pre-addressed stamped envelope. More than 30% are returned, says Judith Braun, BS, BSN, BC, director of clinical operations of Dynasty Healthcare in Savannah, Ga., which manages the center. Ms. Braun posts results to give physicians feedback as needed. "We've been able to improve processes from wait time upon arrival to discharge time, patient education to explanation of charges." ' When Bristol (Conn.) Hospital's patient satisfaction coordinator questioned hospital personnel who underwent surgery there, the grades were glowing and consistent with patient satisfaction scores. "They believed that they were treated with respect," says Janet Brown, RN, MN, CNOR, director of clinical operations of perioperative services. "They felt that the staff was very responsive to their needs, engaged them in their care and were cognizant of their need for privacy." ' Beverly Funseth, RN, MBA, department administrator at KFH Sand Canyon Surgicenter in Irvine, Calif., shares her secrets to patient satisfaction: "The voice of a caring nurse calling preand post-op, pleasant greetings in admissions, smiles from all, passion and concern for every patient. Patients love warm blankets, attentive staff and doctors, timely surgeries. Finally, a rose presented to them at discharge puts the final touch on their positive care experience."

Ms. Laux spends about an hour educating patients about what will happen on the day of surgery and what to expect after the operation. "It's good to make them comfortable with what's coming," she says. Most patients receive enoxaparin sodium (Lovenox) for prophylaxis of deep vein thrombosis. The patients' out-of-pocket cost for enoxaparin sodium can range from nothing to $400, depending on their type of insurance. During pre-op screening visits, Ms. Laux gets the patients' insurance information and then contacts pharmacies to figure out how much each patient is going to have to pay. That way, there's no big surprise for the patient. If the cost of the drug is going to be a hardship, Ms. Laux checks to see if a patient is eligible for a program sponsored by the drug's manufacturer that allows some patients to receive enoxaparin sodium for free.

When patients or family members come from out of town, they stay in the spa-like hotel across the street from the center the night before surgery and the night afterward. The surgery center pays for the hotel, including anything they want from room service. This saves family members from having to get up early in order to arrive at the center at 6 a.m. Staying the night after surgery lets nervous family members get a good night's rest before hitting the road again.

Between the pre-op screening and the day of surgery, the liaison between patients and the homecare nursing company visits patients at home to make sure that it is safe for patients when they return. Often it's a matter of moving a few pieces of furniture and throw rugs, says Ms. Laux.

Hotel-like service On the day of surgery, total- and partial-joint patients check in to the Fox River Room, a hotel-like recovery suite where family members will spend most of the day. Each patient is assigned a nurse who will accompany them throughout the perioperative process and speak with family members several times during their visit. Patients and family appreciate the attention. "They have said they feel like they're the only ones in the building," says Ms. Laux.

The deluxe recovery suite has a large television and recliner, flowers, snacks, takeout menus from nearby restaurants and the magazines, music and films that the patient and family requested. "We try to make their stay here more individualized," says Ms. Laux. When they arrive, patients find a gift basket along with a duffel bag for their personal items, a coffee mug and a blanket that they can take home.

Supplying personalized entertainment for family members helps relieve some of the anxiety that they may experience while their loved one is in surgery. It makes passing the time much more pleasant than the typical waiting room experience that most people have. "We feel that that family's experience counts as much as the patient's," says Ms. Laux.

Total- and partial-joint patients appreciate the hotel-like atmosphere of the Fox River Room because sometimes they stay up to 23 hours at the center. Most joint patients stay 5 to 6 hours, but there's no rush to discharge them. "We leave it up to the patient," says Ms. Laux. At the same time, patients are encouraged to start moving around. "We have a very aggressive program," says Ms. Laux. "We're focused on getting them up and around."

Just how bad was it? When patients are ready to go home, the same nurse that has taken care of them all day gives the discharge instructions. When patients and family members get home, a homecare nurse is already there, ready to help with the transition. Patients are also discharged with 5 frozen dinner entrees from a home-meal replacement service. The next morning, Ms. Laux or a staff member calls patients to see how the first night went. Although patients are also in contact with surgeons and the home healthcare agency, someone from the surgery center calls every couple of days. By the time patients have their sutures removed, about 2 weeks after surgery, a staffer will have called at least 5 times. Patients appreciate the continued attention, says Ms. Laux. "The goal is that the patient isn't left 'out there.'"