Understanding the patient’s perceptions about their care is central to how providers deliver on the promise of providing safe, high quality, patient-centered care. At Mount Sinai West, more than 9,000 ambulatory surgery patients received care in 2021, and the number has grown year over year—a 51 percent growth since 2018. Ambulatory surgeries are expected to continue to grow, with the increasing numbers of innovative procedures that can now be done without requiring an overnight hospital admission.
To continuously advance patient care, the Mount Sinai Health System uses the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey to gather feedback from patients about their experience. The survey includes questions about patients’ experiences with their preparation for the surgery or procedure, check-in processes, cleanliness of the facility, communications with the facility staff, discharge from the facility, and preparation for recovering at home. The survey also includes questions about whether patients received information about what to do if they had possible side effects during their recovery. Reviewing this feedback is a best practice at all organizations, and it is essential to better understand how patients experience their care and where gaps can be improved.
With the leadership of Leah Borenstein, Vice President of Perioperative Services, and Donald Kastenbaum, MD, Vice President and Medical Director of Perioperative Services, the perioperative team at Mount Sinai West has been undergoing a transformative journey to elevate conversations about the patient experience. In partnership with the Office of Patient Experience and Press Ganey, both Ms. Borenstein and Dr. Kastenbaum have been instrumental in not only gaining a deeper understanding of the patient experience but also spreading that insight among the teams who are working in perioperative services and prioritizing process-improvement work.
“Advancing technologies and highest quality care in the safest environment—today, this is not enough. We must continually work to develop team concepts and then analyze our ability to provide every aspect of each patient’s needs,” Dr. Kastenbaum says. “When providers and staff can understand each patient’s expectations and meet and exceed them—these will be the health systems where patients want to be treated.”
“We must continually work to develop team concepts and then analyze our ability to provide every aspect of each patient’s needs.”
- Donald Kastenbaum, MD
Using insights from the Press Ganey database, as well as complaint/grievance data from the Office of Patient Relations, the Mount Sinai West team found that patients often provided feedback that they did not have all of the important information needed when they were discharged home after their surgery or procedure. This information included how to properly care for their surgical incision, signs and symptoms of a possible infection, and how to contact their clinical team. An improvement project was established, with each surgical specialty asked to create or update their discharge instructions with specific details related to the patient’s case.
“This project was extremely successful and improved our patients' experience by ensuring they have all the information needed for a seamless recovery,” Ms. Borenstein says.
Family members also play an important role in a patient's experience, often serving as the primary support person. To meet their need for information, a text-messaging feature was launched in 2021 that would provide updates on their loved one’s care. The support person often felt they could not leave the surgical waiting room, fearing that they would miss an update. With the new system, they can leave with the assurance they will know when their loved one’s surgery starts and ends and when the patient arrives in the recovery room. “Communication and managing our patient and family expectations is one of the foundations of patient experience, and this technology implementation has proven to be very successful thus far,” Dr. Kastenbaum says.
Looking ahead to 2022, the patient experience will continue to be a priority. One of the first projects will be to collaborate with the Health Systems and Process Improvement team to create an in-depth systematic journey map for a patient having ambulatory surgery. Understanding all of the touchpoints that patients have with staff and technology will lead to a greater understanding of where the hospital can remove redundancies and make things more efficient—for both the patient and the staff. In-services will continue with each department involved in a patient’s journey in ambulatory surgery to make sure that the patient experience is always part of the conversation and that staff are familiar with all of the resources to support them and their patients, including Language Services and Patient Relations.
Through the COVID-19 surges, the perioperative teams have continued to prioritize the patient experience and ensure they are continuously providing a safe and compassionate environment. “They are a team of providers, nurses, registration staff, environmental services, and so many others who know that teamwork and agility are paramount to support each other as colleagues and the patients we have the privilege to serve,” Dr. Kastenbaum says.