A medical institution received outstanding results in all three patient experience evaluations. It’s Inha University Hospital.

Inha University Hospital’s grades went up as the evaluation continued, and the hospital rose to “first place” in the third patient experience assessment conducted by the Health Insurance Review and Assessment Service this year. The hospital scored more than 90 points in four of the six categories.

Notably, it won the highest score of 93.29 points in the overall assessment composed of questions, such as whether the patients would recommend the hospital to their family or friends. In addition, Inha University Hospital got the highest score among 45 tertiary hospitals.

In a recent interview with Korea Biomedical Review, Professor Kim Cheol-woo of the Department of the Allergy and Clinical Immunology, who experienced two patient experience evaluations at the hospital’s Division of Medical Innovation, attributed it to the hospital’s consistent efforts to create a “patient-centered culture.” Professor Kim also served as director of the division.

Inha University Hospital has provided medical interview consulting for specialists since 2015 when there were no patient experience evaluations. Besides, it has conducted satisfaction surveys on inpatients and outpatients and improved systems and services based on their results. The hospital also received assistance from polling agencies in the process.

Kim emphasized that there must be a “belief that we must reflect and practice” instead of “listening to opinions and calling it a day.” That enabled them to induce changes from inside, he added.

Inha University Hospital plans to share its “secrets” in showing excellent performances in patient experience evaluation at the Hospital Innovation and Patient Experience Conference (HiPex) 2022 from Oct.26-28.

Question: Inha University Hospital showed well in the second and third patient experience evaluations while you served as the deputy director and director of the Medical Innovation Division. Notably, your hospital took the top position in the third evaluation.

Answer: All this was thanks to employees who work hard in the field. So, I always feel grateful rather than becoming happy or sad about evaluation results.

The workload has been reduced due to partial reorganization than when I was the director of the Medical Innovation Division. At the time, the division was composed of three teams – the Service Innovation Team, responsible for patient-centered activities and patient experience, the Value Innovation Team, responsible for patient safety and quality upgrade, and the Optimal Treatment Team, responsible for insurance claims and cutback management. All three teams were the hospital’s core departments and handled lots of work. Considering the enormous workload, I focused on giving the team members opportunities to become experts in their respective fields and improving hospital systems instead of clinging to short-term attainments.

As a result, all teams could get good results in their areas. We did not prepare for a short time to receive good grades in patient experience evaluations. Rather the hospital has made continuous efforts to create a “patient experience and patient-centered culture,” and the “No. 1 in Korea” title seemed to be its natural consequence. It was an honor for me but was the result of active participation by team members and the entire hospital staff. I appreciate them once again for their efforts.

Q: Inha University Hospital received far higher marks in the third evaluation than in the first and second ones. What was the difference in the third round?

A: There was nothing special. On the contrary, we tried to be “faithful to basics” while checking our existing activities again. Still, we emphasized continuous monitoring and feedback. As patient experience assessment has been conducted three times, specific examples of preparing for evaluations have been shared, as I understood it. Accordingly, it was more important to move beyond “what’s good to do” and toward continuous monitoring and managing “whether we’re doing so.”

Our hospital is conducting various satisfaction monitoring. In particular, we carry out inpatient and outpatient satisfaction surveys daily regardless of the patient experience evaluation cycle. We don’t end up reporting these monitoring results but propose resolving fundamental problems or improving the system. For example, we develop customized teaching plans to conduct education and help improve services.

Such an objective and continuous data management were very helpful because it made employees understand what was wrong with preparing for patient experience evaluation and what should be completed.

Q: We understand that Inha University Hospital prepared for patient experience evaluation with a polling agency.

A: Aside from in-house monitoring, we inspect the service quality with an external agency to upgrade objectivity and expertise. We did not stop at conducting satisfaction surveys based on “evaluation items” but carried out a more comprehensive survey, such as the evaluation of visitors’ entire stay, from reservation to returning home, comparison with and analysis of experiences at other hospitals, grasping the fundamental inconveniences of patients and confirming our hospitals’ advantages and disadvantages.

Since satisfaction surveys are not only for patient experience evaluation, we conduct them every year regardless of the year or cycle of patient experience evaluation (every two years). In addition, we perform overall service monitoring and evaluation, such as hospitalization, outpatient, examination, emergency medical center, and intensive care unit. The result is shared with all employees, not to mention department managers, to instill a sense of the problem and willingness to improve. We are also trying to improve the tasks derived from active leadership through executive reports.

We push ahead with improving satisfaction levels and internal improvement activities through a two-thronged evaluation system of satisfaction survey through our system and specialized external institutions,

Q: Inha University Hospital’s scores also showed overall advances in major categories. The medication-treatment process category (from 87.06 to 87.21 and 90.32 points) and the physician category (from 85.83 to 85.87 and 89.51 points) recorded relatively higher score gains.

A: We racked our brains on how effectively we could deliver essential explanations during the medication and treatment to help patients accept them smoothly. As a result, rather than providing unilateral explanations from the standpoint of the medical staff, we developed standardized explanation tools and steadily practiced them. In addition, we repeatedly confirmed whether they were explained easily, which led to good results.

In addition, we have conducted medical interview consulting for professionals every year since 2015. Most professors are participating, and recently, we have expanded the consulting subject further. Specialists can check their treatment process objectively through the video and receive experts’ feedback to apply it to their job, also leading to good results.

Q: In the third patient experience evaluation, the area with the lowest overall average score was the patient right guarantee category, with 78.77 points. Inha University Hospital scored higher than the overall average in this area but got the lowest out of the six categories. What’s the reason as you see it?

A: As the patient's awareness of participation and rights increases, I think achieving good results in this category with short-term efforts is difficult. Inha University Hospital operates an integrated nursing care service of more than 80 percent (of beds), and the patients’ demand and expectations for the medical services are high, making the results insufficient for our efforts. In particular, it has been impossible for patients to receive aid from guardians, family help, emotional support, or care due to the Covid-19 pandemic for the past two to three years. In addition, patients admitted to our hospital fully implementing integrated nursing care services often leave it alone after being discharged from the hospital. Therefore, it seems that the degree of guarantee of rights felt by patients was relatively low. For this reason, there were also concerns that our hospital was relatively disadvantageous in the patient experience evaluation.

In conclusion, a patient rights guarantee is possible only when a patient-centered organizational culture is created. To establish such an organizational culture, I think we should create a culture that practices it throughout the company through continuous empathy activities, campaigns, and education.

Q: Were there any difficulties while preparing for the patient experience evaluation?

A: The most difficult part of any assessment is how to induce the participation of members of the entire organization aside from the effort of the department responsible for the assessment. We also found it the most difficult part and thought about it much.

We are conducting various monitoring. And we tried to listen to not only the patient's opinions but also the voices of the field staff. Collected opinions are reviewed thoroughly. So, it's not "just listening to your opinions" but "we will reflect them and practice." That seems to be behind the participation of the entire staff.

In addition, when implementing education, we emphasize that it is not just “should” but “why.” In the end, it was beneficial not only to customers but also to employees themselves. Therefore, we provide training to enhance field problem and solving skills suitable for each medical profession of physicians, nurses, and medical technicians. Besides, Based on the vulnerable areas derived by monitoring, we tried to increase the educational effect by proposing improvement strategies.

Above all, positive feedback on employees is essential to induce voluntary participation. We could induce their participation naturally by giving rewards to individuals or departments who have actively participated in improving patient experience, including outstanding medical practitioners, praiseworthy individuals, and departments.

Q: What is the positive effect of patient experience evaluation on the hospital? Also, what needs to be improved, including the evaluation method?

A: Unlike other evaluations, patient experience evaluation is made by patients “themselves” based on “objective opinions” about their experiences.

So, there may be some limitations in simply ranking them based on the evaluation results or looking at them numerically. We need to continue to think about differing results depending on the size of the hospital and how much time and money is invested in evaluation. Some questions are confusing to understand their content or have too many subjective elements. The evaluation score is also bound to vary depending on the type of disease, severity, and patient characteristics.

Accordingly, it will need more objectivity if they survey all medical institutions with the same question, score the results, and announce from the first place. It can also discourage medical institutions from trying to improve and give patients false preconceptions. Therefore, it is necessary to continue to evaluate and supplement the validity of the patient experience assessment survey. Furthermore, they should grade or level the assessment results by the type of medical institution to supplement the problems resulting from simple scoring so that all medical institutions can strive for a better patient experience.

Patient experience evaluation seems to be prepared in various forms depending on the perspective of each medical institution. If they are conscious of simply “evaluation,” they will only look at the “scorecards.” However, if they think about what kind of positive development they can make with this opportunity, they will look at the “patient experience” from the field.

Therefore, developing and supplementing various evaluation tools is a good idea to help us get a little closer to the patient's “sincerity” and fundamentally improve our patient experience. So, patient experience evaluation is meaningful to us.

Lastly, all the staff in the hospital are professionals who have completed all the training necessary for the field and are qualified. Unfortunately, such expertise is not recognized not through high-handed posture or authoritative behavior toward patients but by respecting patients’ values based on high knowledge, ethics, and responsibility and by providing patient-centered, appropriate treatment. I think this is an irresistible trend of the times. The organizational culture should be improved so that all hospital members can understand and participate in this trend.