5 barriers to providing exceptional patient experiences and how University of Utah Health Sciences overcame them

Although a growing number of hospitals and health systems are making the decision to post their physician ratings online, the choice to do so is fraught with hang-ups and concerns about the impact of such transparency. Salt Lake City-based University of Utah Health Sciences opted to go public with physician ratings and has linked that move to improved satisfaction scores and outcomes, according to a study in the journal Academic Medicine.

"Everyone, from payers and policy makers to patients, yearns for reliable, understandable information about the cost and quality of care, and it's our duty as the region's sole academic medical center to respond to that demand," UUHC's CEO and the study's lead author Vivian Lee, MD, PhD, said in a statement. "What we underestimated was how being transparent with our scores would be such a force for cultural change within our organization — a catalyst for engaging physicians in patient-centered care and the glue to further cement the physician-patient relationship."

The paper, titled Creating the Exceptional Patient Experience in One Academic Health System, outlines the five factors that affected the health system's ability to provide exceptional care before choosing to go transparent with ratings:

1. A lack of good decision-making processes
2. A lack of accountability
3. The wrong attitude
4. A lack of patient focus
5. Mission conflict

"Working groups designed initiatives at all levels of the health system to address these issues," the authors wrote. "What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance and improved alignment of the mission and vision across hospital and faculty group practice teams."

The system attributes a number of improvements that influence patient experience to physician rating transparency. These include patient satisfaction scores increasing significantly, half of the health system's providers now ranking in the top 10 percent compared to their peers nationally and 26 percent ranking in the top 1 percent. Employee satisfaction has also improved, malpractice litigation has declined and UUHC maintains it has been able to reign in costs throughout the process.

"This has been truly transformative for our organization. Change didn't happen overnight, and we faced plenty of challenges," UUHC's Chief Medical Officer Tom Miller, MD, said in a statement. "But we overcame the challenges, and the solutions we devised are adaptable to other institutions."

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