i -Sight HC Complaints Database Meets Federal Guidelines while Driving Timely Resolutions at Rush University Medical Center
Rush University Medical Center
At Rush University Medical Center, an academic medical center in Chicago, patient care is both art and science. There, physicians and scientists are committed to research and innovation, as well as the soft side of serving patients. As a result, Rush earned national rankings in 11 specialty areas, as reported in U.S. News & World Report’s 2006 “America’s Best Hospitals” issue. The Medical Center encompasses a 613-bed hospital serving adults and children, the 61-bed Johnston R. Bowman Health Center and Rush University.
To maintain its high rankings, and meet CMS guidelines, the medical center’s Patient Relations Department serves as the central point for managing all reported complaints and closing the loop with patients.
In 2006, the department’s manager found herself bogged down by duplicate entry of patient issues, taking time away from actual patient relations activities. She entered each issue in three different places: a log, an Excel file and an Access database.
“I was a one-man circus responsible for inpatient, outpatient and private practice issues,” said Jeanne Blundy, Manager of Patient Relations. “With a 613-bed hospital, it’s overwhelming. It took a long time to set up each file, so we couldn’t get issues logged fast enough.”
After she entered complaints, she would pass them on to the relevant departments to be addressed. Shuttling issues back and forth, and communicating about them, required considerable calling and emailing between Patient Relations and other departments.
Meanwhile, those involved were under pressure to address grievances per CMS guidelines – seven days to reply to the patient or to send the patient a letter indicating it will be resolved in 30 days.
After evaluating several solutions for managing complaints, Patient Relations chose i-Sight Service and Complaints from Customer Expressions. The application offered the automation and ease of use the team desired, and fit its budget.
At the time, the Medical Center was also involved in a hospital-wide IT deployment that required considerable IT resources. As a Web-based solution, i-Sight would not tax busy IT staff for implementation or maintenance.
“IT resources are scare, and i-Sight had the nice feature of being an ASP model that was secure. It wouldn’t tie up IT time like a lot of other products,” said Francis Fullam, Senior Director, Marketing Research, Strategic Planning, Marketing and Program Development.
A consultant from Customer Expressions assisted with customizing i-Sight for the Medical Center’s specific needs. He created department lists, locations and other issue identifiers such as whether it’s inpatient, outpatient, private practice or a grievance that falls under CMS guidelines.
Automation, Alerts Keep Every Issue on Schedule
Patient Relations now relies on i-Sight as the single point for entering and tracking every patient complaint. Blundy inputs the information once, instead of three times. Also, she can store supplemental documentation or the original letter, email, fax or survey that included the patient’s comments.
Once complaints enter the system, customized workflow rules in i-Sight ensure they follow a specific process. Alerts automatically let team members know when an issue is nearing resolution deadlines, and i-Sight escalates any that go unaddressed to a manger.
“i-Sight just leads me down the path and I don’t have to think about it,” Blundy said. “You can get a quick overview of current issues and you can’t close it out until every question is answered, which is a big help.”
Grievances that fall under CMS guidelines are tagged as higher priority to ensure they are turned around in the required timeframe. “With more specific federal guidelines about time to resolve patient complaints, I can’t imagine how we would do this without a program like i-Sight, without a program that tracks time,” Fullam said. “It’s been very beneficial in helping the complicated process of tracking.”
After deploying i-Sight, the Medical Center extended use to unit directors and clinical nurse coordinators in four departments. They can enter issues easily themselves, and check on and change the status. That frees some of Blundy’s time, and will free even more when the hospital rolls out i-Sight to all departments.
“Multiple people are accessing the real-time system,” Blundy said. “They know the time limit and respond very quickly when things pop up.”
Already, the team has seen enhanced efficiency in processing complaints. “i-Sight cuts down on lots of phone calls and missed calls,” Blundy said. “We’re not wasting our time trying to get a hold of people in departments because i-Sight keeps them aware of issues and on task. We don’t need one-on-one communication unless there’s something specific to discuss.”
That also improves overall communication between Patient Relations and Medical Center departments. “The whole relationship with the units has improved. They are much more receptive with it. It just pulls this whole thing together,” Blundy added.
The ease of entering complaints means that every one – even minor – is tracked in i-Sight – giving Patient Relations a more complete picture of all issues. As the team begins using i-Sight’s detailed reporting capabilities, it can evaluate data such as the number of issues each quarter; complaints by departments and levels; and the top issues.
In turn, Patient Relations can bring that information back to the board for review and decision-making. For example, recurring complaints might indicate a need for training or additional resources to reduce complaints.
“With more specific federal guidelines about time to resolve patient complaints, I can’t imagine how we would do this without a program like i-Sight, without a program that tracks time. It’s been very beneficial in helping the complicated process of tracking.”
— Francis Fullam, Senior Director, Marketing Research, Strategic Planning, Marketing and Program Development