In March 2018, the MHS published its annual “Best of the Best” report of those providers, departments and facilities who earned top honors based on JOES survey results for 2017 (also reported quarterly). Dr. Susan Brunsell, with the Primary Care Clinics at Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland earned top honors in primary care. Dr. John Minarcik, with the Ophthalmology Clinic at Fort Belvoir Community Hospital (FBCH) at Ft. Belvoir in Northern Virginia, scored first in specialty care. Each of them received a 100 percent positive score based on 234 positive responses across 39 surveys returned.
Dr. Susan Brunsell stands in one of the outpatient exam rooms in the Executive Medicine Clinic, part of the Primary Care Clinics at Walter Reed National Military Medical Center. Dr. Brunsell was ranked the top primary care provider in the MHS in 2017 based on patient experience survey results. (Photo courtesy of WRNMMC Public Affairs)
In addition to identifying top scoring providers in primary and specialty care, the JOES survey rated other areas of patients’ experience at a recent visit. The “Best of the Best” report lists the highest performing clinics, clerks and receptionists for primary care and specialty care. It also lists top performing facilities for pharmacy, radiology and laboratory services.
Access and Communication are Key
What makes a patient experience great? Brunsell said that so much of the patient experience relies on what happens before a patient gets in the door. “You could be the best doctor in the world, but patient satisfaction is based on number one, did someone pick up the phone, did someone call me back and what response did I get at the front desk,” Brunsell said.
Minarcik agreed that the team approach is key. “If there was one link in the chain that made a patient angry anywhere on their way to see me, I would not have gotten positive results. Our people at the front desk, screeners, our imagers, anyone involved in patient care.”
Honing Clinical Expertise
One of the most comprehensive data points collected from the survey is overall satisfaction with a provider. The JOES survey asks “Overall, how satisfied are you with your visit with this provider?” Minarcik suggests that in specialty care, you achieve this satisfaction by getting the best possible outcome for your patient.
“I would say the surgical competence is key in satisfaction,” Minarcik said. “We want people to have good results when they’re expected to be good.”
Non-surgical providers must also stay sharp to provide reliably high-quality care. Brunsell described the role of a primary care doctor in care coordination and application of clinical expertise across specialties.
“What we are doing here is something called the patient centered medical home. Patients come here for all their care, and if we can’t provide it we coordinate it for them,” Brunsell explained.
Being a Trusted Advocate
In a fast-moving system with transient patient and provider populations, building rapport with patients can be challenging. On the wall of Minarcik’s office in FBCH hang more than a dozen handwritten thank-you notes from patients. How does he provide care that stands out to these patients enough to write a note, or respond to a survey? Minarcik said that patients’ lives can be drastically improved by just a 20-minute surgical procedure. They can be satisfied after just a six-minute doctor visit. It’s all about showing you are the patient’s top advocate, whether through producing the best outcome or simply listening.
“They like to know that I am personally invested in their outcome,” Minarcik said. “We have a low complication rate, but for that one person that doesn’t turn out perfect out of 100, we lose sleep. If patients really know [that], they trust you.”
Brunsell agreed and said that listening is key. “Give them time to tell you, show them that you’ve heard them,” Brunsell said.