Multiple Patient Feedback Mechanisms Help Build A Patient-Centered Culture

With a caseload of close to 6,000 HIV-infected patients, St. Luke's-Roosevelt Hospital's Center for Comprehensive Care (CCC) is the largest designated AIDS center in New York. In recent years, CCC has been expanding its services to at-risk populations such as formerly incarcerated individuals. It is now serving over 8,000 total patients at three clinical sites.

At CCC, efforts are continually made to assess various aspects of services from a patient perspective-patient feedback is the foundation for the Center's action plan.

"How can you provide patient-centered care if you do not know what the patient wants," says Christine Nollen, Senior Deputy Director. "We are totally committed to patient involvement."

In addition to patient satisfaction surveys, which are administered twice a year, CCC uses multiple methods to gain feedback from patients.

Consumer Advisory Board (CAB)

A member of the Center's Executive Committee is invited to each monthly CAB meeting to respond to questions and concerns about CCC operations and services. This communication allows the Executive team to hear directly from consumer representatives and also helps the CAB communicate with other patients about ways in which the CCC operates and responds to patient concerns. When new programs or initiatives are implemented, the CAB is asked to provide feedback.

Focus Groups

The CCC uses focus groups to gain consumer input related to specific initiatives. For example, focus groups were used to provide insight into the development of a new marketing strategy. Focus groups are often held when the CCC is developing a new program. Not only does the feedback provide insight into needs and barriers that can ensure more responsive services but it also assists in the development of proposals to help fund the program.

Peer Program

Over the past seven years, the CCC has trained approximately 50 consumers to provide supportive counseling to inpatients, assist in patient navigation, and offer adherence support. Currently, there are 15 active peers. Due to their regular interaction with consumers, the peers serve as an informal, two-way feedback system. They hear directly from consumers about needs and barriers, and also communicate new information directly to consumers during regular interactions.

Patient Suggestion Box

A Suggestion Box is available at all three CCC clinical sites. Each month a representative from the CAB collects the suggestions and presents them to the Operations and/or Executive Committees, as appropriate. The feedback loop is closed when these responses are disseminated back to the CAB and, as appropriate, directly to CCC patients in the form of actions or through the CAB newsletter.

Ms. Nollen believes there is more that can be done to get consumer feedback and says the CCC will strive to increase the level of consumer input they already receive. Based on their experience, however, she offers some recommendations for other programs.

• Conduct surveys on a regular basis; respond to what the surveys say, and compare results over time
• Use surveys that generate results that are actionable.
• Use tools that assess a patient's experience with his or her individual provider. More specific findings provide a greater opportunity to learn and make meaningful changes.