By Martyn Buffler and McKinley Thompson / Special to Healthcare Facilities Today

It is a widely accepted fact in today’s healthcare environment that patients hold more power than ever before. No longer are patients limited with where they can seek care — they are consumers and have as much of a choice in their medical treatment as they do buying a new car or house.

Combine this shift in power with the Affordable Care Act’s policy of tying a portion of Medicare reimbursement to patient satisfaction scores, and it’s no wonder that patient care is an increasing focus in hospitals across the country.

But what part do you have to play?

Patient care and satisfaction is a clinical responsibility, right? After all, these members of the hospital staff have the most face time with patients and their loved ones. While it’s true that patient satisfaction surveys like the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) have many questions that tie directly to the clinical staff, a hospital’s physical environment, and the facilities team who maintains it, also play a critical and often under-appreciated role.

Oftentimes during a patient’s stay, it’s the environmental, non-clinical aspects that determine a positive or negative experience. For example, think about the last time you walked into a healthcare facility as a patient. What were the first things you noticed? Chances are cleanliness, noise level, lighting and many other aspects of the physical environment are what formed your first impression and set the tone for your visit.

Beyond first impressions, elements of the physical environment continue to play a critical role in patient satisfaction for the duration of their stay. Is important equipment like call buttons, the TV, restroom fixtures and lights working properly in their room? Are they able to rest and recover, or is there excessive noise? Is the temperature regulated, allowing them to be comfortable, or is it too hot or too cold in the room?

While these details may seem trivial in the grand scheme of things, their importance is reflected on the HCAHPS survey, where two questions are focused solely on the hospital environment, including the cleanliness of rooms and bathrooms and the noise level at night.

But if the HCAHPS survey has 27 questions, two of which focus on the physical environment and almost four times that focusing on the care from nurses and doctors, how can you possibly make the case that a facilities department plays a critical role in a hospital?

A greater impact

The argument can be made that the facilities team has an indirect, yet significant impact on every question, including those about nurses and doctors.

If you consider whom the facilities team handles a majority of requests from and whom the completion of their work orders benefit, the clinical staff is at the top of the list — their "primary stakeholder" if you will. By maintaining and servicing their equipment, limiting obstructions, and having an efficient layout of the building and supplies in place, the facilities team enables the clinical staff to provide quality care and spend time focusing on patients.

At the end of the day, if nurses and doctors are happy, patients are more likely to be satisfied – and the facilities team contributes by setting them up for success.

In addition to satisfaction, patient safety and, ultimately, clinical outcomes are other areas where the facilities team can have a dramatic impact. By properly maintaining air handling equipment, controlling contaminants from construction sites and taking care of upholstery and wood furnishings, the maintenance team is taking steps to assure that the physical environment will not have a negative impact on patient health. Unfortunately, there have been many cases where minor errors in these areas made the difference between life and death.

Similarly, the smallest of tasks can significantly reduce fall risk, such as:

• Securing handrails, grab bars and speed bumps

• Including adequate lighting in rooms and bathrooms

• Placing fluorescent tape on floors to identify pathways at night

• Removing obstructions from hallways

• Having night lights for high-risk patients

While patient falls are often viewed as a clinical problem, because they are tied directly to their care, the physical environment plays a big role in ensuring accidents don’t happen and patients remain as safe as possible.

Training as the key to success

Embracing the mindset that the facilities team plays a critical role in patient care can be a difficult and gradual change, and training is a good place to start. Start by setting the expectation that patient care will be a team responsibility and train staff members to ask certain questions upon entering a patient’s room.

For example, when a request comes in to fix a patient’s bathroom sink, have team members enter the room and introduce themselves, ask the patient’s name and how they are feeling, as well as if they’re comfortable with the room temperature. Taking this simple but personal approach can make all the difference and adds a much-needed human touch to the hospital environment.

Here are some other best practices that can be implemented through proper training:

• Creating a checklist of tasks to be completed before patients enter a room, or a “Pre-Room Survey” — this will ensure that everything is working properly and their stay gets off to a good start. Items to include on the checklist could be seeing if call buttons are functioning, checking the TV and lighting controls, ensuring the bathroom is clean and water working, and if the room temperature is comfortable.

• Some hospitals have even implemented “No Pass Zones” in their facility — this is where no member of the staff, clinical or not, is allowed to walk past a room with the call light on. Instead, they are responsible for checking in with the patient and seeing if there is a way that they could assist them.

Now, what to focus on

With increased patient control over where to seek medical treatment and revenue on the line, it is critical for hospitals to place focus on quality care and patient satisfaction. In order to obtain high scores on surveys like the HCAHPS and get full Medicare reimbursement, hospitals must recognize every department, including facilities, as key contributors to their success.  

Additionally, the facilities department needs to shift their mindset and take a team approach to patient care. It’s not just changing an air filter, it’s contributing to infection control measures and keeping patients safe. It’s not just fixing a piece of equipment, it’s enabling the clinical staff to provide better patient care.

Leverage technology to communicate to other departments about your work. Represent your team on your organization’s patient care committee.

When it comes to patient safety and satisfaction, everyone has a place at the table, and it’s time the facilities department pulled up a seat.

Martyn Buffler is a senior healthcare advisor and McKinley Thompson is a healthcare market specialist, Dude Solutions.