Your Reputation: Building Trust Is the Cornerstone --Our Members' Perspective

Patients put their trust where they believe they will get the best care available. That is why our members see building trust as the key to having a reputation that serves their organization well.

Trust: the jewel that causes community members to choose a hospital, its clinics, and its services when they or their loved ones need medical assistance. They put their trust where they believe they will get the best care available.

This trust is developed through firsthand experience with care accessibility, staff friendliness, nurses, health-care providers, food, wait times, billing, crisis management, respect, surgery outcomes, and a sense that every rock has been upturned for the sake of the patient’s health. These assets build a reputation that serves an organization well.

“In order to thrive and maintain utilization, we must have the trust of the community, and we need to support them as well,” says Renee Jensen, a recipient of the Washington State Hospital Association’s Joe Hopkins Memorial Award, and CEO of Summit Pacific Medical Center, a Critical Access Hospital in Elma, Washington, 30 miles west of Olympia. She is well aware that it takes a lot of work to repair a negative reputation. “In the past, our hospital did not have a good reputation. It was referred to as the ‘Band-Aid’ station,” says Jensen.

“We worked hard to really change that, and it has resulted in community trust and increased utilization and market share.” Summit Pacific now has a brand-new facility, funded by the first USDA loan ($19.5 million) for hospital construction in Washington State.

Maintaining trust and a good reputation also means dealing successfully with the constant challenges in today’s health-care system. “The hospital staff and district patrons are committed to [our] hospital’s success,” says Rosalinda Kibby, Administrator/ Superintendent at Columbia Basin Hospital in Ephrata, Washington, a rural setting 47 miles from Wenatchee. Her hospital treats patients ages newborn through geriatric by offering a wide range of services, including family medicine, long-term care, and assisted living at their facility called Garden Oasis.

The definition of what creates a good reputation seems straightforward. However, other forces influence the way the public might view a particular hospital. Unsettling frontpage headlines and coverage on our 24-hour news cycle are the most glaring: allegations of dishonest researchers, the administration of wrong medication, tragic surgical outcomes, pilfering bookkeepers, and lawsuits for discrimination. One unfortunate incident can cast a pall over the most well-respected medical facility—a tarnished reputation that it must struggle uphill to fix. Yet it is the quieter, less visible blemishes that can present the more common challenges.

The experiences and opinions of patients and their families can have a significant influence on a hospital’s reputation. “Don’t be naïve,” cautions Jensen. “The community may see things differently than you do.” She recommends embracing feedback and says, “Patient complaints are very important.” She asks her executive team or quality manager to handle them all. “We call the patient, discuss the issue, and acknowledge their feelings. Then we explore the problem and get back to them to explain how we’ve made things better for the next patient.” Under Jensen’s leadership, patient complaints decreased by more than 50 percent in 2012.

Complaints aren’t restricted to patient discharge surveys or little pieces of paper slipped into a wooden box at the reception desk. “This is a small place,” says Alayna Lodi, Public Relations Manager at Columbia Basin. “We hear from our community in the vegetable aisle at the local supermarket, at sporting events, and restaurants. Nothing is off limits. No matter what setting we are in, we represent both ourselves and the hospital. We talk with them, try to figure out how we can make it right. Then we get back to them on how we handled [the issue].” Columbia Basin’s other efforts at transparency, like engaging community members on the Board of Commissioners, the Auxiliary, and at Foundation events, also help bolster the hospital’s reputation. “The courtesy of our staff is vital,” says Kibby. “That openness is an invitation to a conversation with patients. They are more willing to talk, engage, and bring up problems if people are truly respecting and listening to them.”

Lauren Day, Summit Pacific’s Marketing Director, utilizes press releases, social media, blogs, and stories as a means of interacting with the community. Both hospitals see Facebook not just as a place to share information, but also as a portal to knowing what patients and families are thinking about their treatment. Just as with complaints made directly to the hospital, “Facebook comments are an opportunity for improvement, not defensiveness,” says Day. A variety of other sites lacks the interactive component available on Facebook. They provide the public with report cards meant to help people select the product or service that meets their needs. Yelp is one such site, with millions of viewers relying on the opinions of others about hair products, restaurants, art dealers, car repair shops, and doctors and hospitals. (See “The Increasing Importance of Online Physician Ratings,” p. 12). Drawbacks? “It’s a one-way message, and you can’t do much about it,” says Kibby. “We try and figure out who the reviewer is, then call them and invite a conversation.”

Healthgrades, another popular rating site, experiences one million hits a day and is now a major resource for health information.4 Their analysis is based on approximately 40 million Medicare discharges for the most recent threeyear time period available.”5 But like Yelp, Healthgrades has its fans, along with those who question its ratings based on the methods and thoroughness of their informationgathering. Yet they are expanding their reach. Associated Press has recently launched a new Digital News Experience (DNE) with Healthgrades to provide newspapers, broadcasters, and other publishers with health information for their websites.

Jensen has a mixed opinion about online rating sites. “I think that the younger generation uses these sites just like they use Twitter and Facebook—to get information.” When Jensen uses Yelp to find a restaurant, she is aware that people have different tastes and their own idea of what “expensive” means. “It is the same in health care,” she says. “It depends on what you want and what you are looking for.” You may or may not see that reflected in the rating criteria. Summit Pacific doesn’t routinely use Yelp, but might when looking to recruit a new primary care provider.

“The community trusts us for our quality of care,” says Kibby, maintaining that quality is intrinsic to the referral process, which involves mutual need. Hospitals rely on referrals from physicians, and they in turn are often in the position of making recommendations to other care providers to treat their patients. In the case of Columbia Basin, like many rural hospitals, there is a need to refer patients for the things the hospital and its clinics can’t provide, such as surgery services. The hospital’s meet-and-greets allow community doctors to get to know each other, as well as hospital administrators and staff. In addition to familiarity, primary care providers will be checking with patients on their experience with the referral specialist.

For the hospitals, referral criteria are evolving. Jensen observes that, “Physician referrals have traditionally been about who one knows, but that is changing. We are moving into value-based purchasing, and hospitals will be able to identify low-cost, high-value providers. We are accountable to our patients, so this is very important. Payers disclose a different data-set than Yelp—claims and quality data,” she adds. “Eventually Yelp and other discerning sites will have this data as well.”