Patient satisfaction at Winneshiek Medical Center exceeds the national average, but there is dissatisfaction with the hospital's billing process.

Winneshiek Medical Center (WMC) Chief Administrative Officer Gretchen Dahlen reported second quarter patient responses (April through June) during the WMC Board of Trustees meeting Wednesday night. The results were provided by the hospital's patient-satisfaction vendor, Avatar International, which provides averages using its national database of all the hospitals it serves.

Avatar, based in Lake Mary, Fla., provides quality improvement services to the healthcare industry.

"Inpatient scores substantially exceeded Avatar averages this quarter with all component scores above the 50th percentile," Dahlen said.

"The survey covers general care, general reputation, patient safety, problem resolution, expectations, facilities, pain management, visitors and more. Ninety-nine percent of the respondents favorably rated their (physician) provider care, and ninety-four percent of patients rated their nursing care favorably," she said.

"This includes any patient coming into the hospital, whether a Mayo patient or a Gundersen patient ... these are scores to be very proud of," Dahlen said.


As for emergency room (ER) care, patient responses slightly exceeded the Avatar average, by .3 point.

"Emergency patients generally don't rate their care as highly as inpatients - the national average is four points lower but we're still exceeding it - slightly - up by three-tenths of a percent," she said.

Emergency room patients gave "exceptional ratings" for pain management and for quickly getting their medical condition addressed after arriving at the ER, Dahlen reported.

"Nursing care (in the ER) was rated favorably by 94 percent of patients; 93 percent thought their provider was thorough during the exam and treatment of the patient's condition; 100 percent thought tests and procedures in emergency were adequately explained before they were done," she said.


Decorah Clinic - Mayo Health System, located at WMC, scores are 3.6 points under the Avatar average, largely due to dissatisfaction with appointment availability, Dahlen explained. In addition, 10 percent of patients were dissatisfied with the billing processes and explanations provided.

"These are areas of focus for improvement in the Clinic. It is good to know that 94 percent favorably rated their provider care and 96 percent favorably rated their nursing care," Dahlen added.

The medical industry is aware billing is a "huge source of frustration" for patients, she said.

"There's a national effort toward patient-friendly billing," she said.

At WMC, she said patients are asking for one bill instead of two.

There are two separate billing systems - one for the Clinic and one for the hospital, which includes ancillary services, such as rehab, emergency department, radiology, lab and inpatient services.

"Hopefully we'll be able to do an affordability analysis to combine them," Dahlen said.

She said WMC Chief Financial Officer Lynn Luloff has been working on improvements with the billing system over the past two years, and some progress has been made. A toll free phone number for billing inquiries was put into effect in June and online payment capabilities went into effect in September, she said.

"We've come a long way from our survey two years ago," Board member Roger Huinker commented.

Same day services

Regarding ambulatory surgery and same-day services, WMC scored slightly under the Avatar average - by one percentage point.

However, Dahlen reported in 10 of 14 areas in that category, WMC was above the 50th percentile in Mayo Clinic Health System and scored in the top quarter for general care (staff working together), patient safety, visitors/family information, facilities, admissions process and after-surgery care.

Ninety-seven percent of patients rated their providers and nursing care favorably for same day services.

WMC needs to work on billing for those services, Dahlen said. Thirteen percent of patients were dissatisfied with the process.