RENEE MONTAGNE, HOST:
Hospitals can no longer afford unhappy customers because bad patient reviews can mean lower pay from the federal government, which is why when the long waits at Rowan Medical Center's emergency room weren't getting any shorter, the hospital replaced all the doctors in charge. Jordan Rau visited the hospital in Salisbury, N.C., which is trying to make its patients happier.
JORDAN RAU, BYLINE: Rowan Medical Center has some of the worst patient reviews in the country. Experiences like the one Lillie Robinson had don't help.
LILLIE ROBINSON: When I came in Wednesday for my surgery, I thought I was just having one foot done. And when I got here, I found out that he was doing both. I signed the consent, but even the nurse in pre-op, she didn't realize that he had wrote it for both until the anesthesiologist came in and started asking questions. And that's when she read further down into the paperwork and she said, yeah honey, it is for both.
RAU: Instead of being in and out the same day, she's got to lie in a hospital bed for weeks, just watching TV and in pain.
ROBINSON: They do the best they can. At times, it gets so bad I'm crying because it's overwhelming to me.
RAU: But the best they can isn't good enough for Medicare. The federal government only gives credit when a patient says an aspect of their hospital stay, like pain control, was always good - usually doesn't count. Novant Health runs Rowan and is looking everywhere for improvements. Jill Rabon is the head of guest services.
JILL RABON: For example, down in our emergency department, we recently have added murals for a positive distraction is what we say because a lot of times people will have extended waits down in the emergency department and there wasn't anything to for them to do besides read magazines, you know, and that causes unnecessary anxiety and stress as they're waiting.
RAU: Rowan has also asked some of its patients for ideas.
RABON: And they said, well, you know, it'd be better if you moved the chairs here so that we could see the mural better.
RAU: Once patients are admitted, there are more substantial changes. Nurses swing by each room every hour, and even the hospital president makes rounds once a day. Doctors and nurses are being coached on their bedside manner, like not staring at their computer when a patient is talking. Nurse Jennifer Payne especially likes the poster boards on the walls, where nurses write a few personal details about their patients.
JENNIFER PAYNE: I can go in there and say, oh, you have three dogs and you have a grandchild. That's a great, great - and they can talk for hours about that.
RAU: The hospital says this is all working. ER waits are down to half an hour and the nurses are spending 70 percent of their time with patients. But Rowan's satisfaction scores aren't going up. The hospital says that may be because bad memories linger.
CARL DENHAM: I was treated like a dog.
RAU: Carl Denham is 76, and like a lot of people in Salisbury, he's been coming here since he was a kid. He says his last visit, about two years ago, was dreadful.
DENHAM: At 5 o'clock in the morning, they come in doing construction work, knocking the walls out. The doctor ordered the oxygen, you know? Well, they kept me just sitting out all day long with the oxygen.
RAU: He says this time has been very different, starting with the ER.
DENHAM: It's fantastic from what it used to be if you want my opinion. I've been both ways, and the way it is now it's great. No waiting and there's doctors and they're all pleasant. I never thought I'd see it like this.
RAU: But Rowan can't figure out why patients aren't so enthusiastic when they fill out their surveys a few weeks later. Rowan scores poorly on questions like was it noisy at night, and how well did your doctors and nurses communicate. This year, Rowan's losing $29,000 for Medicare. That's not a huge amount, but if Rowan doesn't get better, next year it could be a lot more. For NPR News, I'm Jordan Rau.
MONTAGNE: And Jordan Rau is with our partner Kaiser Health News. Visit NPR's Shots blog to find out how your local hospital rates. It's NPR News. Transcript provided by NPR, Copyright NPR.