Natasha Epissina, Harvard University, John F. Kennedy School of Government

Rappaport Fellow Natasha EpissinaHealth care, particularly health care disparities

My internship at the Boston Public Health Commission offered me the opportunity to learn a lot about public health, patient satisfaction, hospital administration, and general management principles. Among others, I learned what determines the satisfaction of patients in the hospital and how satisfaction differs by patient characteristics such as payer group, age, emergency and planned admission. I also became increasingly aware of the decisions senior hospital management have to make, how they approach trade-offs, and how they manage competing demands from donors, funders, community stakeholders, staff and patients.

While I learned a lot, I also provided my supervisor with a number of analyses with respect to patient satisfaction at Boston Medical Center (BMC), which I studied as a major case study during my internship. These included:

  • Data on how patient satisfaction varies by ethnicity, by payer group, by zip code where the patient lives, by length of stay in the hospital and by whether the admission was due to an emergency or planned

  • Summaries of the results from interviews with senior and middle management, physicians, nurses, phlebotomists, housekeeping staff and patients about what they believe affects patient satisfaction and their views on what changes are necessary to improve patient satisfaction with the care they receive

  • I also provided a summary of my ‘outsider’s perspective’ observations about the determinants of patient satisfaction, based on best practice described in the literature, interviews, and hours spent observing the functioning of hospital Units and Specialty areas

The experience of being immersed in healthcare for the summer has made me decide to focus on Healthcare Management and Policy as a concentration during my MPP2 year. I am also considering writing a PAE on a topic related to my work this summer. More long term, I have decided to explore the option of working for the Department of Health or a front-line Healthcare provider once I graduate. If I end up doing this, then the Rappaport Fellowship summer experience will have profoundly altered my career path.