Getting Diagnostic with the Patient Experience. Julie O Shaughnessy Executive Consultant January 11, 2012

Transcription

1 Getting Diagnostic with the Patient Experience Julie O Shaughnessy Executive Consultant January 11, 2012

2 HCAHPS Vital Signs

3 Patient Experience The sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care. ~The Beryl Institute

4 Goals for today Identifying the hidden aspects that influence the patient experience Share what strategies Avatar Partners are using to improve HCAHPS Performance Defining the prerequisites for a culture of Accountability

5 Hidden Aspects

6 HCAHPS Composites Nurse Communication Doctor Communication Responsiveness of Staff Pain Management Communication of Medications Discharge Information Hospital Environment Overall Rating

7 HCAHPS Clusters Nursing Patient Safety Nurse Empathy Problem Resolution Exchange Information Patient Activation Responsiveness Staff Responsiveness Nurse Responsiveness

8 HCAHPS Clusters Physician Empathy Exchange Information Pain Management Physician Nurse Discharge Process Information

9 HCAHPS Clusters Medication Communication Hospital Environment Safety Usability Cleanliness Quietness Medical Team Interaction

10 Diagnostics

11 Doctor Communication

12 Doctor Communication Improvement Strategies that get results: Positive First Impression Reflective Listening Teach-Back Explain each person s role Observe Top Performers and share what they do Engage Champions to coach and mentor peers

13 Developing the Improvement Plan

14 Whack A Mole

15 Whack A Mole or Bowling

16 Why Bowling? Probability of Success One goal has an 80% chance of being achieved with excellence Two to four goals have a 64% chance of being achieved with excellence Five or more goals have a 33% chance of being achieved with excellence Source: Stephen R. Covey

17 Diagnostics

18 Key Drivers Medical Problem Resolution General Care Nursing Care Environment Leaving Pain Management Patient Safety Surgical Problem Resolution Nursing Care General Care Patient Safety Environment Leaving Pain Management Maternity Problem Resolution Nursing Care General Care Maternal Care Environment Pain Management Visitor/Family

19 Key Drivers Medical Problem Resolution General Care Nursing Care Environment Leaving Pain Management Patient Safety Surgical Problem Resolution Nursing Care General Care Patient Safety Environment Leaving Pain Management Maternity Problem Resolution Nursing Care General Care Maternal Care Environment Pain Management Visitor/Family

20 Problem Resolution Aha!

21 Problem Resolution Aha! Trying to Delight Your Customers

22 Problem Resolution Aha! Trying to Delight Your Customers To really win their loyalty, forget the bells and whistles and just solve their problems. Source: Harvard Business Review July-August 2010

23 Eroding Loyalty 56% 59% 59% 62% Having to re-explain an issue Expending moderate-to-high effort to solve the problem Being handed off to someone else Repeated efforts to resolve the issue

24 HCAHPS Improvement Strategies

25 Nurse Communication Improvement Strategies that get results: Bedside Shift Report Hourly Rounding Key Words at Key Times (AIDET SM ) Nurse Leader Rounding

26 Responsiveness of Staff Improvement Strategies that get results: Hourly Rounding No-Pass Zone

27 Pain Management Improvement Strategies that get results: Hourly Rounding Pain Posters Pain Protocols Physician Education Nurse Education

28 Communication of Medications Improvement Strategies that get results: Bedside Shift Report Discharge Phone Calls Key Words at Key Times

29 Discharge Information Improvement Strategies that get results: Discharge Rounds Discharge Phone Calls

30 Hospital Environment Improvement Strategies that get results: Adopt a Unit Program Clean Team Rounding Noise Audits Bundling nighttime tasks together Eliminate overhead paging Provide noise reduction tools to patients

31 A Culture of Accountability

32 Service Driven Culture Pressure for Change Expectations & Accountability Minimal Barriers Vision & Plan Skills & Attitudes Measures and Feedback Recognition & Incentives

33 Accountability ac count a bil i ty noun the quality or state of being accountable; especially an obligation or willingness to accept responsibility or to account for one's actions

34 A Culture of Accountability Prerequisites Make it personal individual vs. teams or departments Be specific-what does acceptable look like Monitor performance-how will change be measured Communicate consequences Enact consequences quickly Leader Role Modeling-consistency is vital

35 Case Study

36 Banner Boswell Medical Center Sun City, AZ 2000 Employees 800 Medical Staff Members 1600 Volunteers 501 Inpatient Beds 45,000 ED Visits

37 Banner Boswell Medical Center Sun City, AZ 2000 Employees 800 Medical Staff Members 1600 Volunteers 501 Inpatient Beds 45,000 ED Visits Every Patient, Every Time

38 Service Driven Culture Pressure for Change Expectations & Accountability Minimal Barriers Vision & Plan Skills & Attitudes Measures and Feedback Recognition & Incentives

39 Improving the Patient Experience CEO shared the vision Every Patient Every Time during Town Hall meetings and with every department.

40 Improving the Patient Experience CEO shared the vision Every Patient Every Time during Town Hall meetings and with every department. CEO department rounding to share patient story

41 Improving the Patient Experience CEO shared the vision Every Patient Every Time during Town Hall meetings and with every department. CEO department rounding to share patient story Developed key commitments

42 Three Key Commitments Hourly Rounding & Starfish customer encounters Prompt response to call lights Acknowledging and welcoming all patients, visitors and staff to each department and unit

43 Improving the Patient Experience CEO shared the vision Every Patient Every Time during Town Hall meetings and with every department. CEO department rounding to share patient story Developed key commitments One hour training for every employee focused on the why and what right looks like

44 Improving the Patient Experience CEO shared the vision Every Patient Every Time during Town Hall meetings and with every department. CEO department rounding to share patient story Developed key commitments One hour training for every employee focused on the why and what right looks like Patient Room Orientation for staff unfamiliar with the environment

45 Improving the Patient Experience CEO shared the vision Every Patient Every Time during Town Hall meetings and with every department. CEO department rounding to share patient story Developed key commitments One hour training for every employee focused on the why and what right looks like Patient Room Orientation for staff unfamiliar with the environment Orange beads to hold each other accountable

46 Service Driven Culture Pressure for Change Expectations & Accountability Minimal Barriers Vision & Plan Skills & Attitudes Measures and Feedback Recognition & Incentives

47 Results Responsiveness of Hospital Staff increased from 65% Always to 72% Always

48 Goals for today Identifying the hidden aspects that influence the patient experience Share what strategies Avatar Partners are using to improve HCAHPS Performance Defining the prerequisites for a culture of Accountability

49 Making a Difference

50 References The HCAHPS Handbook by Quint Studer, Brian Robinson & Karen Cook, Fire Starter Publishing, 2010 Healing Words the power of an apology in medicine by Michael Woods, MD Doctors in Touch, 2004 Leading Change by John P. Kotter, Harvard Business School Press, 2002 Raising the Bar on Service Excellence-The Health Care Leader s Guide to Putting Passion into Practice by Kristin Baird, Golden Lamp Press, 2008 Practicing Excellence by Stephen C. Beeson, MD, Fire Starter Publishing, 2006.

51 Thank You Julie O Shaughnessy joshaughnessy@avatar-intl.com extension 1385