The Future Impact of Patient Experience for Audiology Recorded April 6, /3/2013

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1 The Future Impact of Patient Experience : Improving collection and use of patient experience data today in preparation for tomorrow s reimbursement climate AudiologyNow! April 6, 2013 Anaheim, California Keri Kwarta, AuD Briana Jegier, PhD Francis Fullam, MA Introduction Keri Kwarta, AuD Instructor of Audiology at of the Department of Communications Disorders and Sciences, College of Health Sciences, Rush University Medical Center. She received her AuD from the University of Florida Briana Jegier, PhD Assistant professor in the department of Health Systems Management and Women, Children and Family Nursing at Rush University Medical Center. Dr. Jegier received her PhD in Public Health Studies with an emphasis in management and policy from Saint Louis University Francis Fullam, MA Senior Director for Marketing Research, and Patient Relations and an assistant professor in the department of Health Systems Management at Rush University Medical Center. He has a BA from Colgate University and an MA from the University of Chicago in survey research 2 Agenda and Objectives Part I The changing healthcare landscape The patient experience Drivers of patient experience Tools for measuring patient experience Part II The Rush experience: A case study of the efficacy of patient measurement tools in a practice setting Incorporating measurement in your practice 3 1

The changing healthcare environment Healthcare Environment and Policy Increased demand for services Changing technology New payment systems New federal approach - Value Based Purchasing Increased

Move Towards Lower Cost Self Service A number of procedures and services that once required much hands professional expertise are now are now do-it-yourself Home pregnancy tests Custom orthotic

2 The changing healthcare environment Healthcare Environment and Policy Increased demand for services Changing technology New payment systems New federal approach - Value Based Purchasing Increased direct to consumer sales Increased Do it Yourself services and options Emphasis on value over volume Audiology Specific Example Improved technology of Personal Sound Amplifier Products (PSAP's) 4 Move Towards Lower Cost Self Service A number of procedures and services that once required much hands professional expertise are now are now do-it-yourself Home pregnancy tests Custom orthotic inserts Improvements in over the counter Personal Sound Amplifier Products now may offer increased alternatives in consumers minds to visits to an Audiologist 5 Emphasis on value Thus, we are embarking on the era of Value Value Providing affordable, efficient and acceptable care to patients, their families and the community at large. 6 2

3 What is Patient Experience? The Picker Institute developed a concept patient centered care that had 7 dimensions based on series of focus groups with patients and providers in the 1980 s. The seminal book, Though the Patient s Eyes defined these as: Respect for patients values, preferences and expressed needs Coordination and integration of care Information, communication and education Physical comfort Emotional support and alleviation of fear and anxiety Involvement of family and friends Transition and continuity This definition is the basis on which the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey program about the patient experience is built...but not copied. 7 Built On, Not Copied The CMS program is based on the work of the Picker Institute but there are some difference. The CAHPS survey is based on the survey developed by the Picker Institute similar question formats and domains Picker Institute explicitly incorporates patient s emotional response to health, CMS does not make this explicit in questions. 8 Measuring Patient Experience: Welcome to the Caps Family of surveys! Nursing Home (NH-CAHPS) Home Health (HH-CAHPS) Prescription Drug (PD-CAHPS Medical Group (PQRS CG- CAHPS) Under Consideration Ambulatory Surgery Centers Hospital (H-CAHPS) The Consumer Assessment of Healthcare Providers and Systems (CAHPS) family Dialysis Center (ICH-CAHPS) Medicare Shared Saving & Pioneer ACO (ACO CG- CAHPS) Under Consideration Hospice ED Hospital Outpatient 9 3

4 Three Goals of H-CAHPS These 3 goals for H-CAHPS embody the new federal approach 1. Create standardized data about the patient experience 2. Create financial incentives to improve the quality of the patient experience along with clinical processes/ outcomes 3. Create transparency in this information by making it available to the public From HCAHPS Fact Sheet May Traits of CAHPS Surveys Traits of survey a) Frequency response categories b) Top box reporting (mostly) c) Domains of care d) Coverage of all patient payor groups e) Survey mode adjustments to data and adjustments based on patient characteristics 11 H-CAHPS Questions and Reporting Frequency scale - Never, Sometimes, Usually, Always Responses are not normally distributed but skewed to the positive Reports focus on the percentage who say Always the top box score 12 4

5 H-CAHPS Domains Questions are grouped under 8 domains of care Communication with Nurses Communications with Doctors Staff Responsiveness Pain Management Communications about Medicines Discharge Information Hospital Environment Care Transitions Plus a global rating of the hospital 13 H-CAHPS Adjustments CMS found that a number of things influenced the results that are outside the control of the hospitals. CMS makes adjusts to the data to control for these factors so that no hospital is penalized or benefits from factors outside of their control. This is analogues to risk adjustment in health outcomes research. Survey mode adjustments Survey can be collected by Mail, Telephone, or Interactive Voice Response. Ratings on mail surveys tend to be lower so responses to these surveys are positively adjusted Patient adjustments based on research Age Gender Education Service line (medical, surgical, OB) Response date Self reported health status ( In general, how would you rate your overall health? Excellent, Very good, Good, Fair, Poor ) Interaction of some of the above factors 14 H-CAHPS Rollout History Development of patient-centered care survey by Institute in 1980 s AHRQ questionnaire development begins 2002 based on Picker principles Voluntary participation begins 2006 Pay for Reporting begins 2007 Public reporting of H-CAHPS on Hospital Compare website 2008 Pay for Performance begins in 2012 Value Based Purchasing 1% withhold of federal payments (grows to 2%) 30% of these at-risk funds is determined by patient experience data, the remaining 70% is determined by a mix of quality process and outcome data Based on a formula of relative performance to other hospitals, they can earn back between 0% and about 200% of the funds withheld 15 5

Hospital Compare The Hospital Compare website is accessible to the public and contains a great deal of comparative information for most hospitals for their clinical process and outcome quality as

The initial split 70% based on clinical quality and 30% on patient experience.

6 Hospital Compare The Hospital Compare website is accessible to the public and contains a great deal of comparative information for most hospitals for their clinical process and outcome quality as well as the H-CAHPS patient experience survey results 16 Value Based Purchasing Formula The Value Based Purchasing was described in the dry run period in The initial split 70% based on clinical quality and 30% on patient experience. 17 CG-CAHPS Care Givers Consumer Assessment of Healthcare Providers and Systems Two formats of survey Visit based (not finalized, still in consideration) Retrospective based for 12 months (probably the first survey required) It took decades H-CAHPS to get up and running and linked to Value Base Purchasing CG-CAHPS took years to get up and running the speed of roll out of these programs is increasing Lessons learned in these two will apply to future federal programs and may apply to Audiology practices 18 6

7 Breakout Session 1 Key Drivers Among your tables, please use the provided handouts to respond to the following: a) What do you think are key drivers of patient experience for audiology patients? b) How would you rank those drivers in terms of order of importance? 19 Drivers of patient experience: A literature review LITERATURE REVIEW OF KEY DRIVERS OF PATIENT EXPERIENCE 20 Literature Findings There is an extensive literature on the drivers of inpatient experience. (Picker, Gallup, Press Ganey, etc) Patient characteristics (age, sex, race, education) Provider behavior characteristics (communication, helpfulness) Self-reported health status The literature on drivers in the physician's practice are more limited since the shift to this practice setting has accelerated. (Press Ganey, CMS) Patient characteristics (age, sex, race, education) Facility process characteristics (wait times, information about delays) The study of outpatient practices is relatively new. Press Ganey has provided some insight into this but there is little if any formal literature specific to the outpatient area. 21 7

8 Some Issues More Important to Patients? Managers usually like to focus their efforts and resources where it will do the most good hence understanding patient priorities is important The philosophy of the CMS appears to be that all issues covered in the H-CAHPS are equally important and so they do not provide any guidance Most vendors of standardized surveys provide some guidance to their clients of their own results and sometimes they apply their approaches to H-CAHPS results as well. 22 Priority Index System Managers usually like to focus their efforts and resources where it will do the most good hence understanding patient priorities is important The Press Ganey priority index system is one way that this is done. The score of each item is ranked from low to high and the size of the correlations correlations of each individual item and overall satisfaction is ranked from high to low. These rankings are added together: To have the highest priority items will have to have low scores and strong associations to overall satisfaction. In other words, high priority issues are those that are important to your respondents but ones on which you are not doing so well. Low priority issues consist of items having high scores but weak associations to overall satisfaction. ( Guide to Interpreting Report Interpretation, Press Ganey, Inc. 2011, p. 29 ) 23 National Priority Index Press Ganey is believed to have the largest comparative data base of audiology practices among survey vendors. They currently have 44 clients. This is a rollup for these practices for

9 How Does Rush Compare? Top 10 Priority Index Issues Patients at RUMC Top 10 Priority Index Issues Patients Nationally 1 Our sensitivity to your needs Our sensitivity to your needs 2 Response to concerns / complaints Response to concerns / complaints 3 Ease of registration process Overall rating of care 4 Ease of finding your way around Staff worked together to provide care 5 Staff worked together to provide care Our concern for your privacy 6 Informed about delay during visit (non-standard questions) Likelihood of Recommending 7 Our concern for your privacy Helpfulness of registration person 8 Overall rating of care Comfort of waiting area 9 Comfort of waiting area Cleanliness 10 tie Ease of access for those with physical limitations Ease of finding your way around 10 tie Helpfulness of registration person 25 Which leads to How should/can we measure patient experience? 26 Review of existing tools for measuring patient experience There are multiple tools to measure patient experience including: Patient Satisfaction Tools Patient Quality of Life Tools Patient Perception of Treatment Efficacy 27 9

10 Patient Satisfaction Tools Available tools CMS/AHRQ HRSA RAND Proprietary tools 28 Patient Satisfaction Tools CMS CAHPS Benefits Standardized tool with large research base Free to use Available vendor(s): Press Ganey, The Myers Group, National Research Corporation 29 Patient Satisfaction Tools HRSA Primary Care Health Center Survey ancemeasures/patientsurvey/surveyform.html Benefits Standardized tool with large research base Free to use Available vendor(s): Midwest Clinicians Network 30 10

11 Patient Satisfaction Tools RAND PSQ III and PSQ 18: VS 9: Benefits Standardized tools with large research base Free to use Scoring system published and validated. 31 Patient Satisfaction Tools Proprietary Tools MGMA Clinical professional societies Press Ganey & Associates Bivarius, Inc. Benefits Standardized tool with a specific focal audience Often have research validation Options for advanced analytic services 32 Patient Quality of Life Tools Available tools Short Form (SF) surveys (8, 12, 20, 36; Brazier, Roberts, & Deverill, 2002; 36.org/tools/sf36.shtml) Quality of Well-Being (QWB) Scale SA (Kaplan and Anderson 1988, 1996; EuroQol 5-D (EuroQol Group 1990; PROMIS (Cella et al. 2007, Revicki et al. 2009;

12 Patient Quality of Life Tools SF Survey benefits Standardized tool with large research base Ability to choose length of survey Multiple modalities Analytics are available for a fee 34 Patient Quality of Life Tools QWB SA benefits Standardized tool with large research base Established for use with economic analysis Available for a fee 35 Patient Quality of Life Tools Euro-QOL benefits Standardized tool with large research base Established for use with economic analysis Available and validated in multiple languages Available for a fee 36 12

13 Patient Quality of Life Tools PROMIS benefits Standardized tool with growing research base Multiple disease specific sub scales and strata Free for use 37 Patient Perception of Treatment Efficacy Available tools Service Satisfaction Scale (SSS; Greenfield TK, Attkisson CC, 1994; isfaction_scale_sss_30_sss_15_sss_res) International Outcome Inventory for Hearing Aids (IOI-HA; Cox, et al, 2002) 38 Patient Perception of Treatment Efficacy Benefits of the SSS Self-report inventory Measures patient perception of practitioner manner, patient perception of treatment outcome, office procedures and accessibility Available for a fee 39 13

14 Patient Perception of Treatment Efficacy Benefits of the IOI-HA Self-report inventory Measures overall quality of life for the patient and their significant other Administered from 1 month to 6 months post HA fit Has published group norms which allows benchmarking 40 Summary of Patient Experience Tools Satisfaction Tools Cost Ease of Use Number of Questions Applicability to Audiology CMS/AHRQ $ # 18-60!!! HRSA $ # 33!! RAND $ # 9-60! Proprietary $ -$$$ ## Varies!!! Quality of Life SF $$-$$$ ### 8-36!! QWB $$ ## 65!! EuroQol $$ ## 6!! Promis $ # 4-100s!!! Treatment Efficacy SSS $$-$$$ ## 15-30!! IOI-HA $ ## 7-8!!! 41 Q & A Session I Question and Answer 42 14

Summary Part 1 The healthcare environment is changing with greater emphasis being placed on delivering value This includes being able to quantify patient experience Patient experience is driven by a

15 Summary Part 1 The healthcare environment is changing with greater emphasis being placed on delivering value This includes being able to quantify patient experience Patient experience is driven by a variety of variables There are free and easy to use tools that can help you measure patient experience 43 Case Study Rush University Medical Center Audiology Clinic Audiology at Rush Urban medical center serving a diverse, multi-cultural population Medical center clinic and academic clinic 4 full-time + 4 part-time audiologists (5.5 FTE) Approximately 3,800 patient visits/yr 75% Diagnostic Services 25% Hearing Instrument Services 45 15

16 Audiology at Rush Doctor of Audiology (AuD) program is ranked 10 th in the nation by U.S. News & World Report in their evaluation of the best graduate programs in the country 39 AuD students enrolled The students learn through the teacher-practitioner model Audiologists directly involved in both didactic and clinical education. 46 Audiology at Rush New facility 47 Audiology at Rush New facility 48 16

17 Data Drives Patient-Centered Care Patient-centered care driven by: Evidence-Based Practice Guidelines American Academy of Audiology American Speech-Language and Hearing Association e.g., real ear measurement (REM) to verify appropriate access to the speech spectrum (Valente et al,(2006). Guidelines for Audiological Management of Adult Hearing Impairment. Audiology Today,18:5) Patient Satisfaction Treatment Efficacy Process Efficacy 49 RUMC Data Sources 1. Patient Experience Press Ganey Patient satisfaction with how services are provided HHI, COSI, APHAB Assessment of patient needs Validation of treatment outcome RUMC Data Sources 2. Quality of Life Measures IOI-HA + Explore the impact of treatment on overall function and quality of life 3. Efficiency of Services How efficient is each services we provide? e.g. sedated-abr, cochlear implants, etc. 17

18 Using Data To Quantify Our Patient s Experience Rush University Medical Center Audiology Clinic Measuring Our Patient s Experience Three Areas of Interest: 1. Patient Satisfaction with Service Delivery 2. Patient Perception of Treatment Efficacy 3. Continuous Quality Improvement of Service Efficacy (PDCA) 53 Our Patient s Experience 1. Patient Satisfaction with Service Delivery 2. Patient Perception of Treatment Efficacy 3. Continuous Quality Improvement of Service Efficacy 54 18

19 Patient Satisfaction (Press Ganey) Rush University Medical Center Audiology Clinic Patient Satisfaction Integrating Data How do we get it? What do we focus on? How often do we check it? When and how do we act upon it? 56 The Process of Obtaining Data Online account Customized report options Support/Resources RUMC on-site (e.g., Francis) Press Ganey Customer Support 57 19

20 What Data Do We Focus On? Patient Satisfaction #1: Overall Patient Satisfaction Mean Press Ganey Score rd UHC percentile 83 rd National percentile #2: Most Important to Patients Top 10 Priority Index Issues Patients at Rush University Medical Center 1 Our sensitivity to your needs 2 Response to concerns / complaints 3 Ease of registration process 4 Ease of finding your way around 5 Staff worked together to provide care 6 Informed about delay during visit 7 Our concern for your privacy 8 Overall rating of care 9 Comfort of waiting area 10 tie Ease of access for those with physical limitations 10 tie Helpfulness of registration person 60 20

21 #2: Most Important to Patients Top 10 Priority Index Issues Patients at Rush University Medical Center 1 Our sensitivity to your needs 2 Response to concerns / complaints 3 Ease of registration process 4 Ease of finding your way around 5 Staff worked together to provide care 6 Informed about delay during visit 7 Our concern for your privacy 8 Overall rating of care 9 Comfort of waiting area 10 tie Ease of access for those with physical limitations 10 tie Helpfulness of registration person 61 #2: Most Important to Patients Top 10 Priority Index Issues Patients at Rush University Medical Center 1 Our sensitivity to your needs 2 Response to concerns / complaints 3 Ease of registration process 4 Ease of finding your way around 5 Staff worked together to provide care 6 Informed about delay during visit 7 Our concern for your privacy 8 Overall rating of care 9 Comfort of waiting area 10 tie Ease of access for those with physical limitations 10 tie Helpfulness of registration person 62 #3: Our Performance 1. The overall mean score 2. Individual question scores 3. Comparative rank among UHC members Goals: 1. RUMC outpatient: > 90 for overall mean score 2. Audiology: > 90 for each individual question 63 21

22 How Often Do We Check Data? Weekly Monthly Quarterly Weekly Patient comments majority are compliments 20% 80% Positive Mixed/Negative Red flags? Meet with clinic managers to address any specific concerns 65 Patient Comments Positive: The visit was a very good experience. The Doctor greeted me right away and walked me into the examining room. Positive: The took all the time I needed to make sure I understood what was happening to me. Positive: They provided me with good explanations. Mixed: Mixed: The student was a bit nervous at first. It was hard to find the office but person on the phone gave good directions. Negative: Waiting time too long

23 Monthly Small sample Look for trends/movement in the data Begin to develop strategies for the larger movements Mean Press Ganey Score Overall Patient Satisfaction 67 Quarterly Larger sample now we have something! Statistically significant changes? Press Ganey does the math! We make evidence-based decisions! Identify areas excellence and/or opportunities for improvement Mean Press Ganey Score Overall Patient Satisfaction 68 An Opportunity for Improvement Rush University Medical Center Audiology Clinic 23

Mean Press Ganey Score 98 96 94 92 90 88 86 84 Overall Patient Satisfaction 95.

24 Mean Press Ganey Score Overall Patient Satisfaction Mean Press Ganey Score Overall Patient Satisfaction Mean Press Ganey Score Overall Patient Satisfaction What the H#&% happened? 72 24

25 Revisit: What is Most Important to our Patients? Top 10 Priority Index Issues Patients at Rush University Medical Center 1 Our sensitivity to your needs 2 Response to concerns / complaints 3 Ease of registration process 4 Ease of finding your way around 5 Staff worked together to provide care 6 Informed about delay during visit 7 Our concern for your privacy 8 Overall rating of care 9 Comfort of waiting area 10 tie Ease of access for those with physical limitations 10 tie Helpfulness of registration person 73 Revisit: What is Most Important to our Patients? Top 10 Priority Index Issues Patients at Rush University Medical Center 1 Our sensitivity to your needs 2 Response to concerns / complaints 3 Ease of registration process 4 Ease of finding your way around 5 Staff worked together to provide care 6 Informed about delay during visit 7 Our concern for your privacy 8 Overall rating of care 9 Comfort of waiting area 10 tie Ease of access for those with physical limitations 10 tie Helpfulness of registration person 74 Overall vs. Informed Mean Press Ganey Score Overall Score

26 Overall vs. Informed Mean Press Ganey Score Overall Score Informed about delays Investigation Root-Cause Analysis Discussed with both audiologist and administrative staff/receptionists Did not reveal anything apparent (no staff changes, no policy changes, etc.) Agreed to remain diligent with current practice to: Inform patients about delays See patients on time 77 Intervention - New Audiologists call front desk with UPDATES and ask administrative staff to go over to waiting patient to inform about delay. Make sure patients who arrive early are aware of their scheduled appointment time. Service Recovery: Free parking passes to patients with delays 30 minutes or more

27 Overall vs. Informed Mean Press Ganey Score Overall Score Informed about delays Overall vs. Informed Mean Press Ganey Score Overall Score Informed about delays Overall vs. Informed Mean Press Ganey Score Overall Score Informed about delays

Overall vs. Informed Mean Press Ganey Score 98 96 94 92 90 88 86 84 82 80 78 76 Overall Score Informed about delays 95.0 94.2 82 83 No One Likes to Wait!

28 Overall vs. Informed Mean Press Ganey Score Overall Score Informed about delays No One Likes to Wait! Patients are also asked to report how long they remember having to wait to be seen. A growing number of our patients began to report shorter wait times. FY12 Q3 = 45% reported wait time < 5 min FY13 Q2 = 71% reported wait time < 5 min 84 28

29 No One Likes to Wait! Patients are also asked to report how long they remember having to wait to be seen. A growing number of our patients began to report shorter wait times. FY12 Q3 = 45% reported wait time < 5 min FY13 Q2 = 71% reported wait time < 5 min 85 No One Likes to Wait! Patients are also asked to report how long they remember having to wait to be seen. A growing number of our patients began to report shorter wait times. FY12 Q3 = 45% reported wait time < 5 min FY13 Q2 = 71% reported wait time < 5 min 86 Our Patient s Experience 1. Patient Satisfaction with Service Delivery: Reviewed weekly, monthly and quarterly for timely identification and intervention to improve patient experience Small changes can lead to direct and indirect improvements in patient satisfaction 87 29

30 Our Patient s Experience 1. Patient Satisfaction with Service Delivery 2. Patient Perception of Treatment Efficacy 3. Continuous Quality Improvement of Service Efficacy 88 Treatment Efficacy Goal: To assess self-perceived benefit of amplification / rehabilitation Process: 6 month post-fit mail survey IOI-HA (Cox, et al, 2002) Hearing aid satisfaction, benefit and use Impact on QOL (patient and SO) Published group norms 89 Treatment Efficacy Strengths Anonymous Consistent use of evidence-based protocol across clinicians Reflects the overall effectiveness of the program Challenges Sample size 90 30

Treatment Efficacy Future use: Collect demographic information Similar measures for CI and bone-anchored implant patients 91 Our Patient s Experience 2.

31 Treatment Efficacy Future use: Collect demographic information Similar measures for CI and bone-anchored implant patients 91 Our Patient s Experience 2. Patient Perception of Treatment Efficacy Measurement provides opportunity to not only gauge patient experience but also program quality. 92 Our Patient s Experience 1. Patient Satisfaction with Service Delivery 2. Patient Perception of Treatment Efficacy 3. Continuous Quality Improvement of Service Efficacy 93 31

32 Process Efficiency Metric: Completion rate Not completing delays identification and appropriate treatment Not good enough to show for appointment, especially when completion relies on many factors: Show on time, followed pre-test instructions (e.g., NPO, medications), pre-registered appropriately, etc. Opportunity cost 94 PDCA for Sedated-ABR Patient Patient showed late for the appointment Patient ate/drank Patient ill day of test 95 PDCA for Sedated-ABR Procedural Patient H &P not completed within 30 day period No/not appropriate referral for sedation Limited flexibility with other required services when arrives late 96 32

33 PDCA for Sedated-ABR Operational Patient Procedural Outpatient procedure on an inpatient floor (in-patient infrastructure different from out-patient with respect to admitting, billing, documentation, discharge, etc.) Many cooks in one kitchen 97 PDCA for Sedated-ABR Operational Patient Procedural Inter-professional collaboration was needed! 98 PDCA for Sedated-ABR Outcome Extensive efforts led to more efficient and effective clinical processes

34 PDCA for VNGs FY 2011: 68% completion rate! Obstacles to a better completion rate were difficult to find. Discussion lead to a single modification to our existing protocol: Phone call was made to patient by administrative staff 2 days (instead of 1) prior to appointment 100 Continuous Quality Improvement -PDCA Simple effort led to more efficient and effective clinical processes Case Study Summary Patient experience data can be measured and incorporated in multiple ways Data that are regularly used can assist in identifying priority areas for change Small changes can lead to large improvements in patient satisfaction data and efficiency measures

35 Incorporating measurement of patient experience The future of patient experience in audiology practice: Integrating patient experience in quality improvement Preparing your practice for measuring and linking patient experience and clinical quality improvement Strategies for making measurement easy 103 The future of patient experience Patient experience reporting will become part of the fabric of healthcare delivery Patients will demand transparency and comparability Increased patient sharing of information: Opportunity to shape the narrative 104 Preparing your practice to increase measurement of Patient Experience data Steps to preparing your practice for integrating measurement 1. Choose what you want measure including a specific definition 2. Examine if you might already collect that information 3. Identify whether you will measure it yourself or you ll hire an outside vendor 4. Establish your protocols for how you want measurement to occur and data to be captured and stored

36 Questions to ask What do you really want to know? Why is it important to you? Will you really use this information if you collect it? What is the potential patient burden that collecting this data might present? 106 Questions to ask Does your organization offer data and you just haven t been able to use it? Who do you need to ask to get it? What is your current data capacity and systems? 107 Questions to ask Do you want to collect the data yourself? Can you afford to hire someone else to do it? If you do it yourself, how much staff time will it require Do you really have the expertise for complex analytics? If you don t need complex analytics, do you have the skills for basic analytics?

37 Questions to ask How often do you plan to collect data? Who will be responsible for collection and entry? Where will the data be stored? Who will have access to it? Do you want to have a unique identifier? How will you maintain patient confidentiality? 109 Considerations and rules of thumb Data measurement and storage Start small Resist the temptation to throw in the kitchen sink Plan for turnover Create redundancy 110 Considerations and rules of thumb Data Collection Have a private place where surveys can be returned Create a Chinese wall between the person who enters the data and the one who analyzes the data Automate whenever possible Plan for biases that may result from the method of survey administration

38 Breakout Session 3 measures to improve experience Breakout sessions discussions a) Identify 3 measures of patient experience you currently collect in your practice (or you would like to collect). Select top 3-5 measures b) Develop an operational measure for each of these and how best to collect c) Develop strategies for mitigating the challenges of collecting each 112 Q & A Session I Question and Answer 113 Summary Part 2 Using data to measure patient experience can help you prioritize areas for improvement as well as identify strengths Small changes can lead to large gains in patient experience Collection of patient experience data will occur, planning now will allow you to shape your narrative Four steps are all you need to integrate data collection into your practice

39 Thank you! 39

CAHPS Focus on Improvement The Changing Landscape of Health Care. Ann H. Corba Patient Experience Advisor Press Ganey Associates

CAHPS Focus on Improvement The Changing Landscape of Health Care Ann H. Corba Patient Experience Advisor Press Ganey Associates How we will spend our time together Current CAHPS Surveys New CAHPS Surveys