Enhancing Communication Skills: A Catalyst for Organizational Cultural Transformation Presented by William Maples, MD, Chief Medical Officer,

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1 Enhancing Communication Skills: A Catalyst for Organizational Cultural Transformation Presented by William Maples, MD, Chief Medical Officer, Professional Research Consultants and Executive Director, The Institute for Healthcare Excellence, Galen Perdikis, MD, Faculty, The Institute for Healthcare Excellence, Chadi Ibrahim, MD, Medical Director of Medical House Services, Connie O Malley, Chief Operating Officer and Amanda LaVoie, M.S., R.D., Director of Service Excellence and Environmental Services, Beaumont Hospital Troy

2 Defining Patient Experience - The Beryl Institute 2

3 April Sheraton Dallas Hotel Dallas, Texas Keynote Speakers Ronan Tynan Cynthia Mercer Montel Williams Kelly Corrigan Breakout Sessions Three Pre-Conference Gatherings Patient Advocacy Community Physician Community Pediatric Community Three Pre-Conference Workshops Networking Dinner & Reception The Margot and Bill Winspear Opera House at the AT&T Performing Arts Center The Environment of the Patient Experience: Proactive Design in Practice Lorissa MacAllister and Susan Mazer Coaching and Feedback to Enhance Communication Calvin Chou and Laura Cooley Leading Your Patient Experience Strategy tp the Next Level Wendy Leebov, Jill Golde and Dorothy Sisneros

4 Become a Certified Patient Experience Professional. Applicants should have a minimum 3 years of professional experience in a patient experience related role or completion of 30 Patient Experience Continuing Education Credits (PXEs). Learn more at

5 Housekeeping All participant phone lines are muted. The presentation will run minutes with about min for Q&A. Q&A will be conducted through the Q&A function. Please submit questions to the host for a facilitated Q&A after the presentation. Webinar materials and session recording will be available for all attendees. (receive an notification with the appropriate link) A survey will be distributed following today s session. This program is pending approval for 1 PXE

6 PX Continuing Education Credits In order to obtain patient experience continuing education credit, participants must attend the program in its entirety and return the completed evaluation. The planning committee members and presenters have disclosed no relevant financial interest or other relationships with commercial entities relative to the content of the educational activity. No off label use of products will be addressed during this educational activity. This activity has received no sponsorship or commercial support. No products are available during this educational activity, which would indicate endorsement.

7 Our Speakers William Maples, MD Chief Medical Officer, PRC Executive Director The Institute for Healthcare Excellence Galen Perdikis, MD Faculty, The Institute for Healthcare Excellence Chadi Ibrahim, MD, Medical Director Medical House Services Beaumont Hospital Troy Connie O Malley Chief Operating Officer Beaumont Hospital Troy Amanda LaVoie, M.S., R.D., Director of Service Excellence and Environmental Services Beaumont Hospital Troy 7

8 Communication in Healthcare

9 Why Communication in Healthcare Demonstrated Results Risk Adjusted Mortality ICU Length of Stay Patient Experience Overall Inpatient Physician Communication Scores 50% 1 day 33% 43%

10 Goals: 4-Hour Communication in Healthcare Curriculum Enhance Patient Experience Evolve a culture of safety Enhance Employee Engagement and Satisfaction Create a culture of mutual respect, safety, and teamwork through communication Decrease adverse events Improve patient compliance with treatment plans, thereby enhancing outcomes and decreasing rework resulting from unnecessary readmissions Decrease Staff Turnover Decrease Malpractice Events Restore joy for the practice of medicine Build resilience to meet the ever-changing healthcare environment

11 Program Design PROGRAM DESIGN Interactive Small Group Learning 1 Faculty per 6 Participants COURSE ELEMENTS Interactive/immersive training style Peer to peer teaching (e.g. MD to MD) 1 Faculty per 6 colleagues Didactic discussions and video Longitudinal experience CME accredited Mindfulness/Presence Active listening Information gathering Negotiating an agenda Connecting with patients and team Written communication Appreciative inquiry/debrief

12 Enhancing Communication Skills: A Catalyst for Organizational Cultural Transformation February 2016

13 Beaumont - Troy 458 Licensed Beds 4,675 Employees 1,348 Physicians Employed and Private 35,650 Admissions 93,332 EC Visits 3,736 Births 19,524 Total Surgeries

14 Why did we seek Communication Training? Desire to develop a curriculum that allowed staff to more strongly connect with patients, families and each other Looking for more than an initiative Culture shift to align with our vision

15 Why this concept? Learner centered approach Physician and allied health learning parallel learning Self sustaining model

16 What was the need? Maintain a high level of safety and quality Improve physician patient experience scores Improve overall patient experience scores Desire to improve communication between providers Desire to maintain our facility as the hospital of choice Doing the right thing

17 Challenge in getting physicians on board Not all physicians view patient experience as important aspect of patient care Generally viewed as softer side of medicine Docs don t think they have issues with communication We also didn t know where physician leaders are on the issue Difficult to get physicians interested in taking the lead on the issue

18 Why is physician involvement important? It became clear that the patient experience initiative wouldn t succeed without involving physicians Physicians are well respected by patients Physicians are well respected by others members of the team We have a stake in this Our reputation is on the line Improved job satisfaction

19 How do we involve physicians? The leadership must buy into it It has to be a physician who drives it We have to show physicians that this is a valuable skill It is a way to help improve how we practice medicine Will not take more time! The carrots: CME, Academic Credits, MOC credits Start the conversation Execution is the key!

20 Setting the vision Finding the right program Treading lightly with physicians Having the conversations are crucial Generating a buy in from leadership Leaders need to see these benefits: Improved quality of care, financially sound proposal and sustainability Inviting the right physician leaders to the table Rolling out the program in a stepwise approach

21 Sustaining the Vision Building on momentum Forming a team of advocates Creating ambassadors for the initiative Reaching a critical mass Requiring the skill Weaving into the culture

22 What does the work look like now? Physicians (includes mid-level providers) Monthly classes Allied health staff weekly classes Post-class Letters to homes requesting stories Caring Connections meeting Recognition

23 Patient Satisfaction Data Communication with Nurses HCAHPS Domain April: Initial training July: Training implementation began. 0 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Top Box Percentile Ranking Data displayed by date of service 2/4/

24 Patient Satisfaction Data 90 Communication with Doctors HCAHPS Domain April: Initial training July: Training implementation began. 0 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Top Box Percentile Ranking Data displayed by date of service 2/4/

25 Patient Satisfaction Data 90 Global Rating HCAHPS Domain (9s and 10s) July: Training implementation began. 10 April: Initial training 0 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Top Box Percentile Ranking /4/ Data displayed by date of service

26 Learnings and Results From Institutions Engaged in the Communication in Healthcare Program

27 Critical Success Factors 1. Strong leadership commitment to supporting the program. 2. Curriculum developed to be significantly relevant to the practicing clinician. 3. Program designed to be financially feasible and sustainable. 4. Choose faculty to represent the diversity of the entire physician and allied health staff and are well respected by their colleagues 5. Conduct training sessions on a monthly basis to complete training for the entire faculty over a two year period 6. Physicians and allied health staff should be required or strongly encouraged to participate in the curriculum

28 Physician Program Evaluation Scale of 1-5 Overall, program useful 4.1 Is good for institution 4.5 Was worth the time for me personally 4.1 Ability to help learners become actively engaged 4.5 with exercise Ability to maintain a safe and trusting environment 4.6 Ability to help others accomplish learning goals 4.5

29 Patient Experience Results Outpatient Overall Quality of Care % Excellent Health MCF System Year 1 Year 2 Year 3 Year 4 Year 5

30 Patient Experience Results Inpatient Overall Level of Safety % Excellent Health MCF System Year 1 Year 2 Year 3 Year 4

31 Patient Experience Results Doctor's Involving Patient in Decision-Making Process 66 Doctor's Understanding and Caring Doctor's Communication / Keeping Patient Informed Nurse Listen

32 Patient Experience Results Outpatient Willingness to Recommend % Definitely Would Health MCF System Year 1 Year 2 Year 3 Year 4 Year 5

33 Value Based Purchasing Patient Experience Mission Hospital Hospitals 86% 84% 82% 83% Communication with Nurses 85% 83% U.S. Top 10% U.S. Average 80% 78% 76% 79% 76% 79% 74% /1/ /1/ /1/ /1/ /1/ /1/ /1/ /1/ /1/ /1/ /1/ /1/ /1/ Scheduled Quarterly Release Mar June 2011 Sept Dec Mar June 2012 Sept Dec Mar June 2013 Sept Dec Mar Data Collection Dates Jul. 1, June 30, 2010 Oct. 1, Sept. 30, 2010 Jan. 1, Dec. 31, 2010 Apr. 1, Mar. 31, 2011 Jul. 1, June 30, 2011 Oct. 1, Sept. 30, 2011 Jan. 1, Dec. 31, 2011 Apr. 1, Mar. 31, 2012 Jul. 1, June 30, 2012 Oct. 1, Sept. 30, 2012 Jan. 1, Dec. 31, 2012 Apr. 1, Mar. 31, 2013 Hospital Performance 79% 78% 78% 78% 78% 80% 80% 81% 83% 83% 84% 83% 83% U.S. Top 10% 83% 83% 83% 83% 84% 84% 84% 85% 85% 85% 85% 85% 85% U.S. Average 76% 76% 76% 76% 77% 77% 77% 78% 78% 78% 78% 78% 79% Jul. 1, June 30, 2013 U.S. Rank 939 of of of of of of of of of of of of of 3974 State Rank 40 of of of of of of of of of of of of of 98 Applicable to the 2013, 2014, 2015 and 2016 VBP Programs.

34 Value Based Purchasing Patient Experience 82% Pain Management 80% Mission Hospitals Hospital U.S. Top 10% 78% 76% 74% 76% 78% 77% U.S. Average Scheduled Quarterly Release Mar June 2011 Sept Dec Mar June 2012 Sept Dec Mar June 2013 Sept Dec Mar Data Collection Dates 72% 70% 68% 72% 69% Jul. 1, June 30, 2010 Oct. 1, Sept. 30, 2010 Jan. 1, Dec. 31, 2010 Apr. 1, Mar. 31, 2011 Jul. 1, June 30, 2011 Oct. 1, Sept. 30, 2011 Jan. 1, Dec. 31, 2011 Apr. 1, Mar. 31, 2012 Jul. 1, June 30, 2012 Oct. 1, Sept. 30, 2012 Jan. 1, Dec. 31, 2012 Apr. 1, Mar. 31, 2013 Hospital Performance 72% 71% 71% 69% 71% 72% 71% 75% 76% 78% 81% 80% 78% U.S. Top 10% 76% 76% 76% 76% 76% 76% 76% 77% 77% 77% 77% 77% 77% U.S. Average 69% 69% 69% 70% 70% 70% 70% 70% 71% 71% 71% 71% 71% Jul. 1, June 30, 2013 U.S. Rank 914 of of of of of of of of of of of of of 3969 State Rank 30 of of of of of of of of 97 8 of 97 5 of 97 1 of 98 1 of 98 3 of 98 Applicable to the 2013, 2014, 2015 and 2016 VBP Programs. 71%

35 Value Based Purchasing Patient Experience Mission Hospital Hospitals U.S. Top 10% U.S. Average Scheduled Quarterly Release Mar June 2011 Sept Dec Mar June 2012 Sept Dec Mar June 2013 Sept Dec Mar Data Collection Dates 76% 74% 72% 70% 68% 66% 64% 62% 60% 58% 68% 60% 59% Jul. 1, June 30, 2010 Oct. 1, Sept. 30, 2010 Jan. 1, Dec. 31, 2010 Communication about Medicines Apr. 1, Mar. 31, 2011 Jul. 1, June 30, 2011 Oct. 1, Sept. 30, 2011 Jan. 1, Dec. 31, 2011 Apr. 1, Mar. 31, 2012 Jul. 1, June 30, 2012 Oct. 1, Sept. 30, 2012 Jan. 1, Dec. 31, 2012 Apr. 1, Mar. 31, 2013 Hospital Performance 59% 60% 60% 63% 66% 69% 69% 69% 71% 70% 72% 76% 75% U.S. Top 10% 68% 68% 69% 69% 69% 70% 70% 71% 71% 71% 72% 72% 72% U.S. Average 60% 61% 61% 61% 61% 62% 62% 63% 63% 63% 64% 64% 64% Jul. 1, June 30, 2013 U.S. Rank 2036 of of of of of of of of of of of of of 3967 State Rank 76 of of of of of of of of of of of 98 3 of 98 3 of 98 Applicable to the 2013, 2014, 2015 and 2016 VBP Programs. 75% 72% 64%

36 Value Based Purchasing Patient Experience 92% Discharge Information Mission Hospital Hospitals 90% 90% 88% 88% U.S. Top 10% 86% U.S. Average 84% 85% 85% Scheduled Quarterly Release Mar June 2011 Sept Dec Mar June 2012 Sept Dec Mar June 2013 Sept Dec Mar Data Collection Dates 82% 82% Jul. 1, June 30, 2010 Oct. 1, Sept. 30, 2010 Jan. 1, Dec. 31, 2010 Apr. 1, Mar. 31, 2011 Jul. 1, June 30, 2011 Oct. 1, Sept. 30, 2011 Jan. 1, Dec. 31, 2011 Apr. 1, Mar. 31, 2012 Jul. 1, June 30, 2012 Oct. 1, Sept. 30, 2012 Jan. 1, Dec. 31, 2012 Apr. 1, Mar. 31, 2013 Hospital Performance 85% 84% 85% 86% 87% 88% 88% 88% 89% 88% 88% 90% 90% U.S. Top 10% 88% 88% 88% 88% 88% 88% 89% 89% 89% 89% 90% 90% 90% U.S. Average 82% 82% 82% 82% 83% 83% 83% 84% 84% 84% 85% 85% 85% Jul. 1, June 30, 2013 U.S. Rank 845 of of of of of of of of of of of of of 3973 State Rank 25 of of of of of 97 9 of 97 8 of 97 7 of 97 8 of of of 98 4 of 98 5 of 98 Applicable to the 2013, 2014, 2015 and 2016 VBP Programs.

37 Staff Satisfaction Respect between MD and AHS Service from colleagues Treat others with respect Year 1 Year 2 Year 3

38 Percentile Ranking Nationally 80% 70% 60% 50% * Very near / approaching bucket 40% 30% 20% 10% 0%

39 Reduced the use of Propofol (ICU) 600 Propofol Bottles Removed Bottles Removed, Coli Linear (Bottles Removed, Coli) 0

40 Reduced Length of Stay (ICU) 6 FY11 Flu ABCDE Work 5 MSICU - Average Length of Stay (APACHE) FY10 Flu IHI Projects Intensivist Model FY12 Flu 0 Oct' NovDecJan' Feb Mar Apr' Ma Jun' Jul' AugSep Oct' Nov DecJan' Feb Mar Apr' Ma Jun' Jul' AugSep Oct' NovDecJan' Feb Mar Apr' Ma Jun' 09 '09 '09 10 '10 '10 10 y' '10 '10 10 '10 '10 11 '11 '11 11 y' '11 '11 11 '11 '11 12 '12 '12 12 y'12 12 ALOS Median Goal **ADT data x3mos

41 Risk Adjusted Mortality >500 FEWER Deaths per Year than 2010

42 Questions William Maples, MD Chief Medical Officer, PRC Executive Director The Institute for Healthcare Excellence Galen Perdikis, MD Faculty, The Institute for Healthcare Excellence Chadi Ibrahim, MD, Medical Director Medical House Services Beaumont Hospital Troy Connie O Malley Chief Operating Officer Beaumont Hospital Troy Amanda LaVoie, M.S., R.D., Director of Service Excellence and Environmental Services Beaumont Hospital Troy 42

43 PX Continuing Education Credits This program is pending approval for 1 PXEs In order to obtain PXEs, participants must attend the program in its entirety and complete evaluation.

44 We invite you to join us We invite you to join our global community of over 40,000 members and guests passionate about improving the patient experience. Become a member today at

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