Hardwiring Technology into Care Delivery to Increase HCAHPS
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1 Hardwiring Technology into Care Delivery to Increase HCAHPS March 1, 2016 Peggy Grant, Ph.D. Director of Innovation and Performance Improvement Community Regional Medical Center
2 Conflict of Interest Peggy Grant, Ph.D. Director of Innovation and Performance Improvement Community Regional Medical Center Has no real or apparent conflicts of interest to report.
3 Agenda What is Interactive Patient Care (IPC)? IPC as a patient engagement/education strategic intervention IPC as a Model of Care IPC/EHR Integration Positive impact on Medication HCAHPS Scores Lessons Learned
4 Learning Objectives Discuss methods for improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores through patient medication teaching Integrate Interactive Patient Care (IPC) technology with electronic health record (EHR) systems and other health IT solutions to streamline clinical workflows and document medication teaching Apply strong leadership engagement and a staff education plan to achieve facility-wide change management and cultural adoption of Interactive Patient Care (IPC)
5 How Benefits Were Realized for the Value of Health IT S Increase Patient Satisfaction Scores T Develop Consistent Methodology for Medication Teaching P Patient Engagement through Education (90%)
6 Context Located in Western United States 800-Bed Level One Trauma Center Level 3 NICU Average 58 bed units/85+ nurses per unit 694 Beds with Interactive Patient Care
7 Polling Question What is most important for change management initiatives? A. Executive support B. Clinical staff engagement C. HIT system integration D. Other
8 Interactive Patient Care: An Intervention 8
9 Interactive Patient Care Model Patient Engagement is required to transform care Drivers Clinicians need to shift focus from being providers to partners Patients need to be viewed as consumers who can weigh costs and benefits of health care Communication is changing with health technology patient-facing applications
10 Interactive Patient Care Model Key Process Components Assessment of a person s capacity for engagement Information exchange and communication of choices Strong clinician-person partnership to create plans Mutually determined suitable interventions Behavioral Technological Clinical Evaluation of engagement level/clinical outcomes
11 Outcome Metrics: HCAHPS - Medication Communication Question: Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand? Question: Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? Dimension: Medication Communication 11
12 Polling Question Which EHR integrations help you streamline workflows? A. Communication systems B. Interactive Patient Care C. Patient portal D. All of the above
13 IPC: Patient View (TV)
14 Polling Question How are you conducting patient education? A. Paper-based handouts B. Interactive TV C. Mobile devices D. Verbal instructions
15 IPC: Patient View
16 Polling Question Are your medication teaching aims improving HCAHPS scores? A. Yes B. No C. Not enough
17 IPC: Patient View
18 IPC: Patient View
19 Teach Back 1 Please tell me what this medication is for. Please name the 3 side effects we discussed. 2 3 Give encouragement. Correct any misunderstanding. Continue with the instruction until you are satisfied with the patient s or caregiver s understanding of the medication.
20 IPC: Patient View
21 IPC/EHR Integration Pt Name Redacted
22 RN Medication Teaching Competency Criteria Demonstrate skill in navigating IPC/EHR integration for medication education. Emphasize purpose and side effects of specific medication. Ensure patient and family education utilizing teach back method. Validate process with appropriate EHR documentation. 22
23 CRMC HCAHPS Re: Medication Side Effects What Medicine is For Medication Communication Baseline Apr-June % 76.2% 65.0% FY % 81.2% 70.2% % Difference 4.4% 5.0% 5.2% 23
24 Medication HCAHPS: Unit 1 Side Effects What Medicine is For Medication Communication Baseline Apr-June % 73.9% 60.5% FY % 80.4% 66.5% % Difference 2.2% 6.5% 6.1% 24
25 Medication HCAHPS: Unit 2 Baseline Apr-June 2013 Side Effects What Medicine is For Medication Communication 48% 56% 52% FY % 80.9% 65.9% % Difference 4.7% 23.9% 13.9% 25
26 Medication HCAHPS: Unit 3 Baseline Apr-June 2013 Side Effects What Medicine is For Medication Communication 59.6% 74.5% 66.3% FY % 86% 78.8% % Difference 12.2% 11.5% 22.5% 26
27 Medication HCAHPS: Unit 4 Side Effects What Medicine is For Medication Communication Baseline Apr-June % 62.5% 59.4% FY % 92.2% 81.4% % Difference 17.3% 29.7% 22% 27
28 Lessons Learned Interactive Patient Care is a new model of care. Consistent, effective patient education is a learned skill. Standardized clinical education is required to promote consistency. Regular feedback reinforces accountability. Integration with EHR ensures utilization of IPC. Pharmacists engage with IPC at the patient s bedside with their nursing partners. 28
29 How Benefits Were Realized for the Value of Health IT S Increase Patient Satisfaction Scores T Develop Consistent Methodology for Medication Teaching P Patient Engagement through Education (90%)
30 Questions? Peggy Grant, Ph.D.
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