A Multi-Pronged Approach to Improve Provider Satisfaction Session 149, March 7, 2018 1-2 p.m. Thomas Selva, MD, CMIO, MU Health Care Bryan Bliven, CIO, MU Health Care 1
Conflict of Interest Thomas Selva, MD Bryan Bliven Has no real or apparent conflicts of interest to report. 2
Agenda Ask/Listen Communicate Engage Educate Plan/Do Measure 4
Learning Objectives Identify key components in a multi-pronged approach to positively impact provider satisfaction Demonstrate the importance of provider EMR surveys Recognize the value of physician-funded positions on a EMR council 5
University of Missouri Health 6
Basic Principles Basic principles: no matter what, no matter when, no matter who any CMIO / CIO has a chance to sweep any user off their feet. They just need the right broom. 7
Basic Principles Ask/Listen Communicate Engage Educate Plan/Do 8 Measure
Ask/Listen 9
EMR Survey Results Questions are grouped into five categories to facilitate analysis and to track response trends 4.5 Targeted Impact 4 3.5 2017 Average Score % Change from 2016 3 Ease of Access 4.11 10.5% Patient Safety 3.45-2.3% 2.5 2 2012 2013 2014 2015 2016 2017 Ease of Access Efficiency Communication Patient Safety Research and Process Improvement 10 Communication 2.96-6.6% Efficiency 3.07 0.0% Research & Process Imp. 2.22-5.1%
Ask/Listen 11
Ask/Listen 12
Engage with Stakeholders Communicate Ask/Listen Engage Educate Plan/Do Measure 13
Shared Governance EMR Council PI-LDP/QI Model Experience 14
Shared Governance University System President CEO/President of Cerner Tiger Institute Board of Governors 5MU/5Cerner Population Health Workgroup Value Creation Office Registry Management Tiger Institute Prioritization and Steering Committe (TIPS) Data Governance Value Based Performance / Ops TIPS Sub-Committee Operations Project Management Documentation Provider Experience Patient Engagement Device OVersight Clinic Informatics Multi-D Informatics Orders Management Enterprise Media Pharmacy Advisory Clinical Decision Support / EBM 15
EMR Council 16
PI-LDP/QI 17
Model Experience 18
Plan/Do and Measure Communicate Ask/Listen Engage Educate Plan/Do Measure 19
Plan/Do 20
Plan/Do 21
Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Measure/Measure/Measure DART Team Engagement Results 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Dyn Doc Time Compared to Power Note Time 0:31:41 0:24:29 0:17:17 0:10:05 0:02:53 % Dynamic Documentatio n DynDoc Time Per Note PowerNote Time Per Note 22
Measure/Measure/Measure DART Team Engagement Results 4:48:00 4:19:12 3:50:24 3:21:36 2:52:48 2:24:00 1:55:12 1:26:24 0:57:36 0:28:48 0:00:00 Dyn Doc Impact to Outside Hours Documentation 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% % Dynamic Documentation Documentation Time Outside Hours 23
Plan/Do Case Study: PILDP Project reduce readmissions Cone it down: Start with small test of change on quantifiable population CHF leading cause of readmissions Problem is not identifying patients with CHF when admitted for other issues Build algorithm to look at previous admissions, problem list, subset of labs and medications. Fire alert on admission that patient may have CHF Add CHF to problem list» Sets off process / orders to assure daily weights, discharge education 24
Measure/Measure/Measure CHF Algorithm Results Outcome: Readmissions for CHF drop by 50%!!! 25
Plan/Do Case Study: PILDP Project: Who is My Doctor Right Now? Solve the problem of who is the resident caring for the patient at this moment. Large source of frustration for nursing, consulting, and ancillary services. Engage big-small test of change on Medicine Service using Cerner I-PASS Handoff tool. Challenge: It works! Now spread it to the entire organization. 26
Measure/Measure/Measure Primary Contact Results 27
Educate Ask/Listen Communicate Engage Educate Plan/Do Measure 28
Educate 29
Educate 30
Educate DART Team / EMR Training Team Engagement Meeting with departments during faculty meetings or residency staff meetings. Participation in EMR Happy Hour sessions Cover hot tips or topics of interest to help assure staff are using the best workflows to achieve optimum efficiency with the EMR and associated tools. 31
Communicate Ask/Listen Communicat e Engage Educate Plan/Do 32 Measure
Communicate Regular flash updates from CMIO via e-mail to all staff Distribution list grows each month as staff get interested End of the month CMIO Digest of all updates sent during the previous month One more bite at the apple All CMIO updates stored on CMIO blog site for easy retrieval 33
Communicate 34
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Communicate 36
Communicate 37
EMR Survey Results Overall satisfaction is evaluated with the question I am overall satisfied with the EMR Prior to 2014, overall satisfaction was calculated as an average of all year-over-year comparable questions 3.3 3.2 3.1 Consistent Improvement 3.15 3.25 3.27 3.30 3.25 3.2 3.16 3 2.9 3.03 2.98 2.93 2012 2013 2014 2015 2016 2017 Average Score 38 Overall Satisfaction
Key Take Aways Communicate Ask/Listen Engage Educate Plan/Do Measure 39
Questions? Thomas Selva, MD SelvaT@health.missouri.edu www.linkedin.com/in/ thomas-selva-49207351/ Bryan Bliven BlivenBr@health.missouri.edu @bbliven24 www.linkedin.com/in/bryanbliven/ Please complete the online session evaluation 40