The Clinician s Impact on the Patient Experience Michelle George MSN RN CASC 1 Objectives Achieving desired clinical outcomes through safety initiatives and clinical best practices Communication and engagement solutions to meet patient physical and emotional expectations Understanding survey results and using data to improve your patient s experience 2 1
What is Patient Experience? Your ASC Your Business External Customers (Patients) Patient Safety Clinical Excellence Patient Experience Internal Customers (teammates, clinical and non clinical) Culture of Engagement, Empathy, and Accountability 3 Culture of Patient Safety Protection Protect patients and perform quality work. Protection Prevention Learning Prevention Prevent adverse events and patient harm through supportive culture. Learning Learn best practices and explore improvement opportunities. PATIENT SAFETY 4 2
Protecting Patients: Patient Safety Plan Patient Safety Plan Requires Facility specific Goals GOAL 1 GOAL2 GOAL 3 GOAL 4 GOAL5 GOAL6 Identify patients correctly Improve patient communication Ensure safe medication practices Prevent wrong side, site, patient procedures Prevent surgical site infections Reduce risk of patient falls 5 Clinical Excellence: Patient Centric Culture Drives Outcomes Implementing Clinical Best Practices and Standards Hiring and Training Qualified Teams Leveraging Technology for Data Collection and Analysis 6 3
Clinical Best Practices and Standards Patient care P&Ps Patient safety protocols Hardwired patient engagement strategies Empowered teams and committees Accountable leadership Rounding for outcomes Peer review program Event investigations Commitment to continuous improvement 7 Hiring and Training Qualified Teams Selection of A Players Onboarding program Setting expectations Teammate competencies Education and training Certification programs Coaching for performance 8 4
Leveraging Technology Event reporting systems for data collection and analysis Credentialing platforms Patient portals for education and communication Patient tracking boards While You Wait activities: Wi Fi, TVs, education programs and white noise Real time feedback devices 9 Culture Assessment Predictive How business is conducted in your facility Proactive Leadership and values drive improvements. CALCULATIVE Systems in place to manage hazards. REACTIVE We do a lot when an event occurs. PATHOLOGICAL Who cares as long as we aren t caught. 10 5
Building a Remarkable Patient Experience Culture High performing teams are essential to elevating your patient experience culture. Seven key values drive your team s engagement. 1. Commitment 2. Customer satisfaction 3. Employee fulfilment 4. Continuous improvement 5. Accountability 6. Shared vision 7. Professional growth 8. Teamwork 11 The Relationship Between Engagement & Experience Average National Percentile Rank in Patient Experience 100 80 60 40 20 0 Employee Engagement Improves Patient Experience National Percentile Rank Based on Employee Engagement Scores (1) 72 71 70 70 74 62 61 40 34 27 28 30 20 21 Nurse Responsive Physician Pain Medication Discharge Rate Top 20% of Employee Engagement Bottom 20% of Employee Engagement 1. Based on Engagement data from 52 projects, HCAHPS data from Jan-Dec 2013 facility compare dataset. 12 2016 Press Ganey Associates, Inc. 12 6
Customer Satisfaction What are your patients saying? The terms patient satisfaction and patient experience are often used interchangeably, but they are not the same thing. Patient Satisfaction Were the patient s expectations about a healthcare encounter met? Expectations differ with each patient Can be impacted by prior healthcare encounters Perceptions may include Comfort of the waiting rooms Friendliness of the teammates Cleanliness or repair of the facility Patient Experience Did something that should have happened actually happen? How often did it happen? Encompasses a range of interactions Timely appointments Easy access to information Good communication with health care providers 13 Commitment Patient Centric Alignment 14 7
Continuous Improvement Priorities Focus on those processes or events that contribute to a negative experience. 15 Finding the Balance Safety vs. Comfort Efficiency vs. Listening High Tech vs. High Touch Privacy vs. Communal 16 8
Beware of Pitfalls: Too Much of a Good Thing 17 Beware of Pitfalls: Too Much At Once 18 9
Culture: See It! It all starts with the first impression. Create a clean and welcoming environment. Greetings smile, eye contact, tone of voice Micro Body signs Proactive communications Teamwork Visible and engaged leaders Attention to the physical plant 19 Culture: Feel It! How do your patients feel in your ASC: on arrival, during their procedure and at discharge? Make a connection Pride of ownership Valuing feedback Address primary concern Recognition and managing up Show appreciation Attention and energy Words and actions need to match 20 10
Let s Talk About Influencing Experience 21 Tips for Managing the Journey It is important to manage the patient s emotional journey. Setting expectations Pre op calls Anesthesia calls Intentionality Say what you mean Do what you say Make it personal Use the patient s name Introduce and engage the family Leader rounding for outcomes Targeted questions 22 11
Leader Rounding for Outcomes Rounding for Outcomes is the consistent practice of asking specific questions of key stakeholders to obtain actionable information. Aligns with culture of remarkable patient experience Patient safety Clinical excellence Patient experience Drives to culture of open and transparent communication Provides visibility into your facility s strengths and challenges Puts the leader in a position to spot and address problems Diminishes barriers between management and frontline teammates Increases communication, builds trust and morale Provides opportunity to monitor real time satisfaction 23 Leader Rounding: Who, What, When, and How 1/3 WHO: Leaders rounding Senior leadership Department leaders Support services leaders Key stakeholders Leaders Teammates Physicians Patients 24 12
Leader Rounding: Who, What, When, and How 2/3 WHAT: Targeted stakeholders Build a relationship Key questions WHEN: Weekly or monthly Follow up Calendar for consistency 25 Leader Rounding: Who, What, When, and How 3/3 HOW: Select the model that best matches your facility s resources, preferences and ability to hardwire. Studer Model What s working well? What s not going well? What keeps you up at night? Are you aware of patient care or safety issues? Do you have the resources and tools that you need to do an excellent job? How can I (my department) help you to better perform your job? Before we finish up here, is there anything else that I should know? Is there anyone that I could recognize for doing an outstanding job? Take Ten Model How are you doing? How do you think the team doing? What can I do to help? 26 13
The 3 B s for Rounding Success Be consistent Consistency is one of the biggest contributors to building trust Be balanced Plan your Check Ins so you interact with everyone each week Be mindful Make notes about your conversations Referencing a previous issue shows you are listening Follow up impeccably on issues that are brought up If you ask you must act! 27 Understanding Patient Surveys 28 14
Pursue Consistency: Good Enough is Not Good Enough SERVICE VARIANCE CALCULATOR 90% X 90% X 90% = 73% of the Individuals of Expected Behaviors of the Time 73% Always = 9 th percentile CAHPS Means & Ranks Feb 2015 Nurse Communication Expected Results Source: Adapted from Deanna Frings; Wheaton Franciscan Healthcare/Press Ganey 29 Be Authentic 30 15
OAS CAHPS Outpatient surveys become part of the CMS Quality Reporting Program with data collection effective January 2018 and payment impacts in 2020. Early Adoption: Opportunity to build relationship with your vendor Time to work out any software interface issues Know where you stand before mandatory reporting begins Take targeted action to improve your reporting results Understand your patient s perceptions and make changes to increase overall satisfaction 31 Real Time Feedback Traditional patient surveys are conducted post discharge which impacts future visits. Consider alternatives for real time feedback. Communicates caring and concern Provides opportunity for identifying problems during current stay Proactive management of complaints and grievances Immediate rescue impacts future survey scores Provides immediate insight into improvement strategies 32 16
Best Ways to Use Survey Results Recognize and reward your team Incorporate results and associated strategies into orientation and ongoing training for teammates Compare results to baseline and then period over period; don t forget the comments Analyze data by subsets Outpatient vs. overnight stay patients Specialty or service line By department By provider By payer Form or designate an existing committee to focus on results and development of improvements 33 Let s Recap Patient experience has 3 critical components 1. Patient safety 2. Clinical excellence or outcomes 3. The care experience Your facility culture is key to a consistent patient experience Leader rounding can make the difference Consider early adoption of the OAS CAHPS Survey results are a leaders best resources 34 17
I have learned that people will forget what you said, people will forget what you did, but people will not forget how you made them feel. ~Maya Angelou 35 Michelle.George@scasurgery.com 36 18