Ready, Set, Go! CG-CAHPS Readiness Carter Ahl Vice President, Engagement Services Avatar Solutions October 22, 2015
What early adopters know and do They build on current knowledge They CASE They remember that PEOPLE are at the heart of this transition
CG-CAHPS Several Versions
Core Plus CG-CAHPS v3.0 CORE Supplemental Customized CG-CAHPS Core Composites: Access to Care Provider Communication Care Coordination Office Staff Rate Provider Examples: Health Promotion & Education Shared Decision Making Health & Functional Status PCMH ACO PQRS Others
Principle #2 CASE (copy and steal everything) Hospitals (HCAHPS) Home Health (HH-CAHPS) Hospice Emergency Physicians & Eligible Providers (CG-CAHPS) Ambulatory Surgery (OAS) In-Center Hemodialysis (ICH) SNF/Long Term Care Rehabilitation Cancer Care Behavioral OTHERS
Principle #2 - Learn from OTHERS now Sample Sizes # GROUPS High/Low High/Middle/L ow 4 or more Goal Setting Reliability ~.61 ~.80.88+ Report Cards # Provider Completes 45 115 216+ Benchmarks Driving Improvement # Clinic Completes 300 660 Census
Supplement the Survey Comprehensive Patient Specific Practice Unique Broader Experience Companion Blind Spots Deep Dives Core CG-CAHPS 7
What do we NEED to know? Shared Variance with Overall Rate Provider Nursing Care Provider Environment Office staff Access Problem Resolution Getting Around Lab Billing 0% 10% 20% 30% 40% 50% 60% 70% 80%
Principle #3: It is about PEOPLE
Principle #3: No Surprises Do this WITH me not TO me Be clear about Expectations Show me the instrument Data + Comments Evidence-based Improvement Practices
Early Adopter Messages Head Heart Wallet Evidence Based improvements & Report Cards Making memorable experiences for patients and staff What impact does CG- CAHPS have on $$$ performance?
RESOURCE: Please contact me with any questions or needs: CG-CAHPS Companion Items CG-CAHPS Improvement Needs Add photo Carter Ahl Vice President, Engagement Services Avatar Solutions Phone #720-355-0222 cahl@avatarsolutions.com
Using CG-CAHPS to Measure Patient Satisfaction AMGA IQL Conference, October 2015 Angie Beck, CPHQ Director, Clinical Quality/Patient Safety/Risk Management
About The Polyclinic 187 physicians 40% primary care 30 specialties 1,100 staff members Comprehensive ancillaries 13 locations, mostly in Seattle Physician owned, and governed Avid Seahawk Fans
Our Patient Satisfaction Journey 2011 - Initial survey rollout Poor communication with physicians Little training and few improvement resources provided Small number of survey returns Individual physicians scores posted Result: Anger! Strong physician pushback and distrust of data. 2015 Avatar Rollout Involved Physicians in the process Lots of communication with Staff and Physicians 75 surveys required before distributing reports Added confidence intervals to the reports Announced year long plan for transition to transparency Result: Gradual acceptance.
Example Report: Primary Care by Department
Example Report: Specialty Care by Department
Provider Scores with Confidence Intervals Use graphs to identify low performers and then provide additional improvement resources. Confidence intervals help add validity to the data.
dog Example Report: Provider Report with Confidence Intervals Provider Name Provider incentive displayed on quarterly reports Minimum of 75 surveys for report distribution 90% Confidence Intervals on reports
Provider Support Robbie Sherman, MD Transitioned from longtime family practice into Medical Director for Patient Experience role. Teaches communications training (Four Habits from Kaiser) Leads Balint groups for physicians (specific format to provide support and empathy training) Provides individual physician coaching on request Provides peer support for adverse events Provides information to physicians on external resources for burnout prevention
Executive Operations Visibility Dashboard
Thank you!
Working with Physicians & Improving the Patient Experience AMGA October, 2015 Thom Thomas, MA Vice President of Quality, Risk Management & Compliance
Background Managing Lean 6 Sigma Master Black Belt OSF HealthCare, Peoria IL 8 Hospitals, Multispecialty Physician Group (500+) Senior Director of Quality & Performance Improvement Lexington Clinic, Lexington KY Multispecialty Physician Group Practice (150+) Vice President of Quality, Risk Mgmt & Compliance Meridian Health Services, Muncie IN
Lexington Clinic Journey Partnered with Avatar in 2013 Gathered data for 1 year prior to distribution Sufficient data Attribution Fix bugs Sharing of Data Push instead of pull Supplied resources & education
Tackling the Problem Executive Support Identify Physician Champions Personal approach Education Resources Benchmarking
Identify Physician Champions Utilize Current Structure: Executive Officer Buy-in Chief Medical Officer Monthly reports One-on-one coaching Departmental overviews Department Chairs 6 month reports Departmental meetings Departmental coaching
Personal Approach Reports carefully created and hand delivered CG-CAHPS only Comments No transparency until 6 months after first report Not tied into Bonus structure until 2 years after the first report One-on-one coaching available Moved worst performing physician to above the 50 th percentile in 3 months
When physicians cry foul I don t trust your data My patient population is different I should just start passing out the candy dish of happy pills I must be a horrible doctor I guess I should look for another profession I m a good doctor, my patient s love me, where is the data coming from? You want me to spend more time and see less patients
Education But we only get a few complaints a month. For every one patient who complains, 20 dissatisfied patients do not. The average wronged patient will tell 25 others about the bad experience. 3 63 1575 Complaints per month Dissatisfied Customers per month Hear about the poor experience per month Source: HFMA 2004, Zimowski
Education Correlation between a patients experience and clinical outcomes Engaging patients in their healthcare results in better patient experience Data reveals correlation between better patient experience and lower malpractice risk
Resources Staff: CMO Physician Champions Quality Department Intranet Avatar Resources Articles Power Points
Benchmarking Avatar reports Healthcare Trends Internal Goals Transparency of Data after 1 year Organizational (internal) Department Office
Lessons Learned You do not need to re-invent the wheel; learn from others You have talked to one doctor, you have talked to one doctor Cannot educate enough Before During After Use data to shed light, not start a fire Accountability = Responsibility