I Love My Intern! How can we involve residents in patient satisfaction? APDIM Fall Meeting October 2012 Outline Pre Assessment Introduction Small Groups Small Group Presentations G.U.I.D.E. TM Conclusions
Introduction Educational Objectives 1. Understand the components of patient satisfaction and how it is measured. 2. Learn how we can engage residents to become invested in patient satisfaction. 3. Be prepared to implement a resident driven patient satisfaction program.
Patient Satisfaction What is Patient Satisfaction? Patient satisfaction is achieved when a patient s perception of the quality of care and services that they receive in the healthcare setting has been positive, satisfying and meets their expectations. Patient Satisfaction Why is Patient Satisfaction important? Teaching hospitals have lower patient satisfaction scores than nonteaching hospitals. 1,2 Studies have shown that patient adherence to medical care is directly related to communication skills of physicians (and adherence can be improved when physicians are trained to be better communicators). 7 Meet ACGME core competencies and milestones Patient care Interpersonal and communication skills Professionalism Up to a 2% decline in Medicare payments over the next several years, based on HCAHPS scores. 3
How do we measure patient satisfaction? Surveys: HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) PRESS GANEY (private corporation interested in healthcare performance improvement) Sent to patients after discharge from hospital Gives us a better understanding of our patients perceptions of their healthcare experience How are physicians measured on patient satisfaction? From HCAHPS Survey Doctors treat you with courtesy and respect? Doctors listen carefully to you? Doctors explain things in a way you understand? From PRESS GANEY Survey Time physician spent with you. Physician concern about your questions/worries. Physician kept you informed. Friendliness and courtesy of physician. Skill of physician.
Small Groups Small Group Presentations
G.U.I.D.E. TM Greet your patient Understand your patient s concerns Identify yourself and your team Discuss the plan with your patient and/or their family Educate your patient
HCAHPS Overall Physician Scores (in percentile) 1 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 Jul 10 Aug Sep Oct Nov Dec Jan 11 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 12 Feb Mar Press Ganey Comparative Scores 100 95 FY 10 11 FY 11 12 90 85 p = 0.038 80 75 70 Overall Time physician spent with you Physician concern Kept you informed Friendliness Skill MD in charge identified
Conclusions Conclusions Patient satisfaction is a measurable outcome and these scores will impact residents in their future careers. Approaches to improve patient satisfaction in teaching facilities should be individualized to each program. Buy in from residents is very important to the success of any intervention. Educating residents in this area will provide them with future resources important to: their medical practice re imbursement re certification
References 1. Patient Satisfaction With Hospital Care: Effects of Demographic and Institutional Characteristics. Young, Gary J. JD, PhD et al. Medical Care. March 2000, Volume 38, Issue 3, pp 325 334. 2. Contemporary Performance of U.S. Teaching and Nonteaching Hospitals. Shahian, David M. MD, et al. Academic Medicine. Volume 87(6), June 2012, p 701 708. 3. Regulatory Advisory. American Hospital Association. May 2011. 4. Press Ganey. www.pressganey.com. 2012. 5. HCAHPS. www.hcahpsonline.org. 2012. 6. Value Based Purchasing Presents Challenges to Teaching Hospitals. AAMC Reporter. January 2012. Whitney L.J. Howell. https://www.aamc.org/newsroom/reporter/january2012/271170/valuebasedpurchasing.html. 7. Physician Communication and Patient Adherence to Treatment: a Meta Analysis. Zolnierek and DiMatteo. Medical Care. Vol 47, No 8. August 2009. Thank you for attending. The G.U.I.D.E. TM Program: Amanda Magee DO, FACP Presenters: Ladan Ahmadi MD, FACP Robin Dibner MD, FACP Andrew Yacht MD, FACP
APDIM Fall Meeting October 13, 2012 Pre-assessment: I Love My Intern! 1. Do you personally follow the Press Ganey and/or HCAHPS scores for the medical service at your facility? YES NO 2. Are you aware of the parameters on which physicians are graded in Press Ganey and/or HCAHPS surveys? (pick up to 7) a) Fluent English speaker b) Listens carefully c) Educates patient d) Respectful e) Intelligence f) Keeps patient informed g) Skill of physician h) Time spent with patient i) Empathy j) Friendliness of physician k) Bedside manners l) Cleanliness of physician m) Ability to identify physician n) Ethnicity o) Confidence in physician 3. Have you built patient satisfaction into the resident curriculum at your program? YES NO 4. How is patient satisfaction incorporated into your curriculum? 5. Our current incorporation of patient satisfaction into the curriculum has been successful. Strongly agree Agree Neutral Disagree Strongly disagree 6. Have you built patient satisfaction into the 360 o evaluations at your program? YES NO 7. How is patient satisfaction incorporated into your evaluations? 8. Our current incorporation of patient satisfaction into the evaluations has been successful. Strongly agree Agree Neutral Disagree Strongly disagree
APDIM Fall Meeting October 13, 2012 Post-assessment: I Love My Intern! Time physician spent with you. Physicians concerns about your questions/worries. Physician kept you informed. Friendliness and courtesy of physicians. Can identify your physician.
Doctors treat you with courtesy and respect? Doctors listen carefully to you? Doctors explain things in a way you understand? Motivators for Residents:
APDIM Fall Meeting October 13, 2012 Pre-assessment: I Love My Intern! 1. Do you personally follow the Press Ganey and/or HCAHPS scores for the medical service at your facility? YES NO 2. Are you aware of the parameters on which physicians are graded in Press Ganey and/or HCAHPS surveys? (pick up to 7) a) Fluent English speaker b) Listens carefully c) Educates patient d) Respectful e) Intelligence f) Keeps patient informed g) Skill of physician h) Time spent with patient i) Empathy j) Friendliness of physician k) Bedside manners l) Cleanliness of physician m) Ability to identify physician n) Ethnicity o) Confidence in physician 3. Have you built patient satisfaction into the resident curriculum at your program? YES NO 4. How is patient satisfaction incorporated into your curriculum? 5. Our current incorporation of patient satisfaction into the curriculum has been successful. Strongly agree Agree Neutral Disagree Strongly disagree 6. Have you built patient satisfaction into the 360 o evaluations at your program? YES NO 7. How is patient satisfaction incorporated into your evaluations? 8. Our current incorporation of patient satisfaction into the evaluations has been successful. Strongly agree Agree Neutral Disagree Strongly disagree
APDIM Fall Meeting October 13, 2012 Post-assessment: I Love My Intern! Time physician spent with you. Physicians concerns about your questions/worries. Physician kept you informed. Friendliness and courtesy of physicians. Can identify your physician.
Doctors treat you with courtesy and respect? Doctors listen carefully to you? Doctors explain things in a way you understand? Motivators for Residents: