The Patient Experience: Physician Coaching Paul Pritchard, MD, Vice President and Chief of Quality Eric Dordel, MS, PHR Executive Director of Customer Service, Prevea Health Agenda: Review Prevea Health s challenges and starting point Outline The Promise model and 90 s Plan Describe the Physician Coaching program and its effect on the Patient Experience 1
Physician Owned Hospital Partnered 25 Health Centers 50+ Specialties 1300+ Employees 200+ Providers 500k Annual Visits Our Mission To take care of people with passion, pride, and respect. Our Vision The best place to get care. The best place to give care. 2
Where We Started Many Fragmented Subcultures 37 th Percentile Rank 61% Top Box Overall No Specific Strategy No Standards Data Denial This is the best we have to offer Goal Fatigue No reward for effort The Patient Experience The Four Promises Ripples 3
What is the Prevea Promise? Our Customer Service Philosophy Standardized service approach to: Patient service Patient treatment Coworker interactions Team dynamics Strategic planning Expected of leaders, physicians & staff Components of the Promise The Four Promises Our Core Service Principles Listen, Understand, Share, Recognize Ripples Layers of affect in our organization that originate with the customer Physician/Employee, Department, Leadership The Patient Experience Everything the patient experiences as a Prevea customer Mission & Vision Statements Service Moments Service Standards Service Recovery Each component depends on and reinforces one another in a continuous flow of patient contact, information, and service. Your individual role may differ from your neighbor, but not your service philosophy. 4
Department 90s Plans 5
Goal Setting Theory Difficult goals can lead to higher performance levels Specific goals lead to higher performance People need to be aware of the goal Participation in goal setting leads to acceptance and commitment 6
Notables: All Departments are expected to participate Care Providers have a separate plan Focus Questions are selected in part via the Press Ganey Priority Index Focus Questions do not change often Leaders are forbidden from making the decisions. 7
Physician Coaching Coaching Process 1. Coach & Physician Initial Meeting 2. Shadowing Visit 3. Feedback Session & Improvement Plan 4. 3-Month Improvement Plan Efforts by Physician 5. Follow-Up Shadowing Visit (if needed) 6. Documentation/Goals Review 7. Evaluation 8. Awarding of CME Credit Earned 9. Physicians are included in the 90 s plan 8
Physician Patient Observation Report for John Bently, MD Prepared by Physician Coach Observation Dates: June 8, 2013 Report Date: June 21, 2013 I visited Dr. Bently s office on the above date at the St. Mary s location. Dr. Bently was very welcoming and open to the shadowing experience and worked with me to find a day that would be optimal for shadowing. It is fortunate to have a provider that reaches out to our Hmong community and I am sure his patients appreciate having someone that understands their language, social structure and customs, religious beliefs and support systems. Providing culturally competent health care in this population continues to be a challenge in the region; it was not hard to understand why his patients feel connected and loyal to him. I was able to shadow four different patients, all English speaking with a good variety of cultural backgrounds and medical concerns. It was a fascinating session and it was great to witness the strong connection that Dr. Bently had with all of his patients. Introduction/Greeting: Dr. Bently offered a very friendly environment and focused on eliciting and responding to the patient s personal experience of his illness or concerns. He started out with non-medical conversation and employed a strong emphasis on communication and building provider-patient relationships. For example, during a physical with his first patient he inquired about how he was coping with his wife s death and how his 14 year old daughter was doing. He knew the personal stories of all of his patients and often told me a little bit about their background personally and medically before the visit. His communication and respect toward the patients signified positive regard, trust and caring. Care was tailored to the individual patient, according to the unique attributes of their personality. National Percentile Rank, Dr. Bently Question Rank Before Rank After Change Std Care Provider 11 40 29 Friendliness/courtesy of CP 24 15-9 CP explanations of prob/condition 14 61 47 CP concern for questions/worries 9 62 53 CP efforts to include in decisions 9 26 17 CP information about medications 5 27 22 CP instructions for follow-up care 10 41 31 CP spoke using clear language 15 24 9 Time CP spent with patient 4 23 19 Patients' confidence in CP 16 53 37 Likelihood of recommending CP 10 62 52 Mean Score, Dr. Bently Question Mean Before Mean After Change Std Care Provider 87.9 91.8 3.9 Friendliness/courtesy of CP 93.1 91.7-1.4 CP explanations of prob/condition 88.9 93.3 4.4 CP concern for questions/worries 87.5 93.3 5.8 CP efforts to include in decisions 86.8 90.0 3.2 CP information about medications 84.4 89.6 5.2 CP instructions for follow-up care 86.8 91.1 4.3 CP spoke using clear language 90.3 91.7 1.4 Time CP spent with patient 83.3 88.3 5.0 Patients' confidence in CP 90.3 93.3 3.0 Likelihood of recommending CP 87.5 93.3 5.8 9
95 Physician Overall Performance 94.5 94 93.8 M e a n S c o r e 93 92 91 91.3 Physician Coaching Started mid 2009 92 91.6 91.9 92.5 93.2 93.3 90 89 2006 2007 2008 2009 2010 2011 2012 2013 2014YTD Std Care Provider Prevea Health s Return on Investment 10
Question Mean Score National Percentile Rank Prevea Health Patient Satisfaction Trend Overall National Rank 100 97 94.5 95 92 94.0 90 88 89 93.5 85 80 79 77 79 82 76 80 81 93.0 75 92.5 70 92.0 65 91.5 60 55 91.0 50 2012 2012 2012 2012 2013 2013 2013 2013 2014 2014 2014TD National Rank Mean Score 90.5 Mean Score Range 98 96 94 93.3 93.5 94 94 96.3 95.9 94.5 93.5 93.9 94 94.1 94.2 94.3 94.4 94.7 94.8 94.9 95.1 95.2 95.1 95.4 95.1 95.3 95.3 95.7 94.7 93.7 93.6 93.7 93.7 93.4 92 90 88 86 84 82 80 93.5 93.2 92.9 91.5 91.5 91.5 91.8 91.8 91.7 91.7 92.1 92.3 92.4 91.8 89.6 89.8 88.7 88.9 89.2 89.5 89.7 89.7 89.7 89.8 90.2 90.1 90.4 90.2 90.6 91 90.9 89.7 89.4 81.7 81.9 81.4 2006 2007 2007 82.9 82.8 2007 2007 83.6 83.6 2008 2008 82.9 2008 84.2 84.1 83.9 83.9 83.4 83.8 84.5 2008 2009 2009 2009 2009 2010 2010 85.2 85.3 2010 2010 84.3 2011 88.7 88.1 88.1 86.7 86.6 87 87.4 87.2 86.9 86.8 86.1 2011 2011 2011 2012 2012 2012 2012 2013 2013 2013 2013 2014 2014 High Score Low Score Mean Score Linear (High Score) 11
Mean Score Prevea Health Patient Satisfaction Impact of Care Provider 90s Plans 96 Care Provider 90s Plans 95 94 93 93.2 93 93.5 93.4 93 93 93.1 93.7 93.2 93.5 93.8 94.2 92.8 94.6 93.3 94.3 93.2 94.9 93.5 92 91.5 91.5 91.5 91.8 91.8 91.7 91.7 92.1 91.8 92.3 92.4 91 90 89 '1/1/11 3/31/11' '4/1/11 6/30/11' '7/1/11 '10/1/11 '1/1/12 9/30/11' 12/31/11' 3/31/12' '4/1/12 6/30/12' '7/1/12 '10/1/12 '1/1/13 9/30/12' 12/31/12' 3/31/13' Quarterly Received Date '4/1/13 6/30/13' '7/1/13 '10/1/13 '1/1/14 9/30/13' 12/31/13' 3/31/14' '4/1/14 6/30/14' '7/1/14 9/30/14' Care Provider Prevea Overall Thank You. Any Questions? 12