Creating Value To Your Patients Building A Patient-Centric Culture
CAHPS Surveys Current: Medicare Advantage Health Plans (MA CAHPS) Prescription Drug Plan (PD CAHPS) Hospitals (HCAHPS) Home Health Agencies (HH-CAHPS) Dialysis Centers (ICHCAHPS = In-Center Hemodialysis CAHPS) Future: 2013: Medicare Shared Savings Program & Pioneer ACO Program (ACO GCAHPS) 2014: Pediatric HCAHPS 2014: Medical Groups with 100 or more providers (PQRS CGCAHPS) April 2014: PPS-Exempt Cancer Hospitals (HCAHPS) January 2015: Hospice Providers (New Survey Being Developed) 2015: Hospital Outpatient Departments (Emergency Department Survey Being Developed) 2015: Hospital Outpatient Departments (Outpatient Surgery Survey Being g Developed) 2016: Ambulatory Surgery Centers (Outpatient Surgery Survey Being Developed) TBD: Inpatient Psychiatric Facilities Long Term Care Hospitals Inpatient Rehabilitation Facilities
Typical Implementation Sequence
CAHPS Surveys & Value Based Purchasing Current VBP Programs HCAHPS Part of VBP beginning with 2011 discharges ICHCAHPS Part of VBP beginning with 2012 data collection CGCAHPS Part of VBP beginning with 2014 visits for large medical groups (over 100) Not yet part of VBP. No clear plans to implement any VBP program. HHCAHPS ED CAHPS Outpatient Surgery CAHPS Hospice CAHPS HCAHPS for 11 PPS-Exempt Cancer Hospitals
Surveys, Response Scales and Reporting Survey Scale CAHPS Measures frequency, did something happen Scores based on highest response Press Ganey Measures meeting needs and expectations Scores based on all types of responses
Press Ganey Surveys: The Survey Scale & Mean Score Survey Report Very Poor 1 0 Very Poor Poor Fair 2 3 25 50 Poor Fair Good 4 75 Good Very Good 5 100 Very Good
Press Ganey Surveys: Mean Score & Percentile Rank Mean Score: : Average, Our Score Example: 85.1 (75 = Good - 100 = Very Good) Percentile Rank: : Tells you how you are doing compared to peers Example: 42nd Percentile Scoring same or better than 42% of 1,696 EDs in the database 58% scoring the same or higher
CAHPS Surveys: Percent Top Box Top Box: : Highest response that can be given on a question CG CAHPS: % 9 & 10, % Yes Definitely HCAHPS: % Always
Current CG CAHPS Results Survey Response Scale Reporting Most Recent 6 Month Score Physician Section Physician Office: Press Ganey Very Poor, Poor, Fair, Good, Very Good Mean Score Percentile Rank 93.9 Mean Score, 68 th Percentile Physician Office: CG CAHPS Yes, Definitely Yes Somewhat No Rate 0-10 Top Box Percent % Yes, Definitely % 9 &10 Percentile Rank Doctor Section 93.2% Top Box, 56 th Percentile Rate Doctor 0-10 83.7% Top Box, 47 th Percentile
Physician Office: CGCAHPS
Physician Office: Press Ganey
Agenda 1 2 3 4 5 6 7 Map Refine Align Engage Focus Measure Incorporate
Map patient journey and lifecycle Determine patient touch points STEP 11 Create a team of stakeholders involved in the process of delivering service or care STEP 2 Follow patients one-on-one through the process or conduct small group interviews STEP 3 Review the results and develop a plan to operationalize changes
Agenda 1 2 3 4 5 6 7 Map Refine Align Engage Focus Measure Incorporate
Refine service model to enable patient-centricity Roles & Responsibilities What are the roles of each staff member in how they provide service? Define the expectations and standards of behavior. Interaction Protocol How should these members interact with the patient? How should these members interact with the processes for the care of the patients? Governance What should be measured to ensure service effectiveness? Who is going to govern service standards and conformity?
Agenda 1 2 3 4 5 6 7 Map Refine Align Engage Focus Measure Incorporate
Align processes to support and drive patient engagement
Agenda 1 2 3 4 5 6 7 Map Refine Align Engage Focus Measure Incorporate
Engage leaders and staff 1 Collaboratively problem solve: 22 Communicate often and openly: 3 Show appreciation regularly: 4 Lead through change effectively: Leaders work with employees to find solutions to problems, asking for their input, understanding perspectives shared; Keeping them updated on the solution or the status; The goal is to understand what is working well for staff and what could be working better armed with this information, these leaders can make employees jobs as easy and satisfying as possible; Demonstrate humility in the process, including owning and learning from mistakes; Continuously learning and growing status quo is never okay. Communication with staff is the top priority for this leadership group, with a focus on listening and responding; They are as transparent as possible, sharing yearly department goals (which were developed with staff input), financial updates, Avatar scores, and key strategic information; An email jam-packed with miscellaneous updates goes out to all staff 1-2 times a month; Purposeful and frequent rounding is the routine. Say thank you to employees regularly; Use the R&R programs and create new ones; Recognize accomplishments in team meetings; Say thank you, again! Changes present many challenges; strong, collaborative leadership helps others navigate change with minimal issues; It is important for leaders to by physically present during change to gain input, build trust, and facilitate understanding.
Agenda 1 2 3 4 5 6 7 Map Refine Align Engage Focus Measure Incorporate
Focus development around targeted areas and behavior change Results PERFORMANCE EXPECTATIONS = Actions & Behaviors *The service produced by an employee, measured by departmental objectives and standards. *The method by which a service is provided and the behaviors and values demonstrated during the process. What type of service should my job produce? What impact should my work have on the organization? What behaviors do I expect when interacting with patients, colleagues, and supervisors? What are the organizational values must I demonstrate? What are the processes, methods, or means I am expected to use?
Agenda 1 2 3 4 5 6 7 Map Refine Align Engage Focus Measure Incorporate
Measure change using key metrics 5-Step Approach to Measurement Success: 1 Select 1 or 2 metrics to focus on for a 12 month time period 2 Determine your intervention to respond to the opportunity 3 Define a way to measure it on a daily basis *ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!! 4 COACH, COACH, COACH the behaviors that change your metric 5 Audit for improving metric success once skills have been obtained
Measure change using key metrics 5-Step Approach to Measurement Success: 1 Select 1 or 2 metrics to focus on for a 12 month time period 2 Determine your intervention to respond to the opportunity 3 Define a way to measure it on a daily basis *ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!! 4 COACH, COACH, COACH the behaviors that change your metric 5 Audit for improving metric success once skills have been obtained
Measure change using key metrics 5-Step Approach to Measurement Success: 1 Select 1 or 2 metrics to focus on for a 12 month time period 2 Determine your intervention to respond to the opportunity 3 Define a way to measure it it on a daily basis *ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!! 4 COACH, COACH, COACH the behaviors that change your metric 5 Audit for improving metric success once skills have been obtained
Measure change using key metrics 5-Step Approach to Measurement Success: 1 Select 1 or 2 metrics to focus on for a 12 month time period 2 Determine your intervention to respond to the opportunity 3 Define a way to measure it on a daily basis *ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!! 4 COACH, COACH, COACH the behaviors that change your metric 5 Audit for improving metric success once skills have been obtained
Measure change using key metrics 5-Step Approach to Measurement Success: 1 Select 1 or 2 metrics to focus on for a 12 month time period 2 Determine your intervention to respond to the opportunity 3 Define a way to measure it on a daily basis *ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!! 4 COACH, COACH, COACH the behaviors that change your metric 5 Audit for improving metric success once skills have been obtained
Agenda 1 2 3 4 5 6 7 Map Refine Align Engage Focus Measure Incorporate
Incorporate patient feedback into processes and behaviors Engage patients early and often Engage patients at all points of contact Engage patients in different ways (focus groups, advisory groups, individual opinions, etc.) Patient engagement is resource and time intensive. Give your department BOTH. Most importantly, ensure the change is MEANINGFUL and NECESSARY before asking a patient for help. (i.e., Don t waste their time.)
A customer is the most important visitor on our premises. He is not dependent on us; we are dependent on him. He is not an interruption in our work; he is the purpose of it. He is not an outsider in our business; he is a part of it. We are not doing him a favor by serving him; he is doing us a favor by giving us an opportunity to do so. ~Mahatma Gandhi