PATIENT SATISFACTION: GETTING INTO THE WEEDS TO IMPROVE THE PATIENT/FAMILY EXPERIENCE

PATIENT SATISFACTION: GETTING INTO THE WEEDS TO IMPROVE THE PATIENT/FAMILY EXPERIENCE Sponsored by:  Florida Office of Rural Health  Georgia Office of Rural Health  Hometown Health SHIP Grant Webinar March 14, 2013

PATIENT/FAMILY SATISFACTION AGENDA: • Why do we measure Patient Satisfaction? • Prevention • Mitigation • Transparency/reporting • Review/improvement • Resources

PATIENT/FAMILY SATISFACTION Learning Objectives: • Explain why measuring patient satisfaction is important • List 4 principles of a successful patient satisfaction program • Identify barriers to providing exceptional patient care • Identify best practices that you can implement at your organization to improve patient satisfaction • Name 4 benefits of a successful patient satisfaction program

PATIENT/FAMILY SATISFACTION Why we measure patient satisfaction Patients complain by changing hospitals and telling their friends. (market share) CMS is now linking reimbursement to the patient experience. (revenue) Because we should care. (ethics)

PATIENT/FAMILY SATISFACTION Patient Satisfaction is not objective: HCAHPS: How often did nurses treat you with courtesy and respect? How often did nurses listen carefully to you? How often did nurses explain things in a way you could understand? After pressing the call button, how often did you get help as soon as you wanted it? How often were your room and bathroom kept clean? How often did you get help on getting to the bathroom/bedpan as soon as you wanted? How often was your pain well controlled? Did the hospital staff do everything they could to help you with your pain? Before giving you any new medicine, how often did hospital staff describe possible s/e? ED: Wait times, level of anxiety, empathy BILLING PROCESS: What patients think they should pay, size of their account, patients overall health

PATIENT/FAMILY SATISFACTION It is subjective. Clinical Needs Patients rarely know about the quality of care ✓ Emotional Needs They know about the face of the care ✓ Physical Needs They know about the timeliness of the care To whose expectations is the staff performing?

PATIENT/FAMILY SATISFACTION 4 Principles of a Successful Patient Satisfaction Program:

PATIENT/FAMILY SATISFACTION 4 Principles of a Successful Patient Satisfaction Program: Prevention

PATIENT/FAMILY SATISFACTION 4 Principles of a Successful Patient Satisfaction Program: Prevention Mitigation

PATIENT/FAMILY SATISFACTION 4 Principles of a Successful Patient Satisfaction Program: Prevention Mitigation Transparency

PATIENT/FAMILY SATISFACTION 4 Principles of a Successful Patient Satisfaction Program: Prevention Mitigation Transparency Improvement

PATIENT/FAMILY SATISFACTION Prevention: Distracted pilot forgets to lower landing gear By Mike KrumboltzMikeKrumboltz | Yahoo! Travel – Thu, Apr 19, 2012 4:55 PM EDT We all know that playing on a cell phone while driving a car is a no-no. So, it stands to reason that commercial airline pilots would abstain while flying. Never assume, folks. Never assume.  In a story that is sure to cause no small amount of outrage, a Jetstar pilot was forced to abort his Singapore landing when he realized at the last moment (the plane was 392 feet from the ground) that he'd forgotten to put the landing gear down. His excuse: He was distracted by incoming text messages to his phone. The incident, which took place on a 220-seat Airbus A320, occurred on May 27, 2010. The Australian Transport Safety Bureau recently released the findings of its investigation. The captain was no rookie. He had more than 13,000 hours of flight experience, while the co-pilot had around 4,000 hours.

PATIENT/FAMILY SATISFACTION Prevention: All patients deserve good patient-centered care What could possible interfere with delivery of the care patients expect and deserve? • Distractions (charting, pulling meds, fellow workers, cell phones) • Confusion on job duties and expectations (should BSN’s respond to bed pans) • Poor or miscommunication (shift change, transfers to another department, etc.) • Being human (forgetful) • Time or lack of it, feeling rushed • Lack of communication (listening and engagement skills) • Lack of vision/support from leadership • Staff burnout • Understaffing (tired from working an extra shift, staff cutbacks, high callout rate, etc.) • Does the staff have the tools and equipment needed to do their job • Lack of accountability Takeaway: Use this list as a starting point for discussing which issues are preventing your organization from providing better patient-centered care and develop a plan.

PATIENT/FAMILY SATISFACTION Prevention: All patients deserve good patient-centered care What could possible interfere with delivery of the care patients expect and deserve? • Identify the barriers in your organization barriers to great care barriers you face implementing change • How do you remove those barriers? • Keep the ideas simple • How will you know that you are successful, what do you measure? • What are the goals or desired outcomes Takeaway: Use this list as a starting point for staff discussions on barriers and what can be changed to improve care and experience, then develop a plan.

PATIENT/FAMILY SATISFACTION Prevention: Best Practices: Hourly Rounding (Studer Group) Think like your patients (perform to their expectations, not yours) Manage the patients/family anxiety level (even very demanding patients can be managed) Everybody helps keep it clean Get everyone involved (housekeeping, maintenance, dietary, everyone needs to understand their role in patient satisfaction) Everyone needs to understand their duties (BSN’s and bedpans) Leadership take takes the lead and is visible (leader rounding) Good communication with the patient/family (scripting) Good communication is probably the thing patients value the most (after quality of care) Cross pollination from one department to another Takeaway: How many of these Best Practices does your organization practice?

PATIENT/FAMILY SATISFACTION Prevention: Best Practices: Know your patient(s) Smile and make eye contact (sincere) Resist the urge to be a robot, show some empathy and understanding If possible, get down to the patients level Ask probing questions, avoid “yes” “no” questions when possible Use a communication board Focus on the positives (if responding to a call bell, ask how you did and that the staff has been working on improving response times.) Coach up fellow staff members Make “good” even “better” Takeaway: How many of these Best Practices does your organization practice?

PATIENT/FAMILY SATISFACTION Mitigation: The act lessening the force or intensity of something unpleasant Sometimes referred to as “service recovery” in the business world.

PATIENT/FAMILY SATISFACTION Mitigation: Johnson & Clark (2008). Service Management. Improving service delivery.

PATIENT/FAMILY SATISFACTION Mitigation: We will make mistakes. How do we address mistakes internally? • Punished (missed opportunity to improve) • Seen as learning opportunity (barring negligence) • Opportunity to encourage others to report (self-report) How do we address mistakes to our customers? • Do you have a system in place to mitigate or do you handle them on a case by case basis? • Do we make complaining easy? Feedback should be encouraged & acted upon • Addressed in a timely manner (social media faster than word of mouth) • We probably hear less than 10% of issues/complaints from dissatisfied customers • Follow-up Takeaway: Does your organization’s culture encourage learning from mistakes & improvement? If not, why?

PATIENT/FAMILY SATISFACTION Mitigation: Johnson & Clark (2008). Service Management. Improving service delivery. Key takeaways: The complainers are more likely to continue to use the supplier than the 96% non-complainers. A dissatisfied customer will tell between 10 and 20 other people. (Prevention is the best policy) A customer who has had a problem resolved will tell about 5 people about their situation.

PATIENT/FAMILY SATISFACTION Mitigation: When a promise or implied agreement is broken, customers feel betrayed, let down and angry. They may feel they have little control of the situation, so they exert what control they have…

PATIENT/FAMILY SATISFACTION Mitigation:

PATIENT/FAMILY SATISFACTION Transparency:

PATIENT/FAMILY SATISFACTION Transparency: Line Staff Managers Meetings Training resources and needs can be prioritized/allocated Accountability Cross pollination opportunity Admin Team A strong culture that values a positive patient experience begins here Allocation of resources Accountability Authority/Board Meetings Community perception Negative comments and follow-up Medical Staff How doctors are perceived as communicators Interested in pain control

PATIENT/FAMILY SATISFACTION Review/Improvement: How do you currently review opportunities to improve or reward? Are you happy with your current method/process for improvement Has a vision from leadership be given? Use your HCAHPS account manager and their resources change management best practices data analysis and trending Review the “Best Practices” slide Make “good” “better”

PATIENT/FAMILY SATISFACTION Review/Improvement Expectation: “be nice to patients” GOOD

PATIENT/FAMILY SATISFACTION Review/Improvement Expectation: “be nice to patients” GOOD Knock when entering the room Introduce yourself Explain why you are there and how long it will take Make eye contact Before leaving, ask if there is anything you can do for them BETTER

PATIENT/FAMILY SATISFACTION Review/Improvement Follow established Best Practices: Example  Expectation: Right patient Right medication Right dose Right frequency Right route Right documentation Nurses give meds one way, the approved way that respects the patients 6 medication rights. Not 25 nurses giving meds 25 different ways. Can you really expect a culture of excellence when clinical staff do not even follow best practices learned in nursing school?

PATIENT/FAMILY SATISFACTION Review/Improvement:

PATIENT/FAMILY SATISFACTION Review/Improvement: Call or write Kate Valakos • kvalakos@pressganey.com • 877.352.9692

PATIENT/FAMILY SATISFACTION Benefits of a $uccessful Customer $ervice Program: ) • Return customers (is your market share under pressure) • Happy workforce (lower turnover, reduces costs) • Enhanced public image (brand image and goodwill) • Improved revenue • Increased referrals • Pride in a job well done

PATIENT/FAMILY SATISFACTION Benefits of a $uccessful Customer $ervice Program: ) To All the Staff on Ward 24G I just wanted to express my thanks and appreciation for the wonderful treatment and care you all showed to me following my recent hip replacement surgery. Before I came into hospital for the operation, I was very nervous and daunted by the fear of the unknown but you were all so kind and reassuring when I arrived which took away a lot of my apprehension. You demonstrated your total commitment into caring for me when I was helpless in the days immediately following the operation and also gave me the support and encouragement I needed to take my first steps on the road to my rehabilitation which meant so much to me. I’d like to particularly thank Julie Holmes and Katy Simons who provided me with round the clock nursing care and to Dr Alan Roberts and his surgical team for their expertise in the operating theatre and for their post-operative support. These were members of the team whom I saw on a daily basis and whom I became particularly close to during my stay in the hospital. However, I’d also like to thank all the other people, too numerous to mention, who all played such an important part in my treatment and recovery. Thanks to you all, I’m now able to look forward to a long-held dream to be able to go and visit my son and his family in the USA this coming June. Without your help, this would not have been possible so you can imagine how grateful I am. Thank you all once again for all your care and support. CLINICAL, EMOTIONAL, & PHYSICAL NEEDS ALL ADDRESSED TO HER EXPECTATIONS!

PATIENT/FAMILY SATISFACTION Resources: Hospital Compare, www.medicare.gov/hospitalcompare/ Hometown Health University, www.HTHU.net 10 seats HCAHPS course VBP course (under development) SHIP Grant Resourcesavailable on HTH home page. Password is SHIP HTH staff: Kathy Whitmire, 706-491-3493, KFW@windstream.net Kristy Thomson, 561-339-5081, kristy.thomson@hometownhealthonline.com Lou Semrad, 706-474-0434, Lsemrad@gmail.com Site Visits by HTH staff

PATIENT SATISFACTION: GETTING INTO THE WEEDS TO IMPROVE THE PATIENT/FAMILY EXPERIENCE