2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes

1. 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes October 07, 2008AMERICAN HEALTH CARE ASSOCIATION

2. Bradley N. Shiverick C.P.H.Q Vice President and Chief Quality Officer bshiverick@myinnerview.com 715-848-2713

3. Goals • What is “quality” anyway? • Organizational performance • Satisfaction and loyalty • 2007 national satisfaction report • The importance of the workforce

4. Evidence-based philosophy • Evidence-based management calls for a paradigm shift in the approach to quality improvement: An appreciation of data, the ability to turn data into information and knowledge, and to use that information and knowledgeto improve quality.

5. My InnerView’sevidence-basedpath to quality Evaluateoutcomes:measurevariation Collectdata:ensure validity,organize Turn plan intoaction: improveprocess Turn data intoinformation:benchmark, studyvariation Turn knowledgeinto plan:apply new wisdomto process Turninformation intoknowledge:study currentprocess

6. Collectdata:ensure validity,organize

7. Collectdata:ensure validity,organize Turn data intoinformation:benchmark, studyvariation

8. Collectdata:ensure validity,organize Turninformation intoknowledge:study currentprocess Turn data intoinformation:benchmark, studyvariation

9. Collectdata:ensure validity,organize Turn plan intoaction: improveprocess Turn data intoinformation:benchmark, studyvariation Turn knowledgeinto plan:apply new wisdomto process Turninformation intoknowledge:study currentprocess

10. Collectdata:ensure validity,organize Evaluateoutcomes:measurevariation Turn plan intoaction: improveprocess Turn data intoinformation:benchmark, studyvariation Turn knowledgeinto plan:apply new wisdomto process Turninformation intoknowledge:study currentprocess

11. What is Quality, Anyway? “The totality of features and characteristics of a product or service that meet or exceed customer needs and expectations.”

12. Organizational Performance Leadership Focus on Customer Focus on Workforce Knowledge Management Process Improvement Strategy

13. Organizational Performance Leadership Focus on Customer Focus on Workforce Focus on Customer Focus on Workforce Knowledge Management Process Improvement Strategy

14. Satisfaction … or loyalty?

15. When you don’t remember anything, you’re satisfied!

16. Why look at “Excellent”?

17. Loyalty is generated by memorable things that happen that we didn’t expect.These cause person to give score of “Excellent,” not “Good.”

18. Frederick Riecheld: “The Loyalty Effect” • To grow your business exponentially, you must get serious loyal relationships with your customers • Loyal customers are easiest customers to serve • Long-term customers tend to spend more with you than new customers • Happy, loyal customers purchase other products or services in company’s line • Satisfied, loyal customers recommend company’s products or services The Loyalty Effect: The Hidden Force Behind Growth, Profits, and Lasting Value ;FrederickF. Reichheld,

19. A loyal customer … • Will recommend you to others • Will give you the benefit of the doubt • Will use you again • Will enhance your reputation in the community • Won’t sue you

20. “Research shows that, in most industries, there is a strong correlation between a company’s growth rate and the percentage of its customers who are raving fans — that is, those who say they are extremely likely to recommend the company to a friend or colleague.” For My InnerView users,this is “Excellent”

21. RECOMMEND What is your recommendation of this facility to others? What is your recommendation of this facility as a place to work? … to receive care? EXCELLENT GOOD FAIR POOR

22. The Importance of “Recommendation” • “Recommendation” is touchstone to determine significance of your scores on all other items • “Recommendation” score provides crucial information • Tells you loyalty of respondents • Correlates to other quality outcomes: • All items in survey • Occupancy • Quality indicators • Employee satisfaction • That is why this question is used for Priority Action Agenda

23. Frederick Riecheld: “The One Number You Need to Grow” • Those who are likely to recommend your organization to others are called “promoters” • Why is willingness to promote your company such a strong indicator of loyalty and growth?

24. Because when customers recommend you, they’re putting their reputation on the line. They will take that risk only when they are loyal.

25. “In most of the industries studied, the percentage of customers who were enthusiastic enough to refer a friend or colleague — perhaps the strongest sign of customer loyalty — correlated directly with differences in growth rates among competitors.”

27. Respondents • 27,397 residents • 118,985 family members • 161,908 employees • 4,116 (one in four) nursing homes nationwide

28. Source of data • Largest private dataset of resident, family and employee satisfaction in nation • From mailed resident and family surveys returned to third-party • From self-administered employee surveys; mailed to third party • Respondents rate facilities using four-point scale (excellent, good, fair or poor)

29. SURVEY RESPONDENTS Figure 1 — “Facility count” is unduplicated total of facilities completing consumer and workforce satisfaction surveys.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

30. ConsumerDemographics

31. RESIDENT’S AGE Figure 4 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

32. RESIDENT VISITED Figure 4 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

33. LENGTH OF STAY Figure 4 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

34. VISITOR IS ADULT CHILD Figure 4 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

35. Satisfaction

36. CONSUMER GLOBAL SATISFACTION Figure 8Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

37. 81% CONSUMER SATIFACTION QUALITY OF LIFE Figure 9 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

38. 78% CONSUMER SATIFACTION QUALITY OF CARE Figure 10 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

39. 73% CONSUMER SATIFACTION QUALITY OF SERVICE Figure 11 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

40. SURVEY RESPONDENTS Figure 1 — “Facility count” is unduplicated total of facilities completing consumer and workforce satisfaction surveys.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

41. EmployeeDemographics

42. EMPLOYEE’S AGE Figure 5 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

43. JOB CATEGORY Figure 5 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

44. LENGTH OF EMPLOYMENT Figure 5 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

45. AGE OF NURSING STAFF Figure 6Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

46. LENGTH OF SERVICE Figure 7Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

47. Satisfaction

48. WORKFORCE GLOBAL SATISFACTION Figure 12Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

49. 60% WORKFORCE SATIFACTION TRAINING Figure 13 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.

50. 59% WORKFORCE SATIFACTION WORK ENVIRONMENT Figure 14 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes, My InnerView Inc.