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Session #4: “Voice of the Patient” Using Data to Transform the Patient Experience. James Merlino , MD. Chief Experience Officer, Cleveland Clinic. “Patients First….”. Main Campus Nurse Communication. %ile. Source: CMS and Dashboard 1.31.14. Nurse Communication.
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Session #4:“Voice of the Patient”Using Data to Transform the Patient Experience James Merlino, MD • Chief Experience Officer, Cleveland Clinic
Main CampusNurse Communication %ile Source: CMS and Dashboard 1.31.14
Nurse Communication Data Time Frame: Discharges between Q2 2012 – Q1 2013
Main CampusDoctor Communication %ile Source: CMS and Press Ganey 5.1.14
Healthcare providers understand what their “customer” – the patients, want? Poll Question #1 • True • False
Leaders SurveyTop priorities • New facilities • Quiet-time to ensure rest • Private rooms • Food on demand • Interactive bedside computers • Eliminate visiting hour restrictions
Respect Communication between staff Happy people Patient Desires
Patient Emotions • Stressful • Anxiety • Fear – Terror ! • Uncertainty • Confusion …And the Family
Scale of Importance on Satisfaction Less important Most important Wait time before Doctor Nurse Courtesy Nurse concern for Privacy Staff permitted family & friends to be w/patient Cleanliness Helpfulness of person first asking about condition Wait time for Radiology Comfort during blood draw Wait time before treatment area Comfort during Rad Personal Ins Privacy Rad Staff Courtesy Waiting Area Comfort Ease to provide insurance Courtesy taking ins. Wait time of staff notice Staff Cared Doctor concern for Comfort Doctor Explained Info to care for self at home Doc kept pt Informed Nurse kept pt Informed Info about Delays Family & friends kept Informed Nurses attn to Needs Doctor Listened Pain Control Doctor Courtesy Respect for Privacy Nurses Listened Courtesy to family & friends Global Sat., Concern, Empathy Nursing / ED Staff, Wait Times Communication & Information Ancillary Care, Comfort, Administrative Staff Behavior and Pain
Poll Question #2 What is the most important factor driving improvement in healthcare delivery? • Data transparency • Financial incentives for performance • Improved leadership / management skills • Both 1 and 2 • Both 2 and 3
Quality – Based Payment Reform Initiatives 2010 2011 2012 2013 2014 2015 2016 2017 2018 Inpatient Quality Reporting Requirement (IQR) 2% of APU Value Based Purchasing 2% VBP VBP Readmissions 3% Hospital Acquired Conditions 1% Hospital Acquired Conditions (DRG Demotions) Meaningful Use 1%
Every caregiver in an organization must be held accountable to organizational metrics? Poll Question #3 • True • False
The “360” Before After The Episode Manage the 360 Continuum
Inpatient Journey Follow up care Discharge Activities Admission Ongoing relationship management Ambulatory Hospital Stay Events / Procedures Access Pre-admission activity Calls Visits Billing
Inpatient flowCaregiver Perspective data along the Continuum
Enterprise Strategic Hospital Institute Department Center Business Unit Tactical Floor / Unit data down the vertical data along the Continuum Leader Operational Manager Individual
Center view – Physician specific metrics Unit view – Nurse and team specific metrics
DDI PhysiciansDoctor communication vs. Hospital rating Good doctor Bad hospital rating Poor Doctor Communication High Hospital Rating Low Communication Low Rating Low Reputation
Patient comments – anecdotes and verbatims – alone, can drive improvement! Poll Question #4 • True • False
Verbatims • “Never sure who my doctor was..” • “Surgeon never saw me – until I was very critical” • “Never saw my surgeon – only the fellow” • “Doctor had attitude” • “Doctor was rushed” • “Too many doctors – I never new who was in charge.” • “ ----- group was backing out of the door as my wife was asking questions – very rude.”
Physician Patient Comments N = 540
Opportunities for Improvement Doctor Communication Verbatims 72% Communication
Patients First…. • Purpose is transformational • Understand your customer • Transparency • Collect data across the continuum and drive it down the organization • The “soft” stuff counts!
Analytic Insights Questions & Answers A
Session Feedback Survey On a scale of 1-5, how satisfied were you overall with the Glenn Steele / Geisinger session? What feedback or suggestions do you have for the Glenn Steele / Geisinger session? On a scale of 1-5, how satisfied were you overall with the Jim Merlino / Cleveland Clinic session? What feedback or suggestions do you have for the Jim Merlino / Cleveland Clinic session?
