Value Based Purchasing
The Volunteers’ role in the
Patient Experience
Mary Theobald
Director, Patient & Guest Relations
Volunteer Services
National Attention
Our Call To Action
Measuring the Perception of Patients
How do we do that?
HCAHPS
Consumer Assessment of Healthcare Providers and
Systems
• Produce comparable data for public reporting
• Create incentives for hospitals to improve
• Enhance public accountability and transparency
www.hospitalcompare.hhs.gov
The Survey Process
Send data (patient files) to
Vendor
Surveys done by mail or
phone
Surveys returned to
Vendor
Surveys scanned and data
entered into database
Patient completes survey
Data uploaded
Reports generated
HCAHPS Dimensions
• Eight HCAHPS dimensions included in VBP:
Communication with Nurses
Communication with Doctors
Responsiveness of Hospital Staff
Pain Management
Communication about Medicines
Cleanliness & Quietness of Hospital Environment
Discharge Information
Overall Rating of Hospital
• All HCAHPS dimensions weighted equally within the
Patient Experience of Care (HCAHPS) domain
Current Survey Questions
The HCAHPS survey consists of 27 questions:
 16 evaluative questions about patient care:
 14 never/sometimes/usually/always.
 2 yes/no.
 2 global ratings:
 0-10 scale.
 4 point scale: Definitely No to Definitely Yes.
 4 screening questions.
 5 demographic questions (About You).
Reporting Based on “Top Box”
• What is “top box”?
H-CAHPS Scales
Always
Usually
Sometimes
Never
Definitely Yes
Probably Yes
Probably No
Definitely No
Yes
No
10
9
8
7
6
5
4
3
2
1
0
New: HCAHPS Voluntary Questions
• Five new questions:
▫ Three care transitions questions.
▫ Two demographic questions.
• Voluntary use beginning with July 1, 2012
discharges.
• Mandatory use beginning with January 1, 2013
discharges.
New: Care Transitions Questions
Voluntary use beginning with July 1,
2012 discharges.
Mandatory use beginning with
January 1, 2013 discharges.
New: Demographic Questions
Not publicly reported
Evaluated as part of the patient-mix
adjustment
Performance and payment reductions: How
is my hospital evaluated?
• Achievement, Improvement and Consistency (30%)
▫ Achievement pts gained when performance period score is above the
Achievement Threshold
▫ Improvement pts gained when hospital’s score improves from the
baseline period to the performance period
▫ Consistency pts gained when the hospital’s lowest HCAHPS score is
above the Achievement Threshold
• Your organization’s score = reimbursement
• Schedule for further reduction in DRG payments:
FY 2013
FY 2014
FY 2015
FY 2016
FY 2017
1.00%
1.25%
1.50%
1.75%
2.00%
VBP FY 2013 Performance standards
Achievement
Threshold
(50th Percentile)
Benchmark
(Mean of Top Decile)
Communication with Nurses
75.18
84.70
Communication with Doctors
79.42
88.95
Responsiveness of Hospital Staff
61.82
77.69
Pain Management
68.75
77.90
Communication about Medicines
59.28
70.42
Hospital Cleanliness & Quietness
62.80
77.64
Discharge Information
81.93
89.09
Overall Rating of Hospital
66.02
82.52
HCAHPS Dimension
HCAHPS VBP Timelines
FY 2013
Performance
Period
2009
1Q
2Q
3Q
2010
4Q
1Q
FY 2013
Baseline
Period
© 2012 Press Ganey Associates, Inc.
2Q
3Q
2011
4Q
FY 2014
Baseline
Period
1Q
2Q
3Q
FY 2015
Baseline
Period
FY 2014
Performance
Period
FY 2015
Performance
Period
2012
4Q
1Q
2Q
3Q
2013
4Q
1Q
2Q
3Q
4Q
2013
2014
2015
Lack of Communication is #1 Complaint
• Dr. was very busy with phone calls & could have listened
to me a little better
• I waited for treatment in the waiting room for hours. A
lot of people came after me that were called 1st. There
are exceptions but this is ridiculous!
• The lady who took my blood never introduced herself to
me, she poked me-missed then poked a second time. It
hurt and she never said she was sorry.
• The staff let us know that there was a 3 car accident &
that they were having critical patients coming in so they
would get to my son as soon as they could and
apologized.
How can volunteers help to improve the Patient Experience?
New Volunteer Program - ED
DVS - Begin communication
with key players
• Begin conversations with your VP of nursing and
ancillary departments to let them know you have a
valuable resource that can enhance the patient’s
experience
• Find out what the current focus is for their departments
• Very important that you align yourself with what other
departments are doing
• Ask to be a part of Patient Experience Committees
Educate Yourself
• Ask for copies of the Patient
Satisfaction surveys
• Familiarize yourself with the questions
• Ask for access and training to the
vendor’s database
• Search for comments related to the
volunteers
• Ask that a question pertaining to the
volunteers be put on the survey
Educate Your Volunteers
• Put together an In-service
o Volunteers should be educated on the Patient
Satisfaction surveys, the HCAHPS component and
what it means to your hospital.
o Go over each component of the survey with them.
o Make sure they know that the data collected from
patients is the patient’s perception of how their
hospital stay was.
• Invest in customer service and communication
training
Communicate
• We all want to empower our volunteers, but make sure
you have shared your ideas with your colleagues and get
their “buy in” before your volunteers take the reign.
▫ Example-If you want them to pay particular attention to the
environment and would like the volunteer to make the call to
EVS, make sure the director of EVS is agreeable to it as well as the
director of the unit.
Volunteers Must….
•
•
•
•
•
•
•
•
Smile
Make eye contact
Greet patient with appropriate name and title
Actively listen to patient, repeating things back so they know
you are paying attention
Demonstrate compassion
Demonstrate customer service standards set by the hospital
Ask if there is anything they can do for the patient when
leaving the room or leaving for test or treatment
The volunteer that wants to tell their “stories” to the patient
and/or unable to demonstrate your hospital’s core values
should not be part of your team
Volunteers are vital members of the
caregiver team
• Volunteers personalize and humanize a patient’s
hospitalization
• Increase the numbers of volunteers on the
frontline
▫ Answering call lights and taking care of the nonclinical requests
▫ Taking the needs of the family into consideration
▫ Rounding on patients and writing something
personal on the patient white board that they
would want their care team to know
• Roving comfort or caring carts
• Concierge program
• ASSIST Program
▫ Arrange lodging
▫ Companionship
▫ Provide information about the area
What Message Are We Sending
Behavior vs. Intent