Using Data to Improve the Patient
Experience
Renée Carolan
Patient Experience Advisor
November 18, 2014
Objectives for today:
 Identify Patient Experience Data Collection Tactics
 Understand the Data Basics
 Develop Your Data Strategy
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Identify Patient Experience Data Collection
Tactics
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IDENTIFY: Post-Encounter Surveying
Phone - Paper - E-Survey
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IDENTIFY: Real-Time Surveying
Real-Time Survey and Leader Rounding
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IDENTIFY: Leader Rounding is at the Center of
Success
Leader Rounding is essential to sustain best practices, promote
culture, and drive initiatives
PAIN CONTROL
QUIET AT NIGHT
DISCHARGE CALLS
LEADER ROUNDING
HOURLY ROUNDING
MISSION, VISION, VALUES
HANDWASHING
© 2013
2014 Press Ganey Associates, Inc.
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BEDSIDE SHIFT REPORT
IDENTIFY: Patient Reported Outcomes
PROMs
“Any report of the status of a patient's health condition that comes directly
from the patient, without interpretation of the patient's response by a clinician
or anyone else. In other words, PRO tools measure what patients are able to
do and how they feel by asking questions. These tools enable assessment of
patient–reported health status for physical, mental, and social well–being.”
The most commonly used PROM questionnaires assess one of the following
constructs:
• Symptoms (impairments) and other aspects of well-being
• Functioning (disability)
• Health status
• General health perceptions
• Quality of life
• Health related quality of life
• Reports and Ratings of health care
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www.qualityforum.org
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IDENTIFY: PROMs: Measure Patient Healing &
Engagement
Evaluate patient perception of functional/emotional status over time
Initial encounter,
baseline evaluation
Post-treatment
evaluation
3, 6, 12 month
evaluation
Patient-reported outcome measures (PROMs)
•
Measure impact of treatment from the patient’s perspective before, during and after care
•
Provide insight into the progression, quality and effectiveness of care by clinical diagnosis
or treatment type
•
Segment and manage a patient population
•
Benchmark PROMs and monitor progression of recovery, intervene where necessary
•
Press Ganey vision: combine patient functional status with patient experience to provide
more holistic view for greater patient engagement
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IDENTIFY: Alternative Feedback Avenues
Patient Relations, Social Media
 Align your Complaints and Compliments data from
Patient Relations with your Survey feedback.
 Engage your Public Relations or Marketing departments
in retrieving patient feedback from social media sites,
and in promoting patient centric messages.
 Focus groups are another alternative method of
gathering patient feedback and actionable data.
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Understand the Data Basics
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UNDERSTAND: The Questions
The Total Patient Experience
• Press Ganey survey questions
- Qualitative nature
- Demonstrates quality (“how well” things are done)
- Allows for section specific comments for targeted
improvement
• CGCAHPS survey questions
- Quantitative nature
- Demonstrates frequency (“how often” things are done)
- Addresses the topics that Medicare patients stated were most
important in their care
• Patient Comments
- Invaluable insight opportunities
- Paints the full picture of the patient encounter
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UNDERSTAND: Level of Detail
Level of Detail
Unit/
Dept.
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Shift
Provider
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Specialty
UNDERSTAND: Discharge/Visit Date versus
Received Date
Discharge/Visit Date
Received Date
• Results may change over
time
• Can see results of process
improvements based on
when they were
implemented
• The number of recently
returned surveys will be
smaller
• Recommendation to wait six
weeks after the close of a
month or quarter to view
data
• Results will not change
over time
• All surveys received during
the month will be included
• Can be used for
accountability and goal
setting
• Benchmark comparisons
are based on received date
time frames
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UNDERSTAND: How Scores Are Reported
Top Box - (Patient Loyalty Indicator)
Top Box refers to the percentage of “top box” responses given by patients. On
the Press Ganey surveys, this is the percentage of “very good” responses. On
the CAHPS surveys, it is the most positive response of the survey scale for that
question.
Mean Score - (Composite Performance View)
The mean score is the average of your patients’ responses.
Percentile Rank - (Comparison To Others)
A percentile rank shows how your raw score compares to that of other facilities
in your peer group. It is a ranking from 1 to 99, not a percentage. Percentile
ranks can be based on mean scores or top box scores. Percentile ranks give
important perspective into how your performance measures up to others like
you
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UNDERSTAND: Advantages of Top Box, Mean,
and Percentile Rank
Top Box
Mean Score
Percentile Rank
• Complete
satisfaction is
loyalty index ‒
Impact on bottom
line
• Tied to only your
performance
• Can set the same
percentile goal
across service
lines
• Easy to explain to
staff
• Related to mean
score
improvement
• Easy to
understand
• Motivation for
lower
performers
• Composite view
• Used for CAHPS
questions
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• Assign relative to
performance in
other areas (e.g.,
financial, clinical)
• Takes market
into account
UNDERSTAND: Considerations of Top Box,
Mean, and Percentile Rank
Percentile Rank
Top Box
Mean Score
• Executive team
not used to seeing
goals this way
• Does not take
into account
performance
relative to other
organizations
• Moving target
• Difficult to
determine what
is meaningful
• Mean score can
improve but rank
can decline
• Does not account
for “defects,” i.e.,
very poor
• Larger margin of
error – less
precision and
power
© 2013 Press Ganey Associates, Inc.
• Must be set for
each individual
service/survey
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• Not just tied to
your own
performance
UNDERSTAND: Frequency Distribution
 Overall Score - Inpatient Database 1/1/2013 – 12/31/2013
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UNDERSTAND: Number of Returns
 The importance of “n” size
 Ideally, we would have at least 30 returned surveys, because that is
traditionally viewed as the sample size that allows us to make valid
inferences about the entire population.
 Data from samples of less than 30 can provide useful information for
evaluative purposes; however, clients should take care when using
statistical metrics derived from samples of this small size.
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UNDERSTAND: How to Use the Priority Index
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Develop Your Data Strategy
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DEVELOP: Redefine Patient Experience
Through Data
• You can’t separate the patient experience from
what actually happens to the patient.
• The patients’ experience includes everything that
touches or impacts them including clinical processes,
practices to ensure safety, service delivery and
outcomes of care.
•
Integrating these metrics leads to better knowledge of
care and a single source of truth for improving careprevents waste of efforts and prevents creating
unintended consequences.
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DEVELOP: Measuring What Matters to Improve the Patient
Experience
Avoidable Suffering
Caused by defects in
the approach to
deliver care
Inherent Suffering
Experienced even if
care is delivered
perfectly
OUR GOAL:
Prevent this
suffering for patients
by optimizing care
delivery.
OUR GOAL:
Alleviate this
suffering by
responding to
Inherent Patient
Needs.
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DEVELOP: New Model- Compassionate
Connected Care™
Clinical Excellence:
Connecting clinical excellence
with outcomes
Operational Excellence:
Connecting efficiency
with quality.
Compassionate
Connected Care ™
Caring Behaviors:
Connecting engagement
with action.
© 2014 Institute for Innovation
Culture: Connecting
mission, vision, & value
with engagement.
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DEVELOP: Current Measurement of Patient
Needs Through Compassionate Connected Care
Clinical
Excellence
Operational
Efficiency
Inherent Needs &
Avoidable Suffering
• Demonstrate Clinical Skill
• Manage Pain
• Prepare for Discharge
Caring
Behaviors
• Show Courtesy
• Inform
• Personalize Care
• Show Empathy
• Protect Privacy
• Offer Choice
• Use Service Recovery
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• Minimize Wait
• Provide Clean/Comfortable
Environment
• Offer Adequate Amenities
Culture
• Show Teamwork
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DEVELOP: Telling a “patient condition”
segmentation story
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DEVELOP: Transparency Strategy
 Patients are increasingly seeking data to make informed health care
decisions
 Transparency is a key strategy for delivering on a patient-centered
mission
 Thoughtful, graduated implementation strategies are quickly gaining
traction and creating a culture of excellence
 Online physician ratings yield measureable and qualitative
performance improvement:




Improve patient experience and reduce suffering
Physician engagement
Depth and validity of data
Online search visibility
Robust data collection through Census Based Surveying is the
first step to implementing a successful transparency strategy
© 2014 Press Ganey Associates, Inc.
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DEVELOP: Utilize Comments
Tell The Story
 Review comments weekly to identify trends, reward and
recognize staff, coach or counsel, and let patients know
you hear them
 Use this data and feedback at the beginning of meetings
 Tell patient stories with management and leaders to keep
all work connected to the patient.
 Post comments and foster transparency
© 2014 Press Ganey Associates, Inc.
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DEVELOP: Ideas for Sharing Data
Frequency
Board/Senior
Leadership
Weekly
Directors/
Managers
Staff
• Comments
• Survey images
• Comments
Monthly
• Overall Facility
Performance by
service line
• VBP
• Unit, site,
specialty-level
results
• Monthly
comment report
trends
• Unit, site,
specialty-level
results
Quarterly
• Overall Facility
Performance by
service line
• Priority Index
• Facility Ranking
• Comment
trending
• Overall Facility
Performance
• Unit, site,
specialty-level
results
• Priority Index
• Facility Ranking
• Overall Facility
Performance
• Unit, site,
specialty-level
results
• Priority Index
• Facility Ranking
11/19/2014
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DEVELOP: Engaged Organizations Perform
Better
Comparison of HCAHPS Performance:
National Percentile by Engagement Decile
+ 61 percentile
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DEVELOP: Alignment with Physicians Yields Better
Results
Comparison of HCAHPS Performance Among Organizations
with High- or Low- Physician Alignment
Body Subhead
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REVIEW
•
Identify Ways To Collect Data
• Post-Encounter Surveying
•
•
•
•
Patient Reported Outcome Measures
Patient Relations / Social Media
Understand the Data
• The Questions and How Scores are Reported
•
•
Real-Time Surveying and Leader Rounding
Frequency, Minimum ‘n’, and Priority Index
Develop a Data Strategy
• Reducing Suffering and Compassionate Connected Care
•
•
•
Transparency
Sharing Suggestions and Comments
Physician and Employee Engagement
© 2014 Press Ganey Associates, Inc.
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Thank you for your time!
Questions?
Renee.carolan@pressganey.com