Creating Value To Your Patients
Building A Patient-Centric Culture
CAHPS Surveys
• Current:
Medicare Advantage Health Plans (MA CAHPS)
Prescription Drug Plan (PD CAHPS)
Hospitals (HCAHPS)
Home Health Agencies (HH(HH-CAHPS)
Dialysis Centers (ICHCAHPS = InIn-Center Hemodialysis CAHPS)
• Future:
2013: Medicare Shared Savings Program & Pioneer ACO Program (ACO GCAHPS)
GCAHPS)
2014: Pediatric HCAHPS
2014: Medical Groups with 100 or more providers (PQRS CGCAHPS)
April 2014: PPSPPS-Exempt Cancer Hospitals (HCAHPS)
January 2015: Hospice Providers (New Survey Being Developed)
2015: Hospital Outpatient Departments (Emergency Department Survey Being
Being Developed)
2015: Hospital Outpatient Departments (Outpatient Surgery Survey Being
Being Developed)
2016: Ambulatory Surgery Centers (Outpatient Surgery Survey Being Developed)
Developed)
• TBD:
Inpatient Psychiatric Facilities
Long Term Care Hospitals
Inpatient Rehabilitation Facilities
Typical Implementation Sequence
CAHPS Surveys & Value
Based Purchasing
• Current VBP Programs
HCAHPS – Part of VBP beginning with 2011 discharges
ICHCAHPS – Part of VBP beginning with 2012 data collection
CGCAHPS – Part of VBP beginning with 2014 visits for large medical
groups (over 100)
• Not yet part of VBP. No clear plans to implement any VBP
program.
HHCAHPS
ED CAHPS
Outpatient Surgery CAHPS
Hospice CAHPS
HCAHPS for 11 PPS-Exempt Cancer Hospitals
Surveys, Response
Scales and Reporting
Survey Scale
•CAHPS
Measures frequency, did something happen
Scores based on highest response
•Press Ganey
Measures meeting needs and expectations
Scores based on all types of responses
Press Ganey Surveys:
The Survey Scale & Mean Score
Survey
Very Poor
Poor
Fair
Good
Very Good
Report
1
2
3
4
5
0
25
50
75
100
Very Poor
Poor
Fair
Good
Very Good
Press Ganey Surveys:
Mean Score & Percentile Rank
Mean Score: Average, Our Score
Example: 85.1 (75 = Good - 100 = Very Good)
Percentile Rank: Tells you how you are doing
compared to peers
Example: 42nd Percentile
•Scoring same or better than 42% of 1,696 EDs in the database
•58% scoring the same or higher
CAHPS Surveys:
Percent Top Box
Top Box: Highest response that can be
given on a question
CG CAHPS: % 9 & 10, % Yes Definitely
HCAHPS: % Always
Current
CG CAHPS Results
Survey
Response Scale
Reporting
Most Recent 6 Month Score
Physician Section
Physician
Office:
Press Ganey
Very Poor, Poor,
Fair, Good,
Very Good
Mean Score
Percentile Rank
93.9 Mean Score, 68th Percentile
Physician
Office:
CG CAHPS
Yes, Definitely
Yes Somewhat
No
Rate 0-10
Top Box Percent
Doctor Section
93.2% Top Box, 56th Percentile
Rate Doctor 0-10
83.7% Top Box, 47th Percentile
% Yes, Definitely
% 9 &10
Percentile Rank
Physician Office:
CGCAHPS
Physician Office:
Press Ganey
Agenda
1
Map
2
Refine
3
Align
4
Engage
5
Focus
6
Measure
7
Incorporate
Map…
patient journey and lifecycle
Determine patient “touch points”
STEP
11
Create a team of stakeholders involved in the process of delivering service or care
STEP
STEP
2
Follow patients one-on-one through the process or conduct small group interviews
STEP
3
Review the results and develop a plan to operationalize changes
Agenda
1
Map
2
Refine
3
Align
4
Engage
5
Focus
6
Measure
7
Incorporate
Refine…
service model to enable patient-centricity
Roles
&
Responsibilities
Interaction
Protocol
Governance
What are the roles of each staff member in how
they provide service?
Define the expectations and standards of
behavior.
How should these members interact with the
patient?
How should these members interact with the
processes for the care of the patients?
What should be measured to ensure service
effectiveness?
Who is going to govern service standards and
conformity?
Agenda
1
Map
2
Refine
3
Align
4
Engage
5
Focus
6
Measure
7
Incorporate
Align…
processes to support and drive patient engagement
Agenda
1
Map
2
Refine
3
Align
4
Engage
5
Focus
6
Measure
7
Incorporate
Engage…
leaders and staff
1
Collaboratively
problem solve:
• Leaders
work
with
employees to find solutions
to problems, asking for
their input, understanding
perspectives shared;
• Keeping them updated on
the solution or the status;
• The goal is to understand
what is working well for
staff and what could be
working better – armed
with this information, these
leaders
can
make
employees’ jobs as easy
and satisfying as possible;
• Demonstrate humility in the
process, including owning
and
learning
from
mistakes;
• Continuously learning and
growing—status quo is
never okay.
22 Communicate often
and openly:
• Communication with staff is
the top priority for this
leadership group, with a
focus on listening and
responding;
• They are as transparent as
possible, sharing yearly
department goals (which
were developed with staff
input), financial updates,
Avatar scores, and key
strategic information;
• An email jam-packed with
miscellaneous updates goes
out to all staff 1-2 times a
month;
• Purposeful and frequent
rounding is the routine.
3
Show appreciation
regularly:
• Say
thank
you
employees regularly;
4
to
• Use the R&R programs
and create new ones;
• Recognize
accomplishments in team
meetings;
• Say thank you, again!
Lead through change
effectively:
• Changes present many
challenges;
strong,
collaborative leadership
helps others navigate
change
with
minimal
issues;
• It is important for leaders
to by physically present
during change to gain
input, build trust, and
facilitate understanding.
Agenda
1
Map
2
Refine
3
Align
4
Engage
5
Focus
6
Measure
7
Incorporate
Focus…
development around targeted areas and behavior change
Results
PERFORMANCE
EXPECTATIONS =
*The service produced by an
employee, measured by departmental
objectives and standards.
Actions & Behaviors
*The method by which a service is provided
and the behaviors and values demonstrated
during the process.
• What type of service should my job produce?
• What impact should my work have on the organization?
• What behaviors do I expect when interacting with patients, colleagues, and supervisors?
• What are the organizational values must I demonstrate?
• What are the processes, methods, or means I am expected to use?
Agenda
1
Map
2
Refine
3
Align
4
Engage
5
Focus
6
Measure
7
Incorporate
Measure…
change using key metrics
5-Step
5-Step Approach
Approach to
to Measurement
Measurement Success:
Success:
1
Select
Select 11 or
or 22 metrics
metrics to
to focus
focus on
on for
for aa 12
12 month
month time
time period
period
2
Determine your intervention to respond to the opportunity
3
Define a way to measure it on a daily basis
*ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!!
4
COACH, COACH, COACH the behaviors that change your metric
5
Audit for improving metric success once skills have been obtained
Measure…
change using key metrics
5-Step
5-Step Approach
Approach to
to Measurement
Measurement Success:
Success:
1
Select 1 or 2 metrics to focus on for a 12 month time period
2
Determine
Determine your
your intervention
intervention to
to respond
respond to
to the
the opportunity
opportunity
3
Define a way to measure it on a daily basis
*ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!!
4
COACH, COACH, COACH the behaviors that change your metric
5
Audit for improving metric success once skills have been obtained
Measure…
change using key metrics
5-Step
5-Step Approach
Approach to
to Measurement
Measurement Success:
Success:
1
Select 1 or 2 metrics to focus on for a 12 month time period
2
Determine your intervention to respond to the opportunity
3
Define
Define aa way
way to
to measure
measure itit on
on aa daily
daily basis
basis
*ONLY
LOOK
AT
OVERALL
PATIENT
*ONLY LOOK AT OVERALL PATIENT SATISFACTION
SATISFACTION DATA
DATA ON
ON AA MONTHLY
MONTHLY BASIS!!
BASIS!!
4
COACH, COACH, COACH the behaviors that change your metric
5
Audit for improving metric success once skills have been obtained
Measure…
change using key metrics
5-Step
5-Step Approach
Approach to
to Measurement
Measurement Success:
Success:
1
Select 1 or 2 metrics to focus on for a 12 month time period
2
Determine your intervention to respond to the opportunity
3
Define a way to measure it on a daily basis
*ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!!
4
COACH,
COACH, COACH,
COACH, COACH
COACH the
the behaviors
behaviors that
that change
change your
your metric
metric
5
Audit for improving metric success once skills have been obtained
Measure…
change using key metrics
5-Step
5-Step Approach
Approach to
to Measurement
Measurement Success:
Success:
1
Select 1 or 2 metrics to focus on for a 12 month time period
2
Determine your intervention to respond to the opportunity
3
Define a way to measure it on a daily basis
*ONLY LOOK AT OVERALL PATIENT SATISFACTION DATA ON A MONTHLY BASIS!!
4
COACH, COACH, COACH the behaviors that change your metric
5
Audit
Audit for
for improving
improving metric
metric success
success once
once skills
skills have
have been
been obtained
obtained
Agenda
1
Map
2
Refine
3
Align
4
Engage
5
Focus
6
Measure
7
Incorporate
Incorporate…
patient feedback into processes and behaviors
• Engage patients early and often
• Engage patients at all points of contact
• Engage patients in different ways (focus groups,
advisory groups, individual opinions, etc.)
• Patient engagement is resource and time
intensive. Give your department BOTH.
• Most importantly, ensure the change is
MEANINGFUL and NECESSARY before asking a
patient for help. (i.e., Don’t waste their time.)
“A customer is the most important visitor on our
premises.
He is not dependent on us; we are dependent on him.
He is not an interruption in our work; he is the
purpose of it.
He is not an outsider in our business; he is a part of it.
We are not doing him a favor by serving him; he is
doing us a favor by giving us an opportunity to do
so.”
~Mahatma Gandhi