How one health care system partnered with their patients and staff to achieve breakthrough performance in HCAHPS

A Case Study

This is a story about a dynamic and progressive health care organization dedicated to providing quality, compassionate and accessible care and service to their patients. Nationally recognized for its outstanding patient safety and state-of-the-art technology, they are proud of their reputation as a leader in health care, research and education.

FOOTPRINT

  • 2 medical centers
  • 1 community living center
  • 5 community based outpatient clinics
  • 727 inpatient beds
  • 120 community living center beds
  • 166 primary and specialty clinics
  • 600,000 outpatient visits annually
  • 3,900 providers and employees

SERVICES

Providing acute, surgical, domiciliary, emergency, primary care, specialty, mental health, rehab, geriatric, and long-term care

As part of their accountability to live within their Mission, Vision and Values they implemented multiple interventions in an effort to improve patient experience. Planetree and HCAHPS assessments were conducted, yoga programs implemented, a family lounge in an acute care unit was added, an interactive patient care TV system was rolled out, an extensive noise reduction campaign implemented, leader rounding initiated and much more.

THE RESULT OF EFFORTS WITHOUT TRUTHPOINT

Minimal improvement in HCAHPS scores and frustration on the part of leaders and front-line staff.

Leaders at the system and medical center level were directly engaged to determine ways to proactively round on patients and determine thematic questions to ask to better understand how to improve key drivers of patient experience. As part of the plan TruthPoint was brought on as a patient experience improvement partner to make improvement efforts easier by:

  • Providing a tool and rounding process to capture and disseminate patient feedback at the point of service
  • Monitoring and hardwiring improvement initiatives through emailed reports
  • Disseminating patient feedback directly to clinicians and key stakeholders shortly after service is provided
  • Understanding root-cause “why,” behind patient satisfiers or dissatisfiers
  • Providing a tool to capture immediate service requests and correct problems while patients are still in the hospital

The process was broken down into three phases: design, implement & measure, and reinforce.

DESIGN PHASE

Together with a TruthPoint Improvement Coach, the Patient Care Coordinator engaged the health system and medical center leadership. They reviewed the attributable effects/key correlates from HCAHPS to identify focus areas for improvement.

From this input, a patient assessment of care experience was created to obtain meaningful, timely and specific feedback to improve in these focus areas.
In addition, real-time service intervention opportunities
were created via an email alert
to services such as dietary, housekeeping, and maintenance allowing patients to identify service issues and receive timely follow up and service recovery.

IMPLEMENT & MEASURE PHASE

With a lag time up to three months, the previous feedback tools were not adequate to support rapid improvement. With TruthPoint, the health system was able to receive and review patient feedback to monitor improvement efforts in real-time. If they wanted, providers could even see the feedback from patients they cared for the day before. Department specific and team specific reports were sent daily, weekly and monthly to key stakeholders.

REINFORCE

Through real-time feedback the stakeholders were able to see where their patient improvement programs were succeeding and what areas needed some extra attention. The real time feedback was also used as a tool to recognize and reward individual team members, leading to increased staff morale and inviting friendly competition for patient recognition.

Here is an example of a monthly TruthPoint trending report on noise levels:

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This is an example of a weekly report, again highlighting the feedback from patients around noise:

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h4With the combination of multiple intervention initiatives and real-time feedback, this health system was able to achieve some groundbreaking improvements in their HCAHPS scores. Willingness to recommend increased by 18%, overall rating of the hospital increased by 17%, and communication with nurses was finally aligned with the national average after years of being below.

SUMMARY

Organization
Large Health system with 2 medical centers, 1 community living center and 5 outpatient clinics

Challenge
Minimal HCAHPS improvement despite concerted efforts

Solutions

• Leader engagement coupled with real time feedback and timely service interventions

Results After Leveraging TruthPoint
Double digit improvements in HCAHPS scores