2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes

2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes

October 07, 2008AMERICAN HEALTH CARE ASSOCIATION

Bradley N. ShiverickC.P.H.Q

Vice President and Chief Quality Officer

[email protected]

715-848-2713

Goals

» What is “quality” anyway?

» Organizational performance

» Satisfaction and loyalty

» 2007 national satisfaction report

» The importance of the workforce

Evidence-based philosophy

Evidence-based management calls for a paradigm shift in the approach to quality improvement: An appreciation of data, the ability to turn data into information and knowledge, and to use that information and knowledge to improve quality.

Turn plan into

action: improveprocess

Turn knowledge

into plan:apply new wisdom

to process

Turninformation into

knowledge:study current

process

Collect

data:ensure validity,

organize

Turn data into

information:benchmark, study

variation

Evaluate

outcomes:measurevariation

My InnerView’sevidence-

basedpath to quality

Collectdata:ensure validity,organize

Collect

data:ensure validity,organize

Turn data intoinformation:benchmark, studyvariation

Collect


Turn data into

information:benchmark, studyvariation

Turninformation intoknowledge:study currentprocess

Turn knowledge

into plan:apply new wisdomto process


knowledge:study currentprocess

Collect


Turn data into


Turn plan intoaction: improveprocess

Turn plan into

action: improveprocess

Turn knowledge

into plan:apply new wisdomto process


knowledge:study currentprocess

Collect


Turn data into


Evaluateoutcomes:measurevariation

11

What is Quality, Anyway?

“The totality of features and characteristics of a product or service that meet or exceed

customer needs and expectations.”

Organizational Performance

Focus onWorkforceFocus onWorkforce

KnowledgeManagementKnowledge

ManagementProcess

ImprovementProcess

Improvement

Focus on CustomerFocus on Customer

StrategyStrategy

LeadershipLeadership

Organizational Performance


KnowledgeManagementKnowledge

ManagementProcess

ImprovementProcess

Improvement


StrategyStrategy

LeadershipLeadership



or loyalty?

Satisfaction …

When you don’t remember

anything, you’re satisfied!

Why look at

“Excellent”?

Loyalty is generated by memorable things

that happen that we didn’t expect.

These cause person to give score of

“Excellent,” not “Good.”

Frederick Riecheld: “The Loyalty Effect”

» To grow your business exponentially, you must get serious loyal relationships with your customers – Loyal customers are easiest customers to serve

– Long-term customers tend to spend more with you than new customers

– Happy, loyal customers purchase other products or services in company’s line

– Satisfied, loyal customers recommend company’s products or services

The Loyalty Effect: The Hidden Force Behind Growth, Profits, and Lasting Value ;Frederick F. Reichheld,

A loyal customer …

» Will recommend you to others

» Will give you the benefit of the doubt

» Will use you again

» Will enhance your reputation in the community

» Won’t sue you

“Research shows that, in most industries, there is a strong

correlation between a company’s growth rate and the percentage of its customers who are raving fans — that is, those who say they are extremely likely to recommend

the company to a friend or colleague.”

For My InnerView users,this is “Excellent”

For My InnerView users,this is “Excellent”

RECOMMEND

What is your recommendation of this facility to others?

What is your recommendation of this facility as a place to work?

… to receive care?

EXCELLENT GOOD FAIR POOR

The Importance of “Recommendation”» “Recommendation” is touchstone to determine

significance of your scores on all other items

» “Recommendation” score provides crucial information– Tells you loyalty of respondents

– Correlates to other quality outcomes:• All items in survey

• Occupancy

• Quality indicators

• Employee satisfaction

» That is why this question is used for Priority Action Agenda

» Those who are likely to recommend your organization to others are called “promoters”

» Why is willingness to promote your company such a strong indicator of loyalty and growth?

Frederick Riecheld: “The One Number You Need to Grow”

Frederick Riecheld: “The One Number You Need to Grow”

Because when customers recommend you,

they’re putting their reputation on the line.

They will take that risk only

when they are loyal.

“In most of the industries studied,

the percentage of customers who were enthusiastic enough to refer a friend or colleague — perhaps

the strongest sign of customer loyalty — correlated

directly with differences in growth rates among

competitors.”

Respondents

» 27,397 residents

» 118,985 family members

» 161,908 employees

» 4,116 (one in four) nursing homes nationwide

Source of data

» Largest private dataset of resident, family and employee satisfaction in nation

» From mailed resident and family surveys returned to third-party

» From self-administered employee surveys; mailed to third party

» Respondents rate facilities using four-point scale (excellent, good, fair or poor)

SURVEY RESPONDENTS

Figure 1 — “Facility count” is unduplicated total of facilities completing consumer and workforce satisfaction surveys.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes , My InnerView Inc.

ConsumerDemographics

RESIDENT’S AGE

Figure 4 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes , My InnerView Inc.

RESIDENT VISITED


LENGTH OF STAY


VISITOR IS ADULT CHILD


Satisfaction

CONSUMER GLOBAL SATISFACTION

Figure 8Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes , My InnerView Inc.

CONSUMER SATIFACTION


81%

QUALITY OF LIFE



QUALITY OF CARE

78%



QUALITY OF SERVICE

73%

SURVEY RESPONDENTS

Figure 1 — “Facility count” is unduplicated total of facilities completing consumer and workforce satisfaction surveys.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes , My InnerView Inc.

EmployeeDemographics

EMPLOYEE’S AGE


JOB CATEGORY


LENGTH OF EMPLOYMENT


AGE OF NURSING STAFF


LENGTH OF SERVICE


Satisfaction

WORKFORCE GLOBAL SATISFACTION


WORKFORCE SATIFACTION


TRAINING

60%



WORK ENVIRONMENT

59%


Figure 15–16 — May not total 100% due to rounding.Source: 2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes , My InnerView Inc.

SUPERVISIONSUPERVISION

MANAGEMENT

46%

62%

Willingnessto Recommend

WILLINGNESS TO RECOMMEND


Family



Family



Resident



Resident and family

5.5%

6.0%

6.5%

7.0%

7.5%

8.0%

8.5%

Once yearor more

Every 3months

Oncemonth or

more

Once weekor more

Almostdaily

HOW OFTEN VISITED

Resident Family



Workforce

DATABYTE



Workforce

DATABYTE



Nurses and nursing assistants

LENGTH OF SERVICE

4.0%

4.5%

5.0%

5.5%

6.0%

6.5%

Less than 3months

3 months -1 year

1-2 years 2-5 years 5-10 years 10+ years

Nurse Nursing Assistant




BY AGE

Nurse Nursing Assistant

4.0%

4.5%

5.0%

5.5%

6.0%

6.5%

19 to 29 30 to 39 40 to 49 50 to 59 60 or older

NationalTrends in

Satisfaction

FACILITIES WITH THREE CONSECUTIVE SURVEYS

SATISFACTION TREND


Consumer2005 2006 2007

4.5

5.0

5.5

6.0

6.5

7.0

7.5

Quality of life Quality of care Quality of service Composite

3.0

3.5

4.0

4.5

5.0

5.5

6.0

Supervision Workenvironment

Training Management Composite

FACILITIES WITH TWO CONSECUTIVE SURVEYS

SATISFACTION TREND


All workforce2006 2007


SATISFACTION TREND


Nurses2006 2007

3.0

3.5

4.0

4.5

5.0

5.5

6.0



3.0

3.5

4.0

4.5

5.0

5.5

6.0




SATISFACTION TREND


Nursing assistants2006 2007

Factors DrivingSatisfaction in‘Best-in-Class’

Facilities

DATABYTE

DRIVERS OF CONSUMER ‘RECOMMENDATION’


A Deeper Dive on “Drivers”

QUADRANT ANALYSIS: A DISCOVERY TOOL

MY INNERVIEW’S GOAL

Help providers achieve their quality targets

OUR APPROACH

Help providers:• Turn data into information

— discover patterns• Turn information into knowledge

— discover their roots• Turn knowledge into action

— plan, mobilize, act

QUADRANT ANALYSIS: AN EFFECTIVE TOOL

QUADRANT ANALYSIS: TWO KEY CONCEPTS

1. How residents, families and staff rate your care and services

Your average score on each item:1 – 4: “Poor” “Fair” “Good” “Excellent”

Rank order all items by average score:1 – 100: Lowest to highest ranking score

2. How much each item influences residents,families and staff to recommend to others

Correlate each item with “Recommendation:0 – 1: No correlation to strongest correlation

Rank order all items by correlational strength:1 – 100: Lowest to highest ranking correlation

1 ----- Lowest to highest ranking correlation ------ 100

Su

cces

ses

You have little control over customer expectations

Yo

u c

an m

eet

cust

om

er e

xpec

tati

on

s

C.

Secondary opportunities

D.

Primary opportunities

B.

Primary strengths

A.

Secondary strengths

Ch

alle

ng

es

1 -

Lo

wes

t to

hig

hes

t ra

nki

ng

sco

re

100

QUADRANT AND ACTION PRIORITIES

RESIDENT

FAMILY

Care (concern)by staff

Quality ofRN/LVN/LPN care

Respectfulnessof staff

17

13

2A B

SE

CO

ND

AR

Y S

TR

EN

GT

HS P

RIM

AR

Y S

TR

EN

GT

HS

4

7

103

198

155

FAMILYRESIDENT

1713

2

4

710

3

8

15

14

5

Competency of staff

14

195

Commitment tofamily updates

Safety of facility

17

13

A BS

EC

ON

DA

RY

ST

RE

NG

TH

S PR

IMA

RY

ST

RE

NG

TH

S

4

7

103

5

FAMILYRESIDENT

1713

4

710

314

Quality ofCNA/NA care

Choices/preferences

Responsivenessof management

Attention toresident grooming

Adequacy of staff20

1

C DSE

CO

ND

AR

Y O

PP

OR

TU

NIT

IES P

RIM

AR

Y O

PP

OR

TU

NIT

IES

16

14

12

9

2122

18

6

FAMILYRESIDENT

11

20

1

1619

12

9

2122

18

6

11

19

A BS

EC

ON

DA

RY

ST

RE

NG

TH

S PR

IMA

RY

ST

RE

NG

TH

SFAMILYRESIDENT

D

PR

IMA

RY

OP

PO

RT

UN

ITIE

S

19

Cleanlinessof premises

CSE

CO

ND

AR

Y O

PP

OR

TU

NIT

IES

DATABYTE

2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes


DRIVERS OF WORKFORCE ‘RECOMMENDATION’

EMPLOYEE

1

17

13

2

SE

CO

ND

AR

Y S

TR

EN

GT

HS

SE

CO

ND

AR

Y O

PP

OR

TU

NIT

IES

PR

IMA

RY

ST

RE

NG

TH

SP

RIM

AR

Y O

PP

OR

TU

NIT

IES

16

47

10

3

8

15

14

5

12

918

6

11

A B

C D

EMPLOYEE

17

PR

IMA

RY

ST

RE

NG

TH

SP

RIM

AR

Y O

PP

OR

TU

NIT

IES

7

10

3

8

12

9

6

11

B

D

Adequacy of equipment/supplies

Communication by supervisor

Care (concern) of supervisor

Safety of workplace

Quality of resident-related training

Appreciation of supervisor

Care (concern) of management

Attentiveness of management

Assistance with job stress

EMPLOYEE

Understanding the Critical Importance of

The Workforce


Relationship between consumer and workforce satisfaction

GLOBAL EMPLOYEE SATISFACTION

Bottom 10% Middle 80% Top 10%

CO

NS

UM

ER

SA

TIS

FA

CT

ION

7.9%

8.3%

9.0%

7.9%8.1%

8.7%

7.6%7.8%

8.5%

7.1%

7.4%

8.2%

7.7%7.9%

8.5%

6.0%

6.5%

7.0%

7.5%

8.0%

8.5%

9.0%

Globalsatisfaction

Quality oflife

Quality ofcare

Quality ofservice

Composite

50

60

70

80

Lowest Low High Highest

Source: Nursing home family and employee satisfaction surveys conducted in 2007 by My InnerView Inc.

Facilities with higher family satisfactionhave better work environments

< 54% 54% to 58% 58% to 64% > 64%

Mean = 68.0

EM

PL

OY

EE

EN

VIR

ON

ME

NT

SC

OR

E (

%)

FAMILY SATISFACTION

48

52

56

60

64



Facilities with higher family satisfactionhave better employee training

Mean = 57.1

EM

PL

OY

EE

TR

AIN

ING

SC

OR

E (

%)

FAMILY SATISFACTION

< 54% 54% to 58% 58% to 64% > 64%


Facilities with higher family satisfactionhave better supervision

60

70

80

90


Mean = 72.2

EM

PL

OY

EE

SU

PE

RV

ISIO

N S

CO

RE

(%

)

FAMILY SATISFACTION

< 54% 54% to 58% 58% to 64% > 64%


Facilities with higher family satisfactionhave better management

50

60

70

80


Mean = 66.5

EM

PL

OY

EE

MA

NA

GE

ME

NT

SC

OR

E (

%)

FAMILY SATISFACTION

< 54% 54% to 58% 58% to 64% > 64%


Facilities with higher family satisfactionhave better employee global satisfaction

40

50

60

70

80


Mean = 56.9

EM

PL

OY

EE

SA

TIS

FA

CT

ION

SC

OR

E (

%)

FAMILY SATISFACTION

< 54% 54% to 58% 58% to 64% > 64%

The Impact of Effective Leadership

DATABYTE

Customer and Employee Satisfaction Surveys

The Mechanics

» Instrument

» Distribution

» Communicate

» Communicate

» Communicate

Using Your Results

» Comparison over time

» Comparison to peers

» Lowest “Excellent”

» Highest “Poor”

» Correlations

» The Critical Value of Comments

» Tells you how far ahead or behind you are by survey item, “in the race” for excellence

» What does it tell me?– Your average score

– Your percentile rank

– 90th percentile rank

– Range of scores by quartile

Comparison to Peer GroupPercentile Ranking

Quality ofCNA/NA care

Choices/preferences

Responsivenessof management

Attention toresident grooming

Adequacy of staff20

1

C DSE

CO

ND

AR

Y O

PP

OR

TU

NIT

IES P

RIM

AR

Y O

PP

OR

TU

NIT

IES

16

14

12

9

2122

18

6

FAMILYRESIDENT

11

20

1

1619

12

9

2122

18

6

11

Post Survey

» Identify Priorities for Improvement

» Root Cause Analyses

» Take Action

» Evaluate Effectiveness

» Communicate…

Thank you!

Questions? 715-848-2713

2007 National Survey of Consumer and Workforce Satisfaction in Nursing Homes

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