CME Disclosure

• Accreditation Statement

– Studer Group is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

• Designation of Credit

– Studer Group designates this educational event for a maximum of 12 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the educational event.

• Disclosure Policy

– Martin Padgett and Kathy Neuner have disclosed that they do not have any relevant financial relationships with any commercial interests related to the content of this educational event.

The Best HCAHPS Defense:

A Good Offense

Martin Padgett, CPA, MBA, FACHE

President & CEO, Clark Memorial Hospital (Jeffersonville, IN)

Kathy Neuner, RN,MSN

VP, Inpatient Services, Clark Memorial Hospital (Jeffersonville, IN)

Presentation Objectives

• Understand how a strong culture focused on measured patient satisfaction and quality will automatically result in high HCAHPS outcomes.

• Increase patient satisfaction / quality / HCAHPS scores through tools such as, hourly rounding or AIDET measures that hold team members accountable.

• Utilize patient satisfaction scores to increase volume and achieve financial success in a highly competitive market.

Clark Memorial Hospital

• 241 bed acute care community hospital

• 1600 team members

• 355 registered nurses

• Non-union hospital

• Highly competitive market with several healthcare systems

What Do We Do With This?

HCAHPS

• The HCAHPS bundle has been left on your doorstep…

So what do you do with it?

HCAHPS Fact Sheet

Health Care tomorrow will not remain exactly

like it is today. Transparency is

reaching new levels.

Hospital Implications:Hospitals that fail to

submit data will forfeit 2% of annual payment

update.

Public Implications: Many believe that publicly reported

information on hospital quality and patient

satisfaction will change how patients select their health care providers.

Hospitals can either integrate the HCAHPS survey with their own patient satisfaction

survey or use HCAHPS by itself.

HCAHPS is not something that just happens to us – we

control our interactions with patients.

CMH used

integrated

survey

The Best Defense is a Good Offense

Today’s competitive market demands hospitals aggressively manage HCAHPS results to be “best in market performers”

In other words…

A Good Offense

Clark Memorial Hospital Game Plan

Create a culture focused on

patient satisfaction to manage

HCAHPS results, increase

volume, and maximize

financial success.

Creating a Culture of Service Excellence

• A proactive or offensive move.

• At each level of the organization.

• Service and quality areembedded in the culture and everyday work flow.

SeniorTeam

Directors/Managers

Team members

ClarkFest: An all-team event

Creating a Culture of Service Excellence

• WAY Days

– We Appreciate You

• Positive reinforcement of quality and service.

• Employee satisfaction leads to patient satisfaction

Creating a Culture of Service Excellence

• High Five Awards

– Presented each quarter for high performing units in patient satisfaction

Creating a Culture of Service Excellence

• Ambassadors

– Presented each quarter for team members who live the mission and values of Clark Memorial Hospital.

• Quarterly Team Member Forums

– Communicate Pillar performance

• Leader Rounding

– Identify opportunities for improvement

– Work different shifts

Creating a Culture of Service Excellence

• Leader Development

– Skill building opportunities

Measuring What’s Important

• Press Ganey Associates, Inc.

– Since 2001

– Early adopter

– Integrates the HCAHPS tool with Press Ganey’s questions

– Created first as a quality indicator

– Helps ensures key drivers or leading indicators are not missed

• There is a correlation between the Press Ganey survey questions and Likely to Recommend on the HCAHPS survey.

Measuring What’s Important

Measuring What’s Important

Measuring What’s Important

Tracking Your Results

• HCAHPS results can be accessed through whynotthebest.org

• Capability to review as many hospitals as you like

• Compare your scores to the top 10% and 25% nationally

• Create your own facility profile

CMH Results

CMH Results

66%80%

91%

72% 71% 75%

0%10%20%30%40%50%60%70%80%90%

100%

2006 2007 2008

Perc

en

tile

Ran

k

National Patient Loyalty RankingConsistent Practice = Consistent Results

ATTENTION TO SPECIAL / PERSONAL NEEDS

HCAHPS: Likelihood to Recommend

CMH Results – Hospital Overall

CMH Results

CMH Results

• Net Income on Operations Outcomes

Sustaining the Results

• Aligning actions to move from a culture of “sometimes” to a culture of “always”

– Hardwiring processes to always deliver quality care to every patient, every time.

“Always Coca Cola”

Coca Cola – 1993- 2000

Improvement Tactics

• Using Leader Evaluation Manager (LEM) to drive results and accountability.

– Goals are directly aligned with organization’s goals

– Helps leaders to prioritize goals

– Allows for mid-course corrections if necessary

Improvement Tactics

• LEM

• Patient Satisfaction Posters

– Encourage patients to help us improve

– Educate team that it is O.K. to get feedback

– Stress honest patient assessment

– Reminder to the team

Improvement Tactics

CMH Results

Improvement Tactics

• HandwashingCampaign

– Created as a contest

– January 09

– Improved safety, quality and patient satisfaction.

Improvement Tactics

• Key Words at Key Times

– Crystallizes patient satisfaction tools and standards.

Improvement Tactics

• Thank You notes

– Used hospital-wide

– Aligned with the rate/recommend questions.

Improvement Tactics

• Discharge Phone Calls

– Quality Initiative

• Improve post hospital compliance and outcomes

• Promotes open communication between patient and caregiver

• Prevent re-admissions

Improvement Tactics

• Hourly Rounding

– Improves patient care

– Promotes patient safety

– HCAHPS and patient satisfaction

– Reduces stress for the nursing staff

– Reduces patient anxiety

– Provides accountability

Sustaining the Results

Hourly rounding on the Orthopedics Unit showed:

– Most improved unit HCAHPS scores 2007-2008

Sustaining the Results

• AIDET

– Identifying basic service behaviors that reflect impressive customer service

– Reduces patient anxiety and manages expectations.

Acknowledge Introduce Duration

Explanation Thank

Improve Outcomes with Evidence Based Tools

• Communication from nurses to patients and families

– Start with hiring- peer interviewing

– Adopt AIDET

– Teach skills of attentive listening

– Teach phrases to avoid

– Teach behaviors to avoid

– Do walking introductions between shifts

Improve Outcomes with Evidence Based Tools

• Communication from doctors to patients and families

– Work with medical staff leaders and gain support on building a patient centered culture

– When delivering patient satisfaction scores to physicians offer solutions on methods to improve perceptions

– Teach nurses the skill of managing up the physician

– Give patients paper and pen for writing down questions

Improve Outcomes with Evidence Based Tools

• Call light response

– Set a standard on the patient care units for response time

– Teach everyone on the patient care unit that answering a call light is everyone’s responsibility

– Upon admission; teach the patient and family how to use the call light

– Institute hourly rounding on inpatient units.

Is “Good” Enough

Thank You!

Martin Padgett, CPA, MBA, FACHE

President and CEO, Clark Memorial Hospital (Jeffersonville, IN)

Kathy Neuner, RN,MSN

VP, Inpatient Services, Clark Memorial Hospital (Jeffersonville, IN)