Value Based PurchasingThe Volunteers’ role in the Patient Experience Mary TheobaldDirector, Patient & Guest Relations Volunteer Services

National AttentionOur Call To Action

Measuring the Perception of PatientsHow do we do that?

HCAHPSConsumer Assessment of Healthcare Providers and

Systems

•Produce comparable data for public reporting•Create incentives for hospitals to improve•Enhance public accountability and transparency

www.hospitalcompare.hhs.gov

Surveys done by mail or phone

Patient completes survey

Surveys returned to Vendor

Surveys scanned and data entered into database

Reports generated

Send data (patient files) to Vendor

Data uploaded

The Survey Process

HCAHPS Dimensions• Eight HCAHPS dimensions included in VBP:

• All HCAHPS dimensions weighted equally within the Patient Experience of Care (HCAHPS) domain

Communication with Nurses Communication with Doctors

Responsiveness of Hospital Staff Pain Management

Communication about Medicines Cleanliness & Quietness of Hospital Environment

Discharge Information Overall Rating of Hospital

The HCAHPS survey consists of 27 questions:

16 evaluative questions about patient care: 14 never/sometimes/usually/always. 2 yes/no.

2 global ratings: 0-10 scale. 4 point scale: Definitely No to Definitely Yes.

4 screening questions. 5 demographic questions (About You).

Current Survey Questions

Reporting Based on “Top Box”• What is “top box”?

H-CAHPS Scales

Always Usually Sometimes Never

Definitely Yes

Probably Yes Probably No Definitely No

Yes No

10 9 8 7 6 5 4 3 21

0

•Five new questions:▫Three care transitions questions.▫Two demographic questions.

•Voluntary use beginning with July 1, 2012 discharges.

•Mandatory use beginning with January 1, 2013 discharges.

New: HCAHPS Voluntary Questions

New: Care Transitions Questions

Voluntary use beginning with July 1, 2012 discharges.Mandatory use beginning with January 1, 2013 discharges.

New: Demographic Questions

Not publicly reportedEvaluated as part of the patient-mix adjustment

Performance and payment reductions: How is my hospital evaluated?• Achievement, Improvement and Consistency

(30%)▫ Achievement pts gained when performance period score is

above the Achievement Threshold▫ Improvement pts gained when hospital’s score improves from

the baseline period to the performance period▫ Consistency pts gained when the hospital’s lowest HCAHPS

score is above the Achievement Threshold

• Your organization’s score = reimbursement• Schedule for further reduction in DRG payments:FY 2013 1.00%

FY 2014 1.25%FY 2015 1.50%FY 2016 1.75%FY 2017 2.00%

VBP FY 2013 Performance standards

HCAHPS VBP Timelines

2009 2010 2011 2012 20131Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q

FY 2013Baseline Period

FY 2015BaselinePeriod

© 2012 Press Ganey Associates, Inc.

FY 2014Baseline Period

FY 2013Performance

Period

FY 2014Performance

Period

FY 2015Performance

Period

2013

2014

2015

Lack of Communication is #1 Complaint• Dr. was very busy with phone calls & could have

listened to me a little better• I waited for treatment in the waiting room for

hours. A lot of people came after me that were called 1st. There are exceptions but this is ridiculous!

• The lady who took my blood never introduced herself to me, she poked me-missed then poked a second time. It hurt and she never said she was sorry.

• The staff let us know that there was a 3 car accident & that they were having critical patients coming in so they would get to my son as soon as they could and apologized.

New Volunteer Program - ED

How can volunteers help to improve the Patient Experience?

DVS - Begin communication with key players

• Begin conversations with your VP of nursing and ancillary departments to let them know you have a valuable resource that can enhance the patient’s experience

• Find out what the current focus is for their departments

• Very important that you align yourself with what other departments are doing

• Ask to be a part of Patient Experience Committees

Educate Yourself•Ask for copies of the Patient

Satisfaction surveys•Familiarize yourself with the

questions•Ask for access and training to the

vendor’s database•Search for comments related to the

volunteers•Ask that a question pertaining to

the volunteers be put on the survey

Educate Your Volunteers

•Put together an In-serviceo Volunteers should be educated on the Patient

Satisfaction surveys, the HCAHPS component and what it means to your hospital.

o Go over each component of the survey with them.

o Make sure they know that the data collected from patients is the patient’s perception of how their hospital stay was.

•Invest in customer service and communication training

Communicate • We all want to empower our volunteers, but

make sure you have shared your ideas with your colleagues and get their “buy in” before your volunteers take the reign.▫ Example-If you want them to pay particular attention to

the environment and would like the volunteer to make the call to EVS, make sure the director of EVS is agreeable to it as well as the director of the unit.

Volunteers Must….• Smile• Make eye contact• Greet patient with appropriate name and title• Actively listen to patient, repeating things back so

they know you are paying attention• Demonstrate compassion• Demonstrate customer service standards set by the

hospital• Ask if there is anything they can do for the patient

when leaving the room or leaving for test or treatment

• The volunteer that wants to tell their “stories” to the patient and/or unable to demonstrate your hospital’s core values should not be part of your team

Volunteers are vital members of the caregiver team•Volunteers personalize and humanize a

patient’s hospitalization• Increase the numbers of volunteers on the

frontline▫Answering call lights and taking care of the

non-clinical requests▫Taking the needs of the family into

consideration▫Rounding on patients and writing something

personal on the patient white board that they would want their care team to know

•Roving comfort or caring carts•Concierge program•ASSIST Program

▫Arrange lodging▫Companionship▫Provide information about the area

What Message Are We SendingBehavior vs. Intent