CREATING AN EPIDEMIC OF EMPATHY affairs/Kansas Faculty...LTR Low: Info re delays 82.6% LTR High:...

CREATING AN EPIDEMIC OF EMPATHY

Chrissy Daniels, MSPartner, Strategic Consulting

© 2017 Press Ganey Associates, Inc.

CEO: I want it to feel better. We need to change the culture. Put together a plan

Me: Sure???

University of Utah Provider Rankings All Facility National benchmark

0%

10%

20%

30%

40%

50%

2009n=114

2010n=173

2011n=319

2012n=286

2013n=431

2014n=442

2015 n=481

2016 n=554

4%

1% 3%

9%

22%

13%

27%

17%

46%

25%

50%

26%24%

44%

41% OF PROVIDERSARE IN THE TOP 10%

27% OF PROVIDERS ARE IN THE

TOP 1%


Outline

§ History & present state of US patient experience measurement

§ Statistical drivers that influence patients§ Strategies to influence practice

§ Shared purpose§ Intrinsic motivation§ Purposeful practice


History and Current State of Patient Experience Measurement

6© 2015 Press Ganey Associates, Inc.

Evolution of US Patient Experience Measurement

§ Patient Advocacy emerges§ Joint Commission Requirement to Measure Patient Satisfaction§ Standardized Instrument (voluntary) by CMS§ NQF Defines Patient Experience Measure as PROMs§ Requirement for Participation § Value Based Payment

6


Idea to Implementation

Survey Development

•Literature Review•Request for Information

•Draft Survey•Field Test AHRQ Review

•CAHPS Consortium Review

•Posting to Website

NQF Review•Measure Endorsement

•MAP Recommendations

Pay for Reporting•Program Guidelines & Requirements

•Dry Run•National Implementation Pay for

Performance•Benchmarks Established

•Performance Period


Sample CAHPS Questions


Proposed 2018 Weighting

Clinical25%

Efficiency25%

HCAHPS25%

Safety25%

FY 20182%atrisk


Expansion of CAHPS Requirements

Medical Practices 2+ EPs

Emergency Departments Anticipated ED CAHPS ImplementationED CAHPS Survey Development

Hospital Outpatient Departments, Ambulatory Surgery Centers Anticipated OS CAHPS ImplementationOutpatient Surgery CAHPS

Survey Development

Pediatric Inpatient Hospitals Child HCAHPS Implementation (Voluntary)

2%

Inpatient Hospitals HCAHPS used within VBP

Inpatient Psychiatric Facilities

Inpatient Psychiatric CAHPS Survey Development Anticipated PY CAHPS Implementation

Dialysis Centers ICH CAHPS continue used within QIP

Hospice Providers Hospice CAHPS Implementation (pay for reporting tied to APU)

Accountable Care Organizations ACO CAHPS used within Pioneer & Shared Savings programs

Medical Practices 100+ EPs

25% of quality score

Home Health Agencies HHCAHPS Continues (tied to APU)

PQRS CAHPS used within VBPMPQRS CAHPS

Medical Practices 25+ EPs PQRS CAHPS within VBPMPQRS CAHPS

PQRS CAHPS

2017 2018 2019


Statistical Drivers that Influence Patient Loyalty


What Do Patients Really Value?

High: Confidence in Provider

1.9% Fail to Recommend

High: Worked Together28% Fail to Recommend

Low: Worked Together90% Fail to Recommend

Low: Confidence in Provider

74.6% Fail to Recommend

High: Concern

for Worries

0.6% Fail

Low: Concern

for Worries

5.6% Fail

High: Concern

for Worries

6.3% Fail

Low: Concern

for Worries22.3%

Fail

High: Listens

Carefully24.7%

Fail

Low: Listens

Carefully45.7%

Fail

High: Courtesy78.2%

Fail

Low: Courtesy92.8%

Fail

3% of patients 68.4% of patients

2.4% of patients 5.9% of patients0.8% of patients 3.4% of patients11.4% of patients

2.5% of patients

High: Worked Together1% Fail to Recommend

Low: Worked Together11% Fail to Recommend

8% of patients 72% of patients14% of patients 5% of patients

81% of patients19% of patients

All Patients15.7%

Recommendation Failure Rate

Low Risk

13

HCAHPS Rating 0-10 (% 9-10)

© 2014 Institute for Innovation

High: RN Listen

93.3% 9-10

Low: RN Listen

75.4% 9-10

High: RN Listen

78.1% 9-10

Low: RN Listen

59.5% 9-10

High: RN Listen

55.0% 9-10

Low: RN Listen

36.1% 9-10

High: RN Disch Pref38.0% 9-

10

Low: Disch Pref15.1% 9-

10

4.0% of patients 75.4% of patients




Low: RN Courtesy16.8% Top Box 9-10

High: Staff worked together

87.1% Top Box 9-10

High: RN Courtesy48.5% Top Box 9-10

Low: Staff worked together36.7% Top Box 9-10

High: Room Clean91.8% Top Box 9-10

Low: Room Clean74.8% Top Box 9-10

17.9% of patients

48.1% of patients

10.4% of patients

17.8% of patients

69.5% of patients

28.4% of patients

All Patients72.1%

Top Box 9-10 (Very Good)

14

Emergency Driver of Patient Loyalty

High: Info re delays97.0%

LTR

Low: Info re delays82.6%

LTR

High: Info care at home77.5%

LTR

Low: Info care at home56.0%

LTR

High: RN attn to needs58.1%

LTR

Low: RN attn to needs 33.3%

LTR

High: Info care at home38.4%

LTR

Low: Info care at home10.3%

LTR

8.5% of patients 37.3% of patients2.6% of patients 3.7% of patients6.5% of patients 6.2% of patients20.4% of patients 2.1% of patients

Low: Dr Courtesy12.9% Top Box LTR

High: Staff cared about you91.4% Top Box LTR

High: Dr Courtesy45.4% Top Box LTR

Low: Staff cared about you24.1% Top Box LTR

High: Dr kept you informed94.5% Top Box LTR

Low: Dr kept you informed68.6% Top Box LTR

6.6% of patients 51.2% of patients23.6% of patients 12.9% of patients

59.0% of patients37.4% of patients

All Patients65.0%

Top Box LTR (% Very Good)


What is Correlated with Likelihood to Recommend


Strategies that Influence Practice


3 Strategies to Influence Practice

§ Shared purpose through stories§ Activating intrinsic motivation§ Importance of purposeful practice –

embracing ritual


The creation of a shared purpose begins with stories, not data; the stories that crystallize how caregivers want to see themselves.

Thomas Lee, MD


Focus on Delight

CARING TEAMWORK EFFICIENCYLISTENING EXPLAINING


5 Elements of Patient Experience

CARING

LISTENING

EFFICIENCY

KNOW me

HEAR me

MAKE IT EASY for me

EXPLAINING

TEAMWORK

TEACH me

COORDINATE for me


Tell the Story: Comments of the Week

#1 Wow! Completely blown away by Dr. Greis and his staff! What a wonderful experience I was provided. Dr. Greis is so caring, intelligent and even has a sense of humor (which is rare for a surgeon), lol! I had a complete ACL tear and meniscus tear. He replaced my ACL with a donors so I wouldn’t have to take as long to heal! Which is extremely important to me but even more so as i am a wife and mother of 4, one of my children is a newborn. I noticed your office does a lot of famous sports peoples surgery and I have a feeling Dr. Greis is a major surgeon for these people. He's so awesome and was so good to me I feel he treated me just as good as those famous people. Thank you Dr. Greis for being refreshingly caring and friendly--a rarity in the medical field these days! I would recommend him to ANYONE!!! –Orthopaedic Center, Patrick Greis, MD


I can’t wait to hear what the patient experience people can teach me.

said no clinician, ever.

How You Want Patients to

Describe You

ACCOMODATING ATTENTIVE APPROACHABLE CALM CARINGCOLLABORATIVE COMFORTING COMMITTED COMPASSIONATE COMPETENTCONNECTED CONSCIENTIOUS DELIBERATE ENGAGED EXPERT FRIENDLYHOPEFUL INTELLIGENT INSTRUCTIVE KNOWLEDGEABLE PASSIONATEPERCEPTIVE PERSONAL PRESENT PROBLEM SOLVER PROFESSIONALPROACTIVE RELIABLE REFLECTIVE RESPONSIVE REPSONSIBLE SAFESTABLE THOUGHTFUL THOROUGH TRUSTWORTHY WARM WELCOMING

ACCOMODATING ATTENTIVE APPROACHABLE CALM CARINGCOLLABORATIVE COMFORTING COMMITTED COMPASSIONATE COMPETENTCONNECTED CONSCIENTIOUS DELIBERATE ENGAGED EXPERT FRIENDLYHOPEFUL INTELLIGENT INSTRUCTIVE KNOWLEDGEABLE PASSIONATEPERCEPTIVE PERSONAL PRESENT PROBLEM SOLVER PROFESSIONALPROACTIVE RELIABLE REFLECTIVE RESPONSIVE REPSONSIBLE SAFESTABLE THOUGHTFUL THOROUGH TRUSTWORTHY WARM WELCOMING

3WORDS


When I figured out my vision and how to share it with my team and my patients everything got so much easier.

Stephanie Klein, MD


Move from Idea to Excellence

Lessons from Grit by Angela Duckworth

25

Deliberate PracticePurposePassion


Embracing Ritual through Deliberate Practice

Transforming Patient Experience Through Power of Ritual – D. Glenn, MD Hawaii Pacific Health https://catalyst.nejm.org/patient-experience-power-ritual-physician-checklist/

A ritual is in fact a primitive checklist . . . a series of steps that, when repeated consistently, foster feelings of safety and trust between client and caregiver.• sitting down• making eye contact• being cognizant of nonverbal cues • reflective listening, • proper computer etiquette• use of a patient agenda

Caregivers asked to identify those they already do + 2 more


Further Reading

§ Epidemic of Empathy, Thomas Lee, MD§ Antidote to Suffering, Christina Dempsey, RN§ Team of Teams, General Stanley Chrystal§ What Patients Say, What Doctors Hear, Allison Ofri, MD§ Teaming, How Organizations Learn, Innovate and Compete, Amy

Edmundson


Conclusions

§ Patient experience measurement is a foundational component of value based care

§ Patients value skill, teamwork and empathy. § Activating and directing intrinsic motivation is

key.

Chrissy Daniels, MS Partner, Strategic [email protected]

CREATING AN EPIDEMIC OF EMPATHY affairs/Kansas Faculty...LTR Low: Info re delays 82.6% LTR High:...

Documents

Transcript of CREATING AN EPIDEMIC OF EMPATHY affairs/Kansas Faculty...LTR Low: Info re delays 82.6% LTR High:...