Melissa Taylor Director, Patient Access/Pre-Access Cleveland Clinic
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Transcript of Melissa Taylor Director, Patient Access/Pre-Access Cleveland Clinic
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Melissa TaylorDirector, Patient Access/Pre-Access Cleveland Clinic
Creating a Positive Patient Experience Driven Culture
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Cleveland Clinic – About us
• Located in Cleveland, Ohio• Nonprofit multispecialty academic medical center,
integrating clinical and hospital care with research and education
• Main Campus• 8 Community Hospitals• 18 Family Health Centers• Lou Ruvo Center for Brain Health • Cleveland Clinic Florida• Cleveland Clinic Canada• Cleveland Clinic Abu Dhabi (2013)
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Cleveland Clinic - Statistics
• 1,300 beds on main campus • More than 4,400 beds system-wide• 4.2 million outpatient total visits • 167,100 admissions • 191,500 surgical cases • 2,700 physicians and scientists
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• CMS – Value Based Purchasing• Pay for Performance – reimbursement contingencies• Quality• Efficiency• Patient Satisfaction
• Transparency• Published clinical measures• HCAHPS• Pricing
• Informed Consumers
Patient choice!
State of Healthcare Reimbursement
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Three goals1. Meaningful comparison for consumers2. Public reporting is incentive for hospitals to improve 3. Enhance accountability by increasing transparency of
quality
HCAHPS - Goals
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
Source: www.hcahpsonline.org
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HCAHPS – The Survey
• 18 questions about patient care, four screening questions and five demographic questions
• Eight critical aspects of care, referred to as the HCAHPS Domains• Communication with doctors • Communication with nurses • Communication about medicine • Responsiveness of hospital staff • Cleanliness and quietness of hospital environment • Pain management • Discharge information • Overall hospital rating and recommendation
Source: www.hcahpsonline.org
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ALL OF IT!
“One bad interaction can define the impression. This is well documented in retail and other service business.”
- James Merlino, MDChief Experience Office, Cleveland Clinic
What is Patient Experience?
Quote Source: HealthLeaders Media, February 24, 2012
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Office of Patient Experience
• Video Placeholder
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Where is Patient Access in HCAHPs?
• Overall rating• Would you recommend
• Vendor Supplemental Questions1. Speed of Admission Process2. Courtesy of the person who admitted you
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Organizational Efforts
• Cleveland Clinic Experience
Exceptional Employee Experience + World Class Patient Experience = Cleveland Clinic Experience
• Caregivers• Caregiver Awards• Pre-hire survey – cultural fit• START with HEART ®
• Patient Advisory Councils• Employee Engagement Survey
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Patient Access Focus
• Empower employees to be a part of the solution• Minimize calls post-service due to registration issues • Pre-Registration• Patient wait times• Registration times• Affect and behaviors• Non-patient interfacing registrants in registration
area
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Pre-Registration
• Waiting room as first impression• Impact on department through-put• Set standard as 95% pre-service registration for scheduled
services• Opportunity – Busiest surgery center in enterprise
• Delaying patients to OR• Registered patients at point of decision for surgery• Provided business cards with Express Regi phone #• Leveraged online registration• Supported call center with onsite registration
downtime capacity• Used autodialer to contact patients
• 35% pre-registration rate to 97% - Sustained!
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Customer Service Call Reduction
We’re #1!
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Comprehensive Scorecard
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Scorecard Elements
Quality
Future: Copay Contribution, Customer Service, Productivity
Ad HocDenials Insurance Coaching Score=
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Patient Tracking Software - Benefits
• Elimination of paper sign-in sheets• Identification of bottleneck via dashboard and
reporting• Real-time staff monitoring with opportunity to adjust• Real-time patient flow technology• Constant spotlight on patient experience in Patient
Access
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Robust Reporting
• Patient wait times• Summary• Detail to patient level
• Patient flow
• Productivity
• On demand and scheduled reporting
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Registration Through-put Monitoring
• Patient Check-In• Patient to be greeted by person, not clipboard• Patient checked into software tracking tool by greeter• Clock begins to measure patient wait times• Simple and easy to use
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Real-time Dashboard
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Dashboard Features
• Ability to prioritize patients• Area and priority color-coding for easy detection• Patient Wait Times on dashboard turn colors as
service urgency thresholds met• Manager access to all service locations• Alerts
• Via text or email• Patient wait extends threshold• Patient volume increase to adjust staffing• Registrant in particular status for extended period
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Drill-down Reporting
Patient Names Appear Here for Encounter Specific Detail
Reg Wt Time
Reg Time
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Creative Utilization of Tool - ED
• ED Tracking Board
• Extension of patient tracking beyond registration• Radiology – Baseline 65th percentile• Current 90th percentile
• Call center return call monitoring
SUCCESS!!
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Additional Software Features
• Monitor patient flow and wait times• Registration• Ancillary Check Points
• Anticipate patient arrival in ancillary areas
• Identify scheduled or walk-in patients using "Visit Type" drop down menu
• Prioritize by appointment time
• Require delay code
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Additional Software Features (Cont’d.)
• Customize patient surveys• Detailed view
• Report by visit type with average processing time
• Utilize high-level dashboard to see all locations at enterprise level - hospitals, desks, and current wait times
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Empowerment and Accountability
• Scripting• Customer Service Standards Policy• Engagement in annual goals and monthly review of
performance against metrics – as a team and individual
• Accountability Statement
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Patient Survey trays
• Real-time patient feedback• Focused on experience with registration
and the registrant• Paging to manager if patient ranks low
on “compassion and sincerity” for real-time service recovery
• Download nightly• Reporting - online
• Individual• Department• Facility• By question
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Results
• Customer Service Tray Scores (registration specific) – above 95% Satisfaction
• Cleveland Clinic HCAHPs – Top Box (Current – not yet published)
• Rate Hospital 82%• Recommend Hospital 86%
• Specific Domains
• As high as 15% improvement in one year – 2010 to 2011
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QUESTIONS?