Creating and Sustaining a Patient-Centered Organization

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1 iround for Patient Experience Creating and Sustaining a Patient-Centered Organization Shawn R. Smith Vice President Patient Experience Christiana Care Health System Caroline Leone The Advisory Board Company

2 2 Managing Your Audio Use Telephone Use Microphone and Speakers If you select the use telephone option, please dial the phone number and access code provided. If you select the Use Mic & Speakers option, please be sure that your speakers/ headphones are connected The Advisory Board Company advisory.com

3 3 Managing Your Screen Asking a Question Minimizing and Maximizing Your Screen To ask a question, type it into the question panel Click to minimize and maximize the tool panel Click to maximize the presentation area and press send 2016 The Advisory Board Company advisory.com

4 4 Better Than the Cable Company But Only Just Measuring the Quality of Customer Relationships Net Promoter Scores (NPS) of US Companies -14 Primary care physicians AVERAGE FIRM: NPS OF 5-10 COMPANIES MOST LIKELY TO GROW: NPS OF 50+ Both Hospitals and PCPs Struggle with Detractors 1 Hospital customers PCP customers who 29% 33% who are detractors are detractors 1Customers who are unhappy and could damage your brand and impede growth through negative word of mouth 2016 The Advisory Board Company advisory.com Sources: Bain & Company, Measuring your Net Promoter Score; Satmetrix Systems Inc., The Net Promoter Score and System; Marketing and Planning Leadership Council PCP Consumer Loyalty Survey.

5 5 Fundamental Changes Fuel Focus on Experience More Competition for a Smaller Pie Health Affairs Declining utilization rates signals a change in the inpatient business model Fierce Healthcare Walmart primary care creates stiff competition for providers An Outsized Revenue Impact $22M Average value of a 10% improvement in patient share of wallet More Engaged Patients Health Exchange Enrollees 2014: 3 M $424K Estimated difference in reimbursement for high and low HCAHPS performers Avoidance of VBP Penalties 10% Increase in Loyalty 2018: 40 M 2016 The Advisory Board Company advisory.com Source: Advisory Board Medicare Total Share Performance Assessment; Health Care Advisory Board interviews and analysis.

6 6 iround: A Cross-functional Patient Experience Platform Real-time Data Collection Automated Service Recovery and Staff Recognition Real-time Root Cause and Trend Analysis Inpatient and Ambulatory Coverage Intuitive User Interface 2016 The Advisory Board Company advisory.com

7 7 Included Services Drive Long-term Change Facilitate Adoption and Integration Steward Strategy and Execution Partnership for Sustainable Results Business Analyst Patient experience competency assessment Dedicated Advisor Case studies and bestpractice research Regular status check-ins with Dedicated Advisor Webinars and annual conference The Advisory Board: Seasoned Expertise in Patient Experience 15+ Years researching patient service and experience 70+ Published best practices on patient experience 10 K Nurse leaders attending patient experience training $103 K Average expected VBP gains from better rounding 2016 The Advisory Board Company advisory.com

8 P A T I E N T E X P E R I E N C E Creating & Sustaining a Patient-Centered Organization Shawn R. Smith, MBA Vice President Patient Experience

9 P A T I E N T E X P E R I E N C E Christiana Care Health System 2,370 providers participate in clinically-integrated network Primary Care Office Visits: 227,295 Home Health Care Visits: 308,096 Admissions: 53,072 21st in the nation Surgeries: 38,712 29th in the nation ED Visit: 187,317 21st in the nation Births: 6,469 32nd in the nation

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12 Disappointment = Expectation Reality P A T I E N T E X P E R I E N C E

13 Loyalty The Customer Delight Principle Zone of Pain Zone of Mere Satisfaction Zone of Delight Always Never Sometimes Usually Worse Than Expected Expected Better Than Expected Dissatisfied Merely Satisfied Delighted Level of Satisfaction Source: The Customer Delight Principle: Exceeding Customers Expectations for Bottom-Line Success. Keiningham and Vabra. P A T I E N T E X P E R I E N C E

14 P A T I E N T E X P E R I E N C E Core Competencies for Creating an Exceptional Experience - System Leadership Rounding - Forums - Patient Experience Academy - Christiana Care Way Rounds - Coaching - Patient Advisory Councils - Survey Feedback - Sentiment Analysis - Real-Time Data - PFCC - Portal Experience - Flow - Ease of Directions - Registration Processes - Pre/Post Visit Communication - Reward & Recognition - Huddles - Focus on Excellence

15 P A T I E N T E X P E R I E N C E AUBA The Secret Component to Sustain an Exceptional Experience To change actions, you must first change beliefs.

16 AUBA Learning Matrix P A T I E N T E X P E R I E N C E

17 P A T I E N T E X P E R I E N C E Pre-AUBA HCAHPS Results Rate Hospital 1 10 COMM about Medicines

18 AUBA Learning Matrix P A T I E N T E X P E R I E N C E

19 P A T I E N T E X P E R I E N C E Patient- and Family-Centered Care MUTUALLY BENEFICIAL PARTNERSHIPS Patient- and family-centered care is working with patients and families rather than just doing to or for them.

20 Patient and Family Advisors Add Value 140+ Advisers and 50+ e-advisers Elected Patient Adviser Chairs/Co-Chairs Quarterly System Meetings Embedding within Each Service Line Seamless Onboarding and Electronic Application Process Sub-Councils HFGCC, Women s and Children s NICU, Rehabilitation, Surgery Multiple Local, National Presentations, and Awards

21 Driving Change by Hardwiring Behaviors P A T I E N T E X P E R I N C E

22 Real-time Improvements

23 Simulation Training Communicate with Courtesy, Clarity and Care Christiana Care Way Behavior

24 Training Process P A T I E N T E X P E R I N C E

25 Real-time Behavior Observations

26 Observation Checklist

27 P A T I E N T E X P E R I E N C E Baby Friendly Audit Rounds iround Expansion Volunteer Ambassador Rounds Patient Experience Behaviors Audit Observation Status Rounds Maternity Staff Competency Rounds Discharge Phone Calls Transitional Unit & Home Health (VNA) Palliative Care Chaplain Rounds

28 P A T I E N T E X P E R I E N C E iround Enterprise Expansion Inpatient Tracer Safe Practice Behavior Monitoring & Interviewing Hand Hygiene Audits Medical Office Practices & Outpatient Services Environment of Care

29 P A T I E N T E X P E R I E N C E Patient Experience Academy Strategic partnership with University of Delaware HART/HRIM Accredited program 5 modules/10 weeks/ 15 hours 82 graduates in pilot course 100 currently enrolled +74% in post-assessment grade Engineered for sustainability

30 Patient Experience Academy P A T I E N T E X P E R I E N C E

31 Service Line Engagement P A T I E N T E X P E R I E N C E

32 P A T I E N T E X P E R I E N C E HCAHPS Trends Rate Hospital 1 10 COMM about Medicines COMM with Nurses Quietness of Hospital Environment

33 P A T I E N T E X P E R I E N C E The Virtuous Cycle of Data Aggregation & Utilization As Applied to Creating an Exceptional Experience

34 V CHRISTIANA CARE HEALTH SYSTEM VALUE INSTITUTE iround HCAHPS Data Analysis The project was designed to answer two questions: Does exposure to iround impact HCAHPS scores? Does exposure to iround impact the likelihood that a patient will return their HCAHPS scores?

35 Summary of Available Data C7E, C6A and C3D participated in a pilot collecting FIN numbers for each iround patient from 12/4/2014 to 12/23/2014 1,071 total rounds were attempted on 442 unique patients 279 patients (63%) received at least one round with iround 163 patients (36%) did not receive a round with iround 47 patients (11%) in our pilot returned HCAHPS surveys 41 patients (87%) received one round with iround V CHRISTIANA CARE HEALTH SYSTEM VALUE INSTITUTE 6 patients (13%) did not receive a round with iround

36 Does exposure to iround impact HCAHPS scores? Exposure to iround (at least one completed / roundable = yes during a visit) significantly improves how our patients score the questions Rate Hospital 0-10 (p=0.028) Recommend hospital (p=0.008) Nurses listen (p=0.027) iround does not appear to significantly impact how patients score V CHRISTIANA CARE HEALTH SYSTEM VALUE INSTITUTE Nurses treat w/courtesy (p=0.263)

37 How does exposure to iround impact the likelihood to return a survey? We observed a highly significant (p<0.001) difference in response rates between patients who experienced at least one round with iround and those who did not 14.69% response rate from patients who received at least one round with iround 3.68% response rate from patients who did not receive a round with iround during their stay Patients exposed to at least one round with iround during their visit were FOUR TIMES more likely to return an HCAHPS survey than patients who did not receive a round with iround. V CHRISTIANA CARE HEALTH SYSTEM VALUE INSTITUTE

38 P A T I E N T E X P E R I E N C E

39 Now It s Your Turn 39 How to Submit Questions Enter a Question in the Question Panel Type your question and hit send The presenter may answer the question here or respond verbally 2016 The Advisory Board Company advisory.com