Communication
HCAHPS scores Closely Tied to Readmission Rates
With Medicare payment penalties for excess readmissions now in effect, reducing readmissions has become a top priority for hospitals and other stakeholders. The Centers for Medicare and Medicaid Services (CMS) publicly reports risk-adjusted readmission rates for heart attack, heart failure and pneumonia. The data shows significant variation in performance across hospitals, indicating that some hospitals are more successful than others at addressing the causes of readmissions. A recent study by Press Ganey suggests that performance on readmission metrics is associated with performance on patient experience of care measures.
Press Ganey analyzed hospitals’ readmission penalty data in the context of their scores for CMS’ Hospital Inpatient Value-based Purchasing program (VBP) to determine if there was a relationship in performance on the two pay-for-performance programs. The VBP program establishes scores for both the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results and process of care measures. The study found a demonstrated negative association between hospitals’ HCAHPS VBP scores and readmission penalties; as hospital performance on HCAHPS increased, readmission penalties decreased. Very low HCAHPS performance (scores of 0–19 was associated with much-higher-than-average readmission penalties, and very high HCAHPS performance (80–100) was associated with much-lower-than-average readmission penalties.
These findings support previous research on the link between patient experience and clinical quality found that higher overall patient satisfaction and satisfaction with discharge planning were associated with lower 30-day risk-standardized readmission rates. This current study seems to suggest, HCAHPS scores, not clinical measures, were more closely linked to readmission rates.
To effectively combat patient readmissions, hospitals can benefit from a foundational strategy that starts first and foremost with the patient – and efforts that are aimed at improving HCAHPS scores are an excellent initial step. The majority of the HCAHPS survey questions address communications between caregivers and patients. Effective communications is fundamental to ensuring that patients become engaged in their care and, consequently, better equipped to follow discharge instructions and self-monitor after leaving the acute care setting.
Read Full Post | Make a Comment ( None so far )Interactive Patient Care: The Latest in Patient Engagement
An increasing number of hospital executives and healthcare organizations are discovering that patient and family engagement is the key to the transformation of the healthcare delivery system. The Healthcare Advisory Board stated that patient engagement is one of the three pillars for healthcare transformation in its recent “Playbook for Accountable Care.” In 2008 NQF declared patient and family engagement as “one of the five National Health Priorities that will guide and shape healthcare transformation.” As a result, regulations and standards have been developed to include patient engagement as a core element.
There is a growing amount of data demonstrating that when patients become active participants in their care, they are more inclined and motivated to assume responsibility for managing their own health. Thus, the results are better outcomes for the patient, and lower costs and better performance for the hospital.
Over the past ten years, the healthcare industry has invested countless time and resources finding ways to deliver more patient-centered care. Many different strategies have been tried and tested. Some strategies have proven successful, while others have not. Many of those efforts were focused on strategies around the patient. Many believe that In order to realize the benefit of patient engagement, healthcare facilities will have to change the way they deliver care: moving from a model where care is delivered to and around the patient to one in which the care is delivered with the patient.
There is an emerging care delivery model known as Interactive Patient Care (IPC). IPC is based on the premise that a more engaged patient is a satisfied patient with better outcomes. There is now ample evidence-based outcomes data associated with this innovative care delivery model that demonstrates patient engagement through IPC is a proven strategy for performance improvement.
For more information, or to take your healthcare organization to the next level of patient engagement, contact us,
Read Full Post | Make a Comment ( None so far )Guide for Nurses During Admission and Discharge
There are many things to consider when admitting or discharging a patient in a health care facility. Introcomm can assist healthcare facilities with numerous admissions and discharge objects, especially focusing on clear and concise communication between the healthcare staff and the patient/family.
The following checklist, inspired by a nursing school lesson plan from the Texas Education Agency, contains suggestions and recommendations for guiding a patient through a smooth admissions and discharge process. Please contact us to learn more about utilizing our customized communications toolkit.
Greeting the Patient
Specific admission procedures will depend on the policy of the healthcare facility, however many of these recommendations are relevant for most hospitals and facilities. In some healthcare facilities, the patient is taken directly to the room, where the actual admission process begins. Most facilities, however, start the admission process in the admitting office. A preliminary interview of the patient is done to obtain the necessary medical and financial information. It is important for the family to remain with the patient for this interview.
The First Impression
1. Greet each patient in a friendly, cheerful manner.
2. Introduce yourself, and take the patient to their room.
3. If the patient has a friend or relative with him/her, invite them to accompany you to the room.
4. Introduce the patient to other healthcare providers in the room.
Communication Throughout the Admission Procedure
Statistics show that HCAHPS scores are improved when healthcare providers help the patient become familiar with the new surroundings. Even simple explanations can help the patient feel more connected and cared for by the hospital staff.
1. Explain the facility’s policy on visitors, and the use of the television and telephone.
2. Demonstrate how to use the signal cord system, remote-control television and automatic bed controls.
3. Tell the patient when meals are served.
4. Answer any questions he/she has about scheduled procedures and daily rounding.
5. Comfort the patient by showing him/her where personal items are stored
6. Make a list of the clothing and personal items the patient has, have the patient or a member of the family sign the list, give a copy to the patient and to the nursing supervisor to include in the patient’s chart.
Communicating With Family During Admission
1. Create an atmosphere of warmth and understanding for the patient and the patient’s family.
2. Always be courteous and helpful to the patient and the patient’s family.
3. Kindly communicate with family members during times when they may be required to leave the room.
4. Promptly alert the family when they may return to the patient’s room.
5. If the patient is unable to answer the admission questions, have a family member help you with the information needed
Planning for the Patient’s Discharge
There are many things to consider when planning for the patient’s discharge. If the illness has not been long, complicated, or severe, there may not be special preparations other than general health instructions and information concerning the actual discharge (such as the time and date the patient will be discharged). For other patients, the discharge process is more complicated. The patient’s attitude towards discharge and continued progress toward recovery must be considered. If being discharged to home, the patient may need reassurance that recovery will continue at home.
The nurse should make sure the patient has been given instructions by the doctor for home care and understands the instructions for:
1. Taking medications
2. Exercise programs
3. Physical therapy
4. Changing dressings
5. Giving injections
6. Respiratory treatments that will be continued at home.
* If possible, the nurse should give the patient a written copy of the instructions, such as a copy of the diet or an appointment card for a return visit to the doctor
Patient care does not end when the patient is discharged. The patient may receive visits from a home health agency to supervise the care and treatment. The patient’s home care should make use of existing community resources so the patient and the family will not have to undertake the financial and emotional burden. The patient may be concerned about being able to manage for himself/herself. These worries may keep the patient from looking forward to leaving the healthcare facility. The patient may wonder what kinds of treatment, if any, will be needed at home and how it will be done. Provisions for special nursing care, such as provided by visiting nurses, may be needed for the patient who is unable to manage his/her own hygiene and personal care. An important consideration may be whether help will be required for meals, grocery shopping, etc., for a patient living alone and how long such help will be needed.
Visit us at www.introcomm.com to learn more and to request your FREE educational webinar.
Read Full Post | Make a Comment ( None so far )Improve Patient Experience to Reduce Readmissions
Christy Whipple
According to a research study released by Press Ganey Associates, Inc., hospitals that perform better on patient experience measures also have lower patient readmission rates.
Reducing Readmissions: A Top Priority
With Medicare payment penalties for readmissions now in effect, reducing readmissions has become a top priority for hospitals and other stakeholders. The Centers for Medicare and Medicaid Services (CMS) publicly reports risk-adjusted readmission rates for heart attack, heart failure and pneumonia. A new study by Press Ganey suggests that performance on readmission metrics is associated with performance on patient experience.
HCAHPS Performance Related to Readmission Rates
Sources suggest that many hospitals struggle to identify and address the factors that influence readmissions. However, the Press Ganey study has revealed a strong connection between lower rates of excess readmissions for certain conditions and higher performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) value-based purchasing metrics.
Start with a Focus on the Patient
Nell Buhlman, Press Ganey’s VP of Product Strategy states, “”Readmissions and HCAHPS are multifaceted… To effectively combat patient readmissions, hospitals can benefit from a foundational strategy that starts first and foremost with the patient – and efforts that are aimed at improving HCAHPS scores are an excellent initial step.”
When HCAHPS Increase, Readmissions Decrease
The Press Ganey study found that as hospital performance on HCAHPS increases, readmission penalties decrease: Very low HCAHPS performance (scores of 0-20) was associated with much-higher-than-average readmission penalties, and very high HCAHPS performance (80-100) was associated with much-lower-than-average readmission penalties.
Engage Patients in Their Care
According to a related article written by David Harlow JD MPH, effective communications “is fundamental to ensuring that patients become engaged in their care and, consequently, better equipped to follow discharge instructions and self-monitor after leaving the acute care setting.”
Communication Reduces Readmissions
Harlow also suggests that hospitals adopt a sustainable discharge strategy that identifies and addresses “patient-specific factors that could lead to readmission, strategic patient education, developing a patient-focused after-care plan and ensuring a smooth transition to a post-acute setting.” In summary, he states that “a patient-centered discharge planning process, built on clear communications with the patient, is likely to reduce readmissions.”
Are you ready to improve your patient perception
experience and reduce your readmission rates with improved communication? Introcomm provides custom communications solutions beginning with the admissions and discharge processes. Find out how we can help you improve communication by improving systems you already have in place (meaning little to no additional out of pocket expense).
Effective Communication is an Integral Part of Healing Process
Successful medical encounters require effective communication between the patient and the physician. “Success” implies that the patient and physician have developed a partnership and the patient has been fully educated in the nature of his or her condition and the different methods to address the problem. This allows the patient to be actively involved in the decision-making process and establishes agreed upon expectations and goals.
Ineffective Communication Can Cause Adverse Drug Effects
According to a study done by Dr. Neda Ratanawongsa, an assistant professor in the department of medicine at University of California, San Francisco finds that ineffective communication is a major reason patients don’t properly take medication as prescribed. Communication matters. Thirty percent of people in the study were not necessarily taking their medications the way their doctors thought they were,” said Ratanawongsa in a university news release.
Patients Who Trust Their Doctors Take Better Care of Themselves
“Rates for non-adherence were 4 to 6 percent lower for patients who felt their doctors listened to them, involved them in decisions and gained their trust. By supporting doctors in developing meaningful relationships with their patients, we could help patients take better care of themselves,” she added. The study authors reached their conclusions after giving questionnaires to more than 9,000 patients who took drugs to lower their blood sugar, blood pressure or cholesterol. They completed items on how they communicated with their doctors, and the researchers checked their prescription records to see if they were properly taking their medications.
Andrew Karter, a senior research scientist with the Kaiser Permanente research division who assisted with the study, pointed out what was unique about the findings. “We found that medication adherence is better if the physician has established a trusting relationship with the patient and prioritizes the quality of communication, even if that communication is not specifically focused on medication adherence,” he said in the news release.
Quality of the Encounter is Most Important
Many models have been developed to assist healthcare providers in developing approaches to improve their ability to communicate with their patients. These models focus on improvement in the quality of the encounter and do not necessarily require any significant increased investment in the length of the encounter. These approaches have been demonstrated to improve patient satisfaction and also allow the provider to demonstrate empathy, concern and humanism.
Healthcare Providers Should Cultivate Communication Skills to Build Trust
Communication skills allow the healthcare provider to build trust, promote healing, and ultimately improve outcomes. Interestingly, not only do successful encounters improve patient outcomes they have also been shown to improve professional satisfaction. These skills lead to professional respect among the physician’s peers and result in patients seeking care from these providers. Finally, interviews with patients who have filed malpractice suits against their physicians often site poor communication and lack of empathy as a factor in pursuing legal action.
Read Full Post | Make a Comment ( None so far )Patient Satisfaction Can Be EASY…?
Patient satisfaction is based on what? Patient perception.
Clinton Memorial Hospital CEO Mark Dooley said conversations with patients revealed when they are dissatisfied, it is typically not with clinical quality. Their discontent is with response time to answering a call light, limited communication from the nursing staff, lack of personal connection with the hospital staff. All of these add up to cause a patient to perceive that he is not valued.
Small Things = Easy Improvements
Dooley claims that this perception is not only in hospitals’ control, but one of the easier things to fix. “You call them small things, but I call them easy things. There’s no reason they shouldn’t be fixed,” Dooley said. “I know there’s some image rebuilding we need to do. We have to take care of those needs, do the right things, treat patients the right way.”
Communication Improves Perception
Patient satisfaction and patient centered care go beyond patient needs and incorporate what patients perceive as quality of care. Effective and fluid communication between patients, patient families, and nursing staff, as well as staff efficiency and accessibility, play key roles in determining how patients view their stay at your hospital, and whether they will recommend your facility to their friends and loved ones. Poor communication or miscommunication, as well as lack of staff attention are highly detrimental to patients’ perception of quality of care.
Stay Focused
On the surface, communication appears to be a simple concept within health care. Patients talk to doctors, nurses, and staff members. Doctors explain treatment options to patients. However, obstacles often get in the way of understandable, quality communication. A lack of quality communication limits the quality of service that can be provided to the patient. Some of these issues are rooted within healthcare system design, while others are the result of misplaced focus. Although quality care is important, in some case the perception of care is equally important. According to a study performed in Jackson, Mississippi, the level of patient satisfaction, perceived quality and communication directly correlated with symptom improvement and healing.
Cornerstone of the Healthcare Relationship
Healthcare is a relationship and communication is the cornerstone of every successful relationship. Encourage staff to communicate one-to-one with patient and family members. Improved communication will improve patents perception, satisfaction and quite possibly the healing process. Communication is an inexpensive and easy measure. The key is to remember the importance of communication and make it a high priority. Every hospital can benefit immensely by improved communication.
Are you ready to improve your patient perception with improved communication? Introcomm provides custom communications solutions beginning with the admissions and discharge processes. Find out how we can help you improve communication by improving systems you already have in place (meaning little to no additional out of pocket expense).
Introcomm can certainly help you improve communication, but we can also assist your hospital with HCAHPS, patient experience, reduced readmission rates and more. Contact us today to schedule our complimentary educational webinar.
In Healthcare, Patient Experience Outweighs Price
Healthcare is one of the ONLY industries where experience consistently trumps price. In fact, studies show that customer service (patient experience) is 2½ times more important to the healthcare consumer than in any other industry. This reality may be an eye-opener for some doctors, administrators and medical marketing executives:
Unlike every other industry studied, “price” is not the top consideration. In healthcare, patient experience is the primary driver in the purchase decision. For healthcare consumers, personal experience is the number one reason for choosing a doctor or hospital.
In a recent report by the Health Research Institute of PwC US, both healthcare consumer expectation and the healthcare delivery system are changing. According to the report, these changes in expectation are based on, “inspiration from other industries, competition, health reform, consumer demands and/or the bottom line.”
The PwC report (based on a survey of 6,000 consumers) observes that “agile [healthcare] companies are changing the way they get to know their customers, moving beyond basic transactions and embracing their patients and members as consumers and customers.
“In many respects consumer expectations in healthcare track closely with other industries. Convenience and speed are high on the list… Like the banking and travel industries before them, healthcare companies are recognizing that customer retention comes with repeatable, memorable experiences that match individuals’ wants and needs.”
What is the basis for these new demands? Most professionals believe that the Internet opened the information and communications floodgates, and consumers (patients) have become increasingly aware and empowered in their healthcare decisions.
Others believe that responsibility lies in the shift among healthcare consumers of more conservative spending decisions, as well as many families paying a larger share of costs in health expenses and insurance. The “consumerism” mindset is trending in the healthcare sector, and now more closely parallels the long-established service expectations that are typical in the retail world.
The patient-focus in healthcare—and managing the customer experience—is likely to continue or grow. As the various dynamics of healthcare reform continue to phase-in to the delivery system, over 20 million individual “shoppers” will enter the marketplace in the next five to six years.
According to the report, people are, “acting more like consumers and less like patients.” Adopting a stronger patient-centric approach will provide numerous benefits for the provider, the hospital or healthcare facility, and especially for the individual patient. A positive patient experience clearly improves patient compliance, adherence, quality of care, and ultimately leads to better outcomes.
Consistently delivering a positive patient experience and exceptional customer satisfaction is increasingly tied to revenue. Indirectly, satisfaction and loyalty also inspire patient and professional referrals.
Read Full Post | Make a Comment ( 1 so far )Nurse Communication and Patient Experience
Christy Whipple
“..overall patient satisfaction is linked with quality nursing care, which, in turn, depends on nurse satisfaction…”
It has long been believed that nurses are the backbone of any health care institution and the ‘face’ of the daily care that patients receive. So it’s no surprise that the HCAHPS survey section on nurses’ communication has been found to have the greatest impact on overall patient satisfaction and likelihood to recommend the hospital to family and friends. Nurse communication is an integral part of patient experience and satisfaction.
Nurse Communication Directly Relates to Patient Satisfaction
Recently, popular journal, Quality Management in Health Care, released an article outlining a study regarding the success of nurse communication. The objective was to determine the extent of patient satisfaction with care provided at the hospital at all levels and to correlate patients’ satisfaction with nursing care, in particular, with their overall satisfaction. The study involved a random sample of 420 inpatients in a 110 bed hospital. They found that the overall patient satisfaction with the quality of care provided at the hospital was found to be quite high (Excellent, 74.7%; Very good, 23.7%). Individually, nursing care received the maximum patient satisfaction ratings (Excellent, 91.9%; Very good, 3.9%). A positive correlation was noted between patients’ perception of nursing care and their overall satisfaction with the health care provided at the hospital. They concluded that overall patient satisfaction is linked with quality nursing care, which, in turn, depends on nurse satisfaction, which adds to their work effectiveness and motivates them to provide quality patient care.
HCAHPS Illustrate Importance of Nurse Communication
The impact of nursing care on patient satisfaction and patient outcomes has long been established but hadn’t been linked to financial incentives – until now, with the Hospital Consumer Assessment of Healthcare Providers and Systems initiative. (HCAHPS) According to one nursing educator at American Sentinel University, HCAHPS is poised to have a profound impact on health care and offers a positive and unexpected opportunity to advance the entire nursing profession. With HCAHPS, there is now have a science focused around patient-centered care and a way to measure care that was not in place before. When a nurse is aware of the patient’s perception of the care they are receiving, the nurse can now take measures to correct any negative habits and use the information as a learning tool to increase quality of patient care.
Nurses may Benefit from HCAHPS
Although standardized surveys often carry negative connotations, nurses can view the HCAHPS initiative as a positive and unexpected opportunity to advance nursing interests. HCAHPS is the opportunity for which nurses to demonstrate that what they do does make a difference in health care. Studies have also shown that patient satisfaction is higher when nurses have a better work environment, greater collaboration with physicians and more favorable staffing ratios. Hospitals haven’t always taken note of this data, but now they may have to – and nurses are poised to benefit when they do.
Introcomm provides custom communications solutions for the admissions and discharge processes. To learn more about how Introcomm can assist your hospital with HCAHPS, patient experience, and improved communication (with little to no additional out of pocket expense), please contact us today to schedule our complimentary educational webinar.
Patient Experience Goes Beyond Medical Care
Christy Whipple
“Hospitals will have to venture beyond the traditional realm of merely providing world-class medical care.”
Although 92% of hospital leaders claim to rate patient experience among their top three priorities, it seems no one quite knows what to do or how to improve it. Patients are less forgiving of poor service than they once were, and their expectations are continually rising because of the continually improving customer service offered by other kinds of service providers. A survey done by HealthLeaders found that 41% of patients indicated they would be willing to switch hospitals for a better patient experience.
Good Intentions
The majority of healthcare systems’ mission statements reflect that improving the health of patients is the primary mission. This being the case, then understanding and improving the patient experience must be an important focus. And it would seem that healthcare leaders would be experts at improving the patient experience. However, often this is not the case.
Beyond Medical Care
Hospitals will have to venture beyond the traditional realm of merely providing world-class medical care. They must approach patients as customers, and design the end-to-end patient experience accordingly. This willmove the focus of a hospital’s capabilities from purely clinical competencies to those that also cover customer management.
Customized Communication
The US Medical Center successfully implemented several innovations that have improved the customer experience, especially in terms of information consistency, access, communications and personalized service.The medical center found thatbased on age groups, patients have different needs and preferences, as well as different attitudes and expectations, when it came to their overall patient experience. The younger patients, for example, preferred to pull information when, where and how they wanted it. Older patients, on the other hand, were more interested in having information pushed to them and readily available. Older patients also preferred printed media vs. digital.
Benefits of Satisfied Patients
More satisfied patients bring numerous benefits for hospitals. Satisfied customers often cost less to serve. They consume resources more efficiently.They are more likely to recommend the hospital to friends. They are more likely to give the hospital high ratings, resulting in higher reimbursement rates.
In a healthcare setting, there is an added benefit to satisfied customers: they are more likely to develop good health habits, such as following wellness regimens. They are more tuned into messaging from healthcare providers and, therefore, more likely to make follow-up appointments, take prescribed drugs and keep up with recommended screenings. In other words, they work with their healthcare providers to prevent illness rather than just seek treatment after illness occurs. This preventive approach can dramatically reduce the costs associated with medical care.
More than Patient Satisfaction
The patient experience is more than just patient satisfaction. It incorporates all aspects of the patient’s interaction with the healthcare system. The patient experience includes patient satisfaction, patient engagement, and the quality of the care. To improve the patient experience, leadership needs to focus and truly make the patient experience a priority.
Introcomm provides custom communications solutions for the admissions and discharge processes. To learn more about how Introcomm can assist your hospital with HCAHPS, patient experience, and improved communations (with little to no additional out of pocket expense), please contact us today to schedule our complimentary educational webinar.
Creating Your Patient Experience Program: Where to Begin
Christy Whipple
“…Weave The Patient Experience into the very fabric of your organization’s culture.”
There are plenty of ways to make patient experience more than just another initiative, according to a recent article in HealthLeaders Media. “..To weave it into the very fabric of your organization’s culture, and ultimately to reap the rewards of a healthier bottom line and a reputation that people will talk about with anyone who will listen.”
Does Your Staff “Get It?”
The HealthLeaders article further states that about 95% of the hospitals are current with the latest buzzwords. When asked about ‘patient experience,’ they’ve got it. ‘Service excellence?’ They’ve got it. But Dr. Gnida asks, “Do they really? When we talk to managers who are writing action plans or directors who are frustrated that they can’t move their scores or grow their market, it turns out that they’re not really doing service excellence work, which is creating remarkable experiences. Usually they’re doing service recovery work instead. I don’t want to denigrate service recovery, but it’s a whole other strategy-it’s not patient experience.”
Where Should You Begin?
How will you stay engaged and aligned? How will you know whether the activities are improving the patient experience? Start with a performance analysis accounting for the HCAHPS metrics. This can help an organization understand the current performance along each of these measurements. Deficiencies in any of these areas provide insight on areas to focus improvement efforts. These measures also provide a baseline and a framework for ongoing assessment of the organization’s progress.
Developing a Plan
An execution plan should mimic a road map. It should include the high level work plan, goals, projected timeline, estimated resources and additional support areas required to implement the road map. Throughout implementation and thereafter, the organization can return to the original analysis metrics to assess its performance. This analysis will provide ongoing guidance for prioritizing the activities that may have a significant impact on the Patient’s Experience.
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