enhancing communication skills: a catalyst for ...€¦ · enhancing communication skills: a...

Enhancing Communication Skills: A Catalyst for Organizational Cultural Transformation

Presented by William Maples, MD, Chief Medical Officer, Professional Research Consultants and Executive Director, The Institute for Healthcare Excellence, Galen Perdikis, MD, Faculty, The Institute for Healthcare

Excellence, Chadi Ibrahim, MD, Medical Director of Medical House Services, Connie O’Malley, Chief Operating Officer and Amanda LaVoie, M.S., R.D., Director of Service Excellence and Environmental

Services, Beaumont Hospital – Troy

Defining Patient Experience

www.theberylinstitute.org 2

- The Beryl Institute

Keynote Speakers

Three Pre-Conference Workshops

The Environment of the Patient Experience: Proactive Design in Practice

Lorissa MacAllister and Susan Mazer

Leading Your Patient Experience Strategy tp the Next LevelWendy Leebov, Jill Golde and Dorothy Sisneros

Breakout Sessions

April 13-15 ▪ Sheraton Dallas Hotel ▪ Dallas, Texas

Ronan Tynan

Coaching and Feedback to Enhance Communication

Calvin Chou and Laura Cooley

Cynthia Mercer Kelly Corrigan

Three Pre-Conference Gatherings

Patient Advocacy CommunityPhysician CommunityPediatric Community

Montel Williams

Networking Dinner & Reception

The Margot and Bill Winspear Opera House at the AT&T Performing Arts Center

Become a Certified Patient Experience Professional.

Applicants should have a minimum 3 years of professional experience in a patient experience related role or completion of 30 Patient Experience Continuing Education Credits (PXEs).

Learn more at www.pxinstitute.org

Housekeeping

• All participant phone lines are muted.

• The presentation will run 45-50 minutes with about 10-15 min for Q&A.

• Q&A will be conducted through the Q&A function. Please submit questions to the host for a facilitated Q&A after the presentation.

• Webinar materials and session recording will be available for all attendees. (receive an email notification with the appropriate link)

• A survey will be distributed following today’s session.

• This program is pending approval for 1 PXE

PX Continuing Education Credits

• In order to obtain patient experience continuing education credit, participants must attend the program in its entirety and return the completed evaluation.

• The planning committee members and presenters have disclosed no relevant financial interest or other relationships with commercial entities relative to the content of the educational activity.

• No off label use of products will be addressed during this educational activity.

• This activity has received no sponsorship or commercial support. No products are available during this educational activity, which would indicate endorsement.

Our Speakers


William Maples, MDChief Medical Officer, PRC

Executive DirectorThe Institute for Healthcare Excellence

Galen Perdikis, MDFaculty, The Institute for

Healthcare Excellence

Connie O’MalleyChief Operating Officer

Beaumont Hospital – Troy

Chadi Ibrahim, MD, Medical Director

Medical House ServicesBeaumont Hospital – Troy

Amanda LaVoie, M.S., R.D., Director of Service Excellenceand Environmental ServicesBeaumont Hospital – Troy

Communication in Healthcare

Why Communication in HealthcareDemonstrated Results

Risk Adjusted Mortality

ICU Length of Stay

Patient Experience

Overall Inpatient

50% 1 day 33%

Physician Communication

Scores

43%

• Enhance Patient Experience• Evolve a culture of safety• Enhance Employee Engagement and Satisfaction• Create a culture of mutual respect, safety, and teamwork through

communication• Decrease adverse events• Improve patient compliance with treatment plans, thereby

enhancing outcomes and decreasing rework resulting from unnecessary readmissions

• Decrease Staff Turnover• Decrease Malpractice Events• Restore joy for the practice of medicine• Build resilience to meet the ever-changing healthcare environment

Goals: 4-Hour Communication in Healthcare Curriculum

Program DesignPROGRAM DESIGN

Interactive Small Group Learning

1 Faculty per 6 Participants

Interactive/immersive training stylePeer to peer teaching (e.g. MD to MD) 1 Faculty per 6 colleaguesDidactic discussions and video Longitudinal experienceCME accredited

Mindfulness/Presence Active listening Information gathering Negotiating an agenda Connecting with patients and team Written communication Appreciative inquiry/debrief

COURSE ELEMENTS

Enhancing Communication Skills:A Catalyst for Organizational

Cultural TransformationFebruary 2016

Beaumont - Troy• 458 Licensed Beds

• 4,675 Employees

• 1,348 Physicians– Employed and Private

• 35,650 Admissions

• 93,332 EC Visits

• 3,736 Births

• 19,524 Total Surgeries

Why did we seek Communication Training?• Desire to develop a curriculum that allowed staff to

more strongly connect with patients, families and each other

• Looking for more than an initiative

• Culture shift to align with our vision

Why this concept?

• Learner centered approach• Physician and allied health learning parallel

learning• Self sustaining model

What was the need?

• Maintain a high level of safety and quality

• Improve physician patient experience scores

• Improve overall patient experience scores

• Desire to improve communication between providers

• Desire to maintain our facility as the hospital of choice

• Doing the right thing

Challenge in getting physicians on board

• Not all physicians view patient experience as important aspect of patient care

• Generally viewed as softer side of medicine• Docs don’t think they have issues with

communication• We also didn’t know where physician leaders are on

the issue• Difficult to get physicians interested in taking the

lead on the issue

Why is physician involvement important?

• It became clear that the patient experience initiative wouldn’t succeed without involving physicians

• Physicians are well respected by patients

• Physicians are well respected by others members of the team

• We have a stake in this

• Our reputation is on the line

• Improved job satisfaction

How do we involve physicians?

• The leadership must buy into it• It has to be a physician who drives it• We have to show physicians that this is a valuable skill• It is a way to help improve “how we practice

medicine”• Will not take more time!• The carrots: CME, Academic Credits, MOC credits• Start the conversation• Execution is the key!

Setting the vision

• Finding the right program

• Treading lightly with physicians

• Having the conversations are crucial

• Generating a buy in from leadership

• Leaders need to see these benefits: Improved quality of care, financially sound proposal and sustainability

• Inviting the right physician leaders to the table

• Rolling out the program in a stepwise approach

Sustaining the Vision

• Building on momentum

• Forming a team of advocates

• Creating ambassadors for the initiative

• Reaching a critical mass

• Requiring the skill

• Weaving into the culture

What does the work look like now?

• Physicians (includes mid-level providers) – Monthly classes

• Allied health staff – weekly classes

• Post-class – Letters to homes requesting stories

• Caring Connections meeting

• Recognition

Patient Satisfaction Data

2/4/2016 23

0

10

20

30

40

50

60

70

80

90

100

Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15

Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15Top Box 74.8 76.1 75.2 76.4 76.9 74.7 79.5 81.5 81.3 81.7 82.2 85.5Percentile Ranking 13 19 14 21 24 13 44 62 61 64 68 87

Communication with Nurses HCAHPS Domain

April: Initial training

July: Training implementation began.

Data displayed by date of service

2/4/2016 24

0

10

20

30

40

50

60

70

80

90


Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15Top Box 75.6 75.8 74.5 78.5 75.7 75.1 77.3 77.9 78.7 77.6 80.5 81.2Percentile Ranking 13 13 9 27 13 11 19 23 28 21 42 47

Communication with Doctors HCAHPS Domain





2/4/2016 25

0

10

20

30

40

50

60

70

80

90


Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15Top Box 68 71.2 67.3 70.3 69.8 64.9 74 77.4 76.3 73.2 76.2 76.7Percentile Ranking 30 45 27 41 38 19 57 73 69 53 68 70

Global Rating HCAHPS Domain (9s and 10s)





Learnings and Results From Institutions Engaged in the Communication in

Healthcare Program

Critical Success Factors 1. Strong leadership commitment to supporting the program.

2. Curriculum developed to be significantly relevant to the practicing clinician.

3. Program designed to be financially feasible and sustainable.

4. Choose faculty to represent the diversity of the entire physician and allied health staff and are well respected by their colleagues

5. Conduct training sessions on a monthly basis to complete training for the entire faculty over a two year period

6. Physicians and allied health staff should be required or strongly encouraged to participate in the curriculum

Physician Program Evaluation Scale of 1-5

• Overall, program useful 4.1• Is good for institution 4.5• Was worth the time for me personally 4.1• Ability to help learners become actively engaged

with exercise4.5

• Ability to maintain a safe and trusting environment 4.6• Ability to help others accomplish learning goals 4.5

Patient Experience ResultsOutpatient Overall Quality of Care

% Excellent

7273747576777879

MCF

Year 1 Year 2 Year 3 Year 4 Year 5

Health System

Patient Experience ResultsInpatient Overall Level of Safety

% Excellent

01020304050607080

MCF

Year 1 Year 2 Year 3 Year 4

Health System

Patient Experience Results

505560657075808590

Doctor's Communication / Keeping Patient Informed

505560657075808590

Doctor's Involving Patient in Decision-Making Process

36414651566166

Doctor's Understanding and Caring

505560657075808590

Nurse Listen

Patient Experience ResultsOutpatient Willingness to Recommend

% Definitely Would

888989909091919292

MCF

Year 1 Year 2 Year 3 Year 4 Year 5

Health System

Value Based Purchasing – Patient Experience

3/1/2011 6/1/2011 9/1/2011 12/1/2011 3/1/2012 6/1/2012 9/1/2012 12/1/2012 3/1/2013 6/1/2013 9/1/2013 12/1/2013 3/1/20142011 2011 2011 2011 2012 2012 2012 2012 2013 2013 2013 2013 201403 06 09 12 03 06 09 12 03 06 09 12 03Scheduled Quarterly Release Mar. 2011 June 2011 Sept. 2011 Dec. 2011 Mar. 2012 June 2012 Sept. 2012 Dec. 2012 Mar. 2013 June 2013 Sept. 2013 Dec. 2013 Mar. 2014

Data Collection Dates Jul. 1, 2009 - June 30, 2010

Oct. 1, 2009 - Sept. 30, 2010

Jan. 1, 2010 - Dec. 31, 2010

Apr. 1, 2010 - Mar. 31, 2011

Jul. 1, 2010 - June 30, 2011

Oct. 1, 2010 - Sept. 30, 2011

Jan. 1, 2011 - Dec. 31, 2011

Apr. 1, 2011 - Mar. 31, 2012

Jul. 1, 2011 - June 30, 2012

Oct. 1, 2011 - Sept. 30, 2012

Jan. 1, 2012 - Dec. 31, 2012

Apr. 1, 2012 - Mar. 31, 2013

Jul. 1, 2012 - June 30, 2013

Hospital Performance 79% 78% 78% 78% 78% 80% 80% 81% 83% 83% 84% 83% 83%

U.S. Top 10% 83% 83% 83% 83% 84% 84% 84% 85% 85% 85% 85% 85% 85%U.S. Average 76% 76% 76% 76% 77% 77% 77% 78% 78% 78% 78% 78% 79%

U.S. Rank 939 of 3809 1254 of 3811 1305 of 3826 1340 of 3836 1388 of 3850 927 of 3857 997 of 3866 840 of 3891 546 of 3903 558 of 3911 432 of 3923 596 of 3938 619 of 3974State Rank 40 of 97 53 of 97 51 of 97 56 of 98 54 of 97 38 of 97 42 of 97 31 of 97 16 of 97 15 of 97 14 of 98 22 of 98 25 of 98

Communication with Nurses

Applicable to the 2013, 2014, 2015 and 2016 VBP Programs.

79%

83%83%

85%

76%

79%

74%

76%

78%

80%

82%

84%

86%

Mission Hospitals

U.S. Top 10%

U.S. Average

Hospital


Scheduled Quarterly Release Mar. 2011 June 2011 Sept. 2011 Dec. 2011 Mar. 2012 June 2012 Sept. 2012 Dec. 2012 Mar. 2013 June 2013 Sept. 2013 Dec. 2013 Mar. 2014


Oct. 1, 2009 - Sept. 30, 2010

Jan. 1, 2010 - Dec. 31, 2010

Apr. 1, 2010 - Mar. 31, 2011

Jul. 1, 2010 - June 30, 2011

Oct. 1, 2010 - Sept. 30, 2011

Jan. 1, 2011 - Dec. 31, 2011

Apr. 1, 2011 - Mar. 31, 2012

Jul. 1, 2011 - June 30, 2012

Oct. 1, 2011 - Sept. 30, 2012

Jan. 1, 2012 - Dec. 31, 2012

Apr. 1, 2012 - Mar. 31, 2013

Jul. 1, 2012 - June 30, 2013


U.S. Top 10% 76% 76% 76% 76% 76% 76% 76% 77% 77% 77% 77% 77% 77%

U.S. Average 69% 69% 69% 70% 70% 70% 70% 70% 71% 71% 71% 71% 71%

U.S. Rank 914 of 3807 1200 of 3810 1233 of 3826 1895 of 3836 1260 of 3850 1039 of 3856 1368 of 3864 513 of 3889 430 of 3900 251 of 3906 114 of 3921 151 of 3934 285 of 3969

State Rank 30 of 97 42 of 97 42 of 97 63 of 98 50 of 97 38 of 97 47 of 97 15 of 97 8 of 97 5 of 97 1 of 98 1 of 98 3 of 98

Pain Management


72%

78%

76%77%

69%

71%

68%

70%

72%

74%

76%

78%

80%

82%

Mission Hospitals

U.S. Top 10%

U.S. Average

Hospital




Oct. 1, 2009 - Sept. 30, 2010

Jan. 1, 2010 - Dec. 31, 2010

Apr. 1, 2010 - Mar. 31, 2011

Jul. 1, 2010 - June 30, 2011

Oct. 1, 2010 - Sept. 30, 2011

Jan. 1, 2011 - Dec. 31, 2011

Apr. 1, 2011 - Mar. 31, 2012

Jul. 1, 2011 - June 30, 2012

Oct. 1, 2011 - Sept. 30, 2012

Jan. 1, 2012 - Dec. 31, 2012

Apr. 1, 2012 - Mar. 31, 2013

Jul. 1, 2012 - June 30, 2013


U.S. Top 10% 68% 68% 69% 69% 69% 70% 70% 71% 71% 71% 72% 72% 72%

U.S. Average 60% 61% 61% 61% 61% 62% 62% 63% 63% 63% 64% 64% 64%



Communication about Medicines


59%

75%

68%

72%

60%

64%

58%

60%

62%

64%

66%

68%

70%

72%

74%

76%

Mission Hospitals

U.S. Top 10%

U.S. Average

Hospital




Oct. 1, 2009 - Sept. 30, 2010

Jan. 1, 2010 - Dec. 31, 2010

Apr. 1, 2010 - Mar. 31, 2011

Jul. 1, 2010 - June 30, 2011

Oct. 1, 2010 - Sept. 30, 2011

Jan. 1, 2011 - Dec. 31, 2011

Apr. 1, 2011 - Mar. 31, 2012

Jul. 1, 2011 - June 30, 2012

Oct. 1, 2011 - Sept. 30, 2012

Jan. 1, 2012 - Dec. 31, 2012

Apr. 1, 2012 - Mar. 31, 2013

Jul. 1, 2012 - June 30, 2013


U.S. Top 10% 88% 88% 88% 88% 88% 88% 89% 89% 89% 89% 90% 90% 90%

U.S. Average 82% 82% 82% 82% 83% 83% 83% 84% 84% 84% 85% 85% 85%



Discharge Information


85%

90%

88%

90%

82%

85%

82%

84%

86%

88%

90%

92%

Mission Hospitals

U.S. Top 10%

U.S. Average

Hospital

Staff Satisfaction

0102030405060708090

100

Respect between MD andAHS

Service from colleagues Treat others with respect

Year 1 Year 2 Year 3

Percentile Ranking Nationally

0%

10%

20%

30%

40%

50%

60%

70%

80%

2012

2013

* Very near / approaching bucket

Reduced the use of Propofol (ICU)

0

100

200

300

400

500

600

Propofol Bottles Removed

Bottles Removed,Coli

Linear (BottlesRemoved, Coli)

Reduced Length of Stay (ICU)

Oct'09

Nov'09

Dec'09

Jan'10

Feb'10

Mar'10

Apr'10

May'10

Jun'10

Jul'10

Aug'10

Sep'10

Oct'10

Nov'10

Dec'10

Jan'11

Feb'11

Mar'11

Apr'11

May'11

Jun'11

Jul'11

Aug'11

Sep'11

Oct'11

Nov'11

Dec'11

Jan'12

Feb'12

Mar'12

Apr'12

May'12

Jun'12

ALOS 4.8 2.9 4.6 5.4 3.1 5.1 3.4 3.1 2.9 3.6 3.6 3.8 3.6 2.4 3 4.2 3.8 3.7 3.6 3.2 2.2 3.3 2.3 3.5 2.6 2.9 3.8 2.6 3.0 3.2 2.3 2.7 2.5Median 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6Goal 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0

0

1

2

3

4

5

6

MSI

CU

-Av

erag

e Le

ngth

of S

tay

(APA

CH

E)

**ADT data x3mos

FY11 Flu

FY10 Flu

IHI Projects

Intensivist Model

ABCDE Work

FY12 Flu

Risk Adjusted Mortality

>500 FEWER Deaths per Year than 2010

Questions


William Maples, MDChief Medical Officer, PRC

Executive DirectorThe Institute for Healthcare Excellence

Galen Perdikis, MDFaculty, The Institute for

Healthcare Excellence

Connie O’MalleyChief Operating Officer

Beaumont Hospital – Troy

Chadi Ibrahim, MD, Medical Director

Medical House ServicesBeaumont Hospital – Troy

Amanda LaVoie, M.S., R.D., Director of Service Excellenceand Environmental ServicesBeaumont Hospital – Troy

PX Continuing Education Credits

• This program is pending approval for 1 PXEs

• In order to obtain PXEs, participants must attend the program in its entirety and complete evaluation.

We invite you to join us…

We invite you to join our global community of over 40,000 members and guests passionate

about improving the patient experience.

Become a member today atwww.theberylinstitute.org

http://www.theberylinstitute.org

enhancing communication skills: a catalyst for ...€¦ · enhancing communication skills: a...

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