iuha ed patient satisfaction quality improvement presentation

IU Health Arnett Emergency Department Patient Satisfaction Survey

By: Madalyn Tadrowski, Marissa Wuethrich, Jaclyn Bourdon, Brianna Tharp, Margo Pok, Lyndsey Sangalis

Hountz, Diane L

Would have each team member state their name and role within the group.

HUMM Patient Satisfaction Survey• IU Health Arnett Emergency Department

o HUMM surveys on patient satisfaction 5 questions Administered on tablets Started in December 2015

Hountz, Diane L

Great overview of the problem!

Key Stakeholders• Practice Partners

o Nicole Adams, PhD, RN Director of Emergency Services of IU Health Arnett

o IU Health Arnett Emergency Department Level 3 Trauma Center, 3 Trauma rooms 20 bed unit 1 ENT room, 3 Fast Track rooms

• Stakeholderso Patients o Nurseso ED patient care technicianso C-suite

www.iuhealth.org

Hountz, Diane L

Would also expand on the IUHA ED...how many beds, who is on their staff.

Define• Problem: In the month of August 2016, only 13 out of 3859

(0.3%) patients completed a HUMM patient satisfaction survey.

• Goal: Nurse leaders desire meaningful question content and a 25% response rate.

% Satisfaction0

5

10

15

20

25

30

0.3%

25%

Performance Gap

Now Goal

% S

atisf

actio

n

Define• Background:

o Patients choose where they go for healthcareo Patient satisfaction surveys can assist in identifying ways to improve

practice resulting in better care and satisfied patients

• Business case:o The top 25% of U.S. hospitals with the highest scores on the HCAHPS

performance question were the most profitable and had the highest clinical scores.

o CMS may develop a payment policy that penalizes facilities based on poor performance

o Healthcare administrators should incorporate techniques based on the customer satisfiers

(ED Patient Satisfaction, 2013; Hall 2010 ;Indovina et al., 2016; Mazurenko, Zemke & Lefforge, 2016;White, 1999; Mazurenko, Zemke & Lefforge, 2016)

Hountz, Diane L

These are great! Be sure to summarize these during presentation!

Current State Map

Hountz, Diane L

Would advise you to project this onto a screen to see if this is readable to your audience...if not may need to adjust the font size.

Data Tools

• Nurse Surveyo Total collected: 17

• Patient Interviewo Total collected: 23o Delegated to Junior clinical group

• HUMM data provided by IU Health Arnetto Data collected from December 2015 to August

2016

www.austinchronicle.com

Hountz, Diane L

Would expand upon the collaboration with the junior students. What does the collaboration look like, what leadership skills are being utilized (Delegation, etc). What will the junior students role be in the future?

Hountz, Diane L

Would also state the number of times gone to Gemba so far.

IUHA HUMM Patient Responses

Dec-15 Jan-16 Feb-16 Mar-16 Jun-16 Jul-16 Aug-160

102030405060708090

100

1424.9 24

7.750 0 0.3

% HUMM Survey Responses

Month

Res

pons

e Ra

te (%

)

Nurse and Patient Data

Worth Their Time Understand questions

Voice Heard02468

10121416

1415 15

Patient interview

Yes No Questions Asked

# Re

spon

ses

Nurses: Patients DO NOT Find Value

Patients DO Find Value

Process Not offered Pt. do not value

Language0

2

4

6

8

10

12

14 1312

11

4

Barriers As Indicated By Nurses

Barriers

# of

nur

ses

Hountz, Diane L

Would change the words used for patient doesn't care. Is patient not interested in taking survey or patient refused more accurate of a statement?

Hountz, Diane L

Would also include the Number N=15) on each of these slides to demonstrate how strong some of these data points are.

AnalzeAnalyze

5 Why Analysis

Top 3 Categories of Questions

Overall Expe-rience

D/C Info Dr Commu-nication

Nurse Com-munication

11

8 8 8

Top Suggestions For Questions: Nurses

Category on Survey

# of

nur

ses?

Nurses:1. Overall Experience2. Doctor and Nurse

Communication3. Discharge Information

Quick Thorough Waiting Time Competant Communi-cation

54

3 3 3

What Type of Care is Important To The Patient?

Type of Care

# of

Res

pons

es

Patients: 1. Quick Visit2. Thorough care3. Competent staff

Hountz, Diane L

Great info and great presentation!

Previous Survey Questions1. Were the nurses and techs nice to you today?

2. Did the staff explain what they were going to do to you before they did it?

3. Did the nurses and techs wash their hands at the sink or use hand foam to clean their hands before and after taking care of you today?

4. Based on your experience, would you recommend Indiana University Health Arnett Hospital to someone you know?

5. Is there anything you’d like to share or a team member you’d like to recognize today?

6. Thank you for leaving your feedback! If you would like for a member of our leadership team to follow-up with you, please leave your email address.

Deliverable: New Survey Questions1. Did the staff care for you in a respectful and polite way?2. Did the staff explain your care in a way that you could understand?3. Did the staff carefully listen to you during your stay?4. Choose a number that you would use to rate the care you were given

during this Emergency Room visit. 0 to 10 scale, 0 being the worst care, 10 being the best care.

5. Based on your experience, would you recommend Indiana University Health Arnett to someone you know?

6. Is there anything you would like to share or a team member you would like to recognize?

7. Thank you for leaving your feedback! If you would like for a member of our leadership team to follow-up with you, please leave your email address or phone number.

Future State Map

• Release data results to staff• Add language options

o Spanisho Burmese

• Remove “skip” option• Add option to give phone

number• Reward nurses who are

recognized

Recommendations

14; 2%850

Emergency Room visits 11/6-11/12

# surveys total # seen

• Did the staff listen: 100%• Staff responsiveness: 100%• Respectful and polite care: 100%• Staff communication: 93%• Overall Experience: 89%• Explain care in a way you

understand: 85.7%

PDCA

HUMM Survey Results

New HUMM Survey Questions Implemented on November 1st, 2016

• Process Owner: o Director of Emergency Services: Nicole Adams, PhD, RN

• Review survey results weekly• Provide feedback to ED staff• Release positive results of increased survey

rates to other IU Health hospitals

Sustaining Improvement

www.linkedin.com

• Focus on quality and not just quantity.• Drive out fear by encouraging employees to

participate actively in the process.•Promote teamwork rather than individual

accomplishments.• Delegation and collaboration with Junior

clinical group

Management Principles

(Marquis & Houston, 2014)

Conclusion• Patient satisfaction surveys are important• There was a discrepancy between what nurses believe and what

patients truly think• Through implementation of our deliverable the expected outcome

is to: o Motivate ED staff to administer surveyso Increase response rate from HUMM surveyo Receive meaningful data from patients to improve care in ED

www.careers.iuhealth.org

ReferencesED Patient Satisfaction, The Future of Reimbursement. (2013). Retrieved from www.forerunsystems.com/news/bid Hall, E. (2010). Patient Satisfaction-Why Should We Care? Retrieved from http://www.medscape.com/viewarticle/736495 Indovina, K., Keniston, A., Reid, M., Sachs, K., Zheng, C., Tong, A., … Burden, M. (2016). Real-

time patient experience surveys of hospitalized medical patients. Journal of Hospital Medicine, 11(4), 251-256. doi:10.1002/jhm.2533

Mazurenko, O., Zemke, D. M., & Lefforge, N. (2016). Who is a hospital's "customer"?. Journal Of Healthcare Management, 61(5), 319-333.

Marquis, B. L., & Huston, C. J., (2015). Leadership Roles and Management Functions in Nursing: Theory and Application (8th ed.). Philadelphia, PA: Wolters Kluwer Health Lippincott Williams & Wilkins.

White, B. (1999). Measuring patient satisfaction: how to do it and why to bother. Family Practice Management, 6 (1), p. 40-44. Retrieved

from http://www.aafp.org/fpm/1999/0100/p40.html