Improving Patient’s

Experience in 7W WPLC

Marquez, G., Sands, C., Kemerley, P.,

Walczak, D., De Asis, A.

Purpose

• To evaluate patient satisfaction

rate in 7 West

• To develop tools in measuring

patient satisfaction

Background

Clark (2006) mentioned four elements of discharge process that influence patients' overall satisfaction are “patients' readiness to be discharge, speed of discharge process, home care instructions, and coordination of care across the continuum.” (p. 2)

DHHS (2011) recommended valid, reliable measures are the cornerstone of monitoring quality improvement efforts. In order to achieve the quality improvements envisioned by the National Quality Strategy, data on care delivery and outcomes should be measured. Quality improvement can be measured by asking patients for feedback through survey forms. Patient satisfaction is also link to financial benefits. In fact, Clark (2006) mentioned that “discharge is significantly related to earnings per bed. For earnings per bed, the dollar amount associated with a one-point gain or loss (e.g. Moving from an average rating of good= 3 points, to a very good= 4 points) in satisfaction is $4980.” (p. 6)

Discharge Process

Clark, PA (2006). Patient Satisfaction and the Discharge Process Evidence-Based Best Practices.

Retrieved on 08/28/12 from www.hcmarketplace.com/supplemental/4069_browse.pdf

DischargeProcess

Readiness

Coordination of care

Home care instructions

Speed

Procedure/Methods

Patient Satisfaction Survey was developed based on Press Ganey’s previous study. 52 patients answered the Patient Satisfaction Survey, and 16 patients answered the Discharge Process survey. Patient Surveys were confidential. Nurses were instructed to use/prepare the 7WPLC Packet (Information brochures), Depart Process (these include Discharge Instructions and Patient Education print-out), and the Survey form. When discharging a patient a nurse should make use of the four elements of the discharge process. After the discharge process, a survey form will be given to a patient.

Procedure/Methods Survey forms were used as a tool to collect data. Data collections were from patients of 7West WPLC with different disease case mix and diagnosis. Survey forms were collected upon discharge and satisfaction rate were measured using a Likert Scale:

Satisfaction Rate Per Provider Group

4 -very good, 3- good, 2- satisfactory, and 1- unsatisfactory.

Discharge Process Satisfaction Rate

4- strongly agree, 3- agree, 2- disagree, 1- strongly disagree.

We also included additional comments to identify perceptions of patients regarding quality of care especially during the discharge process. Data collection is within 3 months.

Results • Nurses ranked first (95.67%) in the Patient Satisfaction

Survey among the four professionals. Next is the ancillary staff (93%), followed closely by nurse techs(92.79%), and lastly the physicians (92.16%).

• The nurses were rated satisfactory by (5.77%) of the respondents, while the rest answered either good (5.77%) or very good (88.46%). Nurse Techs were assessed as very good (80.77%), good (11.54%) or satisfactory (5.77%) but had (1.92%) unsatisfactory evaluation. The ancillary staff were not rated as unsatisfactory and received (79.59%) very good and (12.24%) good ratings. The physicians were rated as very good by (80.39%) of the respondents, good by (9.8%), satisfactory by (7.84%), and unsatisfactory by (1.96%).

Results • For the discharge process questionnaire, both the home

instruction and team coordination(93.75%) ranked first, followed by readiness to be discharged(92.19%) and lastly by the speed of discharge(89.06%). A total of 16 respondents answered the discharge process questionnaire.

• For the first question, all respondents agreed (31.25%) or strongly agreed (68.75%) that they felt ready to be discharged. For the second question, only 1 disagreed (6.25%) that the discharge occurred within a reasonable period of time, while the rest agreed (31.25%) or strongly agreed(62.5%). Question three and four have the same results: respondents agreed (25%) and strongly agreed (75%) regarding clear home instructions and coordination of care.

Satisfaction Rate Per Provider Group

90.00 91.00 92.00 93.00 94.00 95.00 96.00

Physicians

Nurses

Nurse Techs

Ancillary Staff

Series1

Discharge Process Satisfaction Rate

86.00% 87.00% 88.00% 89.00% 90.00% 91.00% 92.00% 93.00% 94.00%

"I Felt Ready to Be Discharged From the Hospital"

"My Discharge Occurred Within A Reasonable Period of

Time"

"My home-care and follow-up insturctions were clear and

thorough."

"I felt as though the medical staff and support services

worked together well to address my healthcare needs."

Series1

Conclusions • Patients of 7 west were satisfied with the service

they received.

• The speed of discharge can be improved to

increase patient satisfaction of the discharge

process.

Recommendations/Limitations

• small sample size

• effects of demographics: gender, age, level of

education, length of stay, medical complexity

• comparison of the authors questionnaire to the

Press Ganey questionnaire

Implications to Practice

• Nurses will understand the importance of the quality discharge process to increase satisfaction rate

• Nurses will be able to implement quality improvement projects such as patient satisfaction survey to contribute to quality care

• Nurses will make use of the four essential elements of the discharge process

References Clark, PA (2006). Patient Satisfaction and the Discharge Process Evidence-Based Best Practices. Retrieved on 08/28/12 from www.hcmarketplace.com/supplemental/4069_browse.pdf

Rau, J. (2012). Medicare To Penalize 2,211 Hospitals For Excess Readmissions. Retrieved from http://www.kaiserhealthnews.org/Stories/2012/August/13/medicare-hospitals-readmissions-penalties.aspx?goback=.gde_144864_member_146634479

Branz, K. (2011). Patient Surveys Help Improve Care and Satisfaction. Retrieved from http://www.healthshare-tha.com/resources/best-practices/c009texashospitalsbestpractices/BP_MayJune%202011.pdf

Daniels, A. (2001). Crossing the Quality Chasm; A New Health System for the 21st Century. Retrieved from http://www.iom.edu/Reports/2001/Crossing-the-Quality-Chasm-A-New-Health-System-for-the-21st-Century.aspx

Wu, C. et al. (2001). Measurement of Patient Satisfaction as an Outcome of Regional Anesthesia and Analgesia: A Systematic Review. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11359218

Leitheiser, R. (2001). Data Quality in Health Care Data Warehouse Environments. Retrieved from http://www.hicss.hawaii.edu/HICSS_34/PDFs/HCIST01.pdf

DHHS (2011). National Strategy for Quality Improvement in Health Care: Report to Congress. Retrieved from http://www.healthcare.gov/law/resources/reports/quality03212011a.html

Press Ganey (2010). Press Ganey Knowledge Summary: Patient Satisfaction with Emotional and Spiritual Care. Retrieved from http://hmablogs.hma.com/hmachaplains/files/2010/05/Press-Ganey-Patient-Satisfaction.pdf

Appendix 7-West Walter Payton Liver Center

Staff Performance and Discharge Survey

As a patient on 7-West, we value your opinions and comments to improve patient care.

We want to know about your experience on the unit, including your discharge process. We are seeking your input on ways we can improve our practices and provide better patient care. Please complete the following survey to help us improve our services and better assist you with your future needs. Thank you for choosing the

University of Illinois Hospital and Health Sciences System.

How do you rate the services of the following staff? Please circle one:

Physicians ------------- Very Good Good Satisfactory Unsatisfactory

Nurses ------------------- Very Good Good Satisfactory Unsatisfactory

Nurse Technicians ------ Very Good Good Satisfactory Unsatisfactory

Ancillary Staff (Transporters, Very Good Good Satisfactory Unsatisfactory

Housekeeping, Dietary and others)

Please rate your agreement with the following statements related to your

discharge process by circling one of the options below:

I felt ready to be discharged from the hospital.

Strongly Agree Agree Disagree Strongly Disagree

My discharge occurred within a reasonable period of time.

Strongly Agree Agree Disagree Strongly Disagree

My home-care and follow-up instructions were clear and thorough.

Strongly Agree Agree Disagree Strongly Disagree

I felt as though the medical staff and support services worked together well to address my healthcare needs.

Strongly Agree Agree Disagree Strongly Disagree

Any additional comments you would like to share with us, please include them on the reverse side.