Service Excellence - National Research Corporation

Service Excellence
Sheilahn Davis-Wyatt, MHA, FACHE
Senior Director of Ambulatory Services/Service Excellence
NRC Picker Patient Centered Care Symposium | September 22, 2012
Clinical Care
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Free-standing 355 bed not-for-profit magnet designated children's hospital across
multiple locations
Medical staff of more than 700 pediatric specialists with more than 40 pediatric
specialties
Primary Care Clinic and over 36 Specialty Clinics; Perform Outreach clinics across
Missouri and Kansas
Education
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Affiliation with University of Missouri-Kansas City School of Medicine ;
Residency affiliations with major medical schools nationwide
Provides training to Nursing students from 16 schools in the Kansas City area
Research
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Over 100 physician & basic scientists, nurses, fellows and residents involved in
research projects
One of 13 nationally designated Pediatric Pharmacology Research Units, which
study the safety of new medications for use by children
The Center for Pediatric Genomic Medicine, established in 2011
Team Effort
Linda Taloney, MBA
Director of Patient Advocacy
Patient Care Services
Mike Sayer, MBA, MPH, CPHQ
Director of Decision Support
Quality Improvement
Learning Objectives
• Identify Key Stakeholders to engage when
designing a comprehensive program
• Identify metrics that can be used to evaluate
Service Excellence Initiatives
• Describe Children’s Mercy Hospitals and
Clinics Success and Barriers post
implementation
Presentation Agenda
• Understanding the Program Development
Rationale
• Our Program – Extraordinary Every Time
• Measures of Success and Effectiveness
• Success Stories and Barriers Along the Way
Historical Focus/Culture
Essential Stakeholders
Leadership Commitment
UNDERSTANDING THE PROGRAM
DEVELOPMENT RATIONALE
Historical Focus/Culture
Our Vision
To be recognized as one of the best
Children’s Hospitals in the World
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Children’s Mercy History
“Skill cannot take the place of sympathy
and understanding, for science without
heart is ugly and pitiless.”
Dr. Katharine Berry Richardson
Co-Founder, Children’s Mercy Hospital
9
Children’s Mercy History
• Philosophy: We serve
everyone by understanding
the needs of the patients
and their families.
This takes:
– Teamwork between
colleagues
– Patient and Family Centered
Care (PFCC)
10
Development Rationale
• Building Upon Our Foundation
– Lots of effort; small group focus
• 2009 determined the need for more ownership to drive
improvement
– ‘Helpful, Friendly, Courteous & Kind’ was the
mantra
– Differing perspectives and interpretations
Development Rationale
• Building Upon Our Foundation
– What we were doing was ok but not meeting our
vision
– Needed consistency throughout all aspects of our
operation….not just at the bedside
Patient Experience Results
Summary: Where We Were
• A Few of the Many Extremely Dedicated
– Consistent mantra not taken to heart by all
– Periodic spikes with room left for overall improvement /
ownership
• Key Drivers
– Had not changed significantly since beginning NRC Picker
survey
– Several overlaps of key drivers needing to engage
providers and their team
– Families had unmet needs
• Emotional Support for Guardian was #1 theme across all areas
To Move Forward.…
• Education Needed
– Send message that this applies to everyone
– That we were transitioning our mantra
– This is being driven as a part of our policies, the
care we provide and overall operations
– This was ENHANCING our culture
– There is a need through the eyes of those we
serve
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Essential & Key Stakeholders
Essential Stakeholders / Efforts
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Family Advisory Board (FAB)
Consejo de Familias Latinas/Hispanas
Teen Advisory Board (TAB)
Family-Centered Care Coordinators
Family Time
Parents Offering Parent Support (POPS)
Patient/Family Experience Tracers
Family as Faculty Program
Human Resources: Let’s Talk Program
Patient Advocates
Family Advisory Board
Family Advisory Board
• Parent Activated Response
Team
• Inpatient Room Orientation
Video
• Family Message Video for
new employee orientation
• New Journeys Handbook
• Panel for educating medical
students
El Consejo
• Way finding and signage in
Spanish
• “Public service” health
messages for area Spanish
radio stations
• Spanish marketing and
messaging
Teen Advisory Board
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Same Day Surgery teaching video
Hospital Cafeteria design
Teen Room
Teen Pain Management brochure
Care bags for patients in crisis
Young Adult Guidelines
Family Time
• Program hosted by the
Family-Centered Care
Coordinators on inpatient
units.
• Parents have an opportunity
to connect with other
parents.
• Beverages and snacks are
provided.
• Connected with over 2500
family members in first
year.
Parents Offering Parent Support
(POPS)
• Parent volunteers are trained to provide emotional
support to parents of a child with a new diagnosis.
• Over 20 parents have applied and interviewed to be
mentors.
• We have already “popped” a number of parents
together.
Patient/Family Experience
Tracers
• Parent involvement in the evaluation of
family-centered care which is part of our
hospital mission.
• Focus on the patient/family experience with
the processes of care.
• Staff are able to understand the benefits and
barriers to families as advisors.
Tracer Methodology
• Conducted by choosing patient and interviewing
patient/family during their encounter.
• Can be tailored to evaluate current issues or areas
of interest.
• Results used to establish system level priorities
for improvement and quality improvement
initiatives.
Family as Faculty Program
• Use family leaders to implement PFCC
education for physicians, nurses, and ancillary
staff.
• Provide the opportunity for a resident to visit
the home of a child with complex medical
needs.
Human Resources: Let’s Talk
Program
Program content:
• The impact of communication breakdowns on patient
safety.
• Elements of a crucial conversation.
• Questions to answer when planning a crucial
conversation.
• Silence Kills (Vital Smarts White Paper)
Patient Advocates
• Liaison between patients, families, visitors and
hospital staff and administration.
• Facilitate problem resolution
• Support the hospital's goal of continually meeting and
exceeding the needs of patients and families
Communication Culture
• SBAR (Situation, Background, Assessment,
Recommendation)
• Crucial Conversation skills
• Commitment from Leadership to provide
organizational support
• Result is high priority outcomes
Leadership Commitment
Through the Years
• Leaders have witnessed significant growth over the past
20 years
• Approach and mentality toward service excellence has
had to change with larger organization
– More employees with varying perspectives and approaches
– Highly skilled and educated staff
– Expectations for something different required doing the
something different
Leadership Commitment
• CEO and Executive Vice Presidents
recognized the need and championed the
change
• Present during training roll-out; campaign
• Helped to drive message of need and focus
– Enforcing Accountability
Key Components of the Program:
Training
Policy
Communication
Recognition
Performance Enhancement
Program Structure
Patient Experience:
Patient & Family Centered
Employee Engagement
Community Referral Providers
SERVICE EXCELLENCE PROGRAM
– EXTRAORDINARY EVERY TIME
Key Program Components
Training for Change
• Large Organization (6,000+ employees)
– Required EVERYONE to take training
• Use of Liaisons
• Alternate methods of communication
• Consistency in roll-out and training approach
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Training: Use of Liaisons
• Role of Service Liaison
– Serve as communicator to give and receive
information regarding service excellence in the
organization
• When/Where Service Liaisons Needed
– During Service Excellence Kick-off
– During Education and Training Sessions
– Ongoing – Behavioral Examples
Education & Training
Sessions
• Leader Sessions (2 hours)
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More in-depth information
Covered leader expectations and improvement initiatives
Department/Section Communication on Service Excellence
Communicating Service Excellence information in
Department/Section Orientation
– Keeping the focus on Patient and Family Centered Care
– Incorporating Performance Evaluation and behavioral
competencies
– Having and Receiving conversations on Service
Education & Training
Sessions
• Employee Sessions (1 hour)
– Covered purpose of training: to build upon the
ground work that has already been laid and achieve
a higher level of service throughout the
organization
– Also included:
• Common definition
• Behavioral expectations
Education System Wide
• Training offered at each location:
• Main
• South
• Broadway
• North
• West
• Online for distant staff
Service Excellence Kickoff
• Video Message from the CEO, Rand
O’Donnell
– Posters went up at all sites
– Service Excellence Tab added to Scope (Intranet)
– Service Excellence Bars distributed across at each
location across the Organization
Message
Be the Change
YOU want to see
in the Organization
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Helpful, Friendly, Courteous &
Kind
Time to Transition…
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Together with our patients, families and communities,
we are creating a special place of Care, Service and Respect
Service Excellence Policy
• Re-evaluated Shared Values
– Added essential values to drive success
• Added Behavioral Expectations
• Included Service Recovery Guidelines
Policy Shared Values
Accountability
Clinical Excellence
Continuous Improvement
Empowerment
Respect
Teamwork
Transparency
Shared Values Definitions
ACCOUNTABILITY As individuals and organization, do what we say we are
going to do….
CLINICAL EXCELLENCE We pursue and deliver clinical excellence on behalf of our
patients, families, referring providers and payers….
CONTINUOUS IMPROVEMENT We endorse the principle of continuous improvement
as the way to make good health care even better….
EMPOWERMENT We empower one another by encouraging initiative….
RESPECT We respect our patients, families and one another with dignity,
compassion and courtesy….
TEAMWORK We honor teamwork. ….
TRANSPARENCY We are open and honest about what we do, how we do it, what it
costs, and how it measures up against our goals and our peers….
Service Excellence Behavioral Expectations
CARE
SERVICE
RESPECT
Provide a personal
touch making each
person feel important
by anticipating their
needs, recognizing
and celebrating their
contributions and
exceeding their
expectations
Take responsibility
for your actions and
behaviors; apologize
and take steps to
correct the problem
Demonstrate positive
intent through
behaviors; make eye
contact and
communicate at eye
level; explain what you
are doing and why in
easy-to-understand
language
Service Excellence Standards & Skills
• Acknowledge others’ presence right away, even when busy.
• Communicate making eye contact and at eye level when appropriate.
• Introduce yourself in person and on the phone; speak with a smile.
• Answer phone calls by the third ring and include your department name and
your name. For external calls include the Hospital name.
• Listen completely before responding.
• Let families and visitors on and off elevators first.
• Help make things more convenient for patients, families and each other.
• Take responsibility to resolve problems.
• Make sure there are no remaining questions prior to leaving patients and
families.
• Close each encounter on a positive note, including a word of thanks.
Service Recovery Guidelines
1.Prevent service shortfalls by using Service
Excellence standards and skills.
2.Recognize when a service shortfall has occurred.
3.Apologize for the experience and inconvenience.
4.Be accountable by taking the necessary steps to
make sure the situation is resolved.
Communication
‘Make Others Feel Important’
Our Skills/Standards At Work
Family Advisory Board Member
Play video
55
Service Excellence Messenger Articles
• Each component of Service Excellence
featured in Messenger Article over the past 2
years
• Readership level of 2,000 considered
successful
• All articles rated 4.5 and higher
– “Rating” is 1 to 5 Scale (1 = Poor, 5 = Great)
– “Votes” is number of employees who rated the article
Service Excellence Messenger Articles
Article
Published
Views
Rating
Teams Use Quality Program for Service Excellence
1-15-12
1,596
4.5
Pull Up a Chair (Same Day Surgery)
4-6-12
3,161
4.9
Service Excellence Keeping a Promise (Ophthalmology)
5-14-12
2,547
4.8
Leah Makes a Patient’s Day
6-7-12
2,114
4.9
Service Excellence Exceeds Expectations
7-25-12
3,334
4.9
I Have an Idea
10-11-12
2,693
4.6
How are We Doing? (Great Job/Ouch-Oops Cards)
1-9-13
2,402
4.7
Service Excellence by the “Teen Clinic Troopers”
1/30/13
2398
4.9
Service Excellence Journey Continues
7/31/13
1826
4.5
Through the Eyes of Those We
Serve
• Engaged Family Advisory Boards and Parents
on Staff
• Employed Transparency Broadly
Service Excellence Every Time?
Family Advisory/Consejo Board Members
Play video
59
Recognition
Recognition
• Expands the opportunity to recognize the
behaviors we want to see across the organization
• Pulls together service excellence recognition
across the organization
• Online Recognition from staff
• Leader Recognition for staff
• Team Recognition
• Through Messenger Articles (incorporates family perspectives)
• Employee of the Month & Year
• Volunteer of the Month & Year
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Performance Enhancement
Performance Enhancement
• I Have an Idea! – Recommendations
• Extraordinary Every Time Recommendation Cards
• Patient and Family Centered Care
– Patient Family Centered Policy
• Moments of Truth
• Guest Services
I Have an Idea Submissions
Through August 2013
• 882 Ideas submitted
• 232 Ideas implemented
• 330 Ideas in process of review
• 155 Ideas not possible at this time (tabled)
• 165 Ideas rejected
Extraordinary Every Time
Recognition Card
65
Service Excellence Good Job Cards
2012
Total: 488
Extraordinary Every Time
Recommendation Card
67
Service Excellence Ouch Cards
2012
Total: 89
Patient & Family Centered Care Policy
PURPOSE:
• To create an environment where the perspectives and
information provided by the patients and families that we care
for are respected and valued by each member of the health care
team.
• To provide the best clinical care that can be delivered when
patients and family are integral partners with the health care
team.
• Applies to all Hospital staff, volunteers and representatives of
Children’s Mercy Hospital and Clinics.
Patient & Family Centered Care Policy
DEFINITIONS:
• Patient /Family Centered Care –Approach to the planning,
delivery, and evaluation of health care grounded in mutually
beneficial partnerships among healthcare providers, patients,
and families.
• Patient and Family Advisors (PFA) –Patients or family
members who have been identified for their ability to
contribute to the provision of care, treatment and services
provided at the hospital.
• Family Advisory Boards (FAB) − Boards made up of families
who are or were primary caregivers of a child who has been
cared for at Children's Mercy Hospitals and Clinics.
Patient & Family Centered Care Policy
DEFINITIONS:
• Family Centered Care Coordinators – Parents who have been
hired by Children’s Mercy Hospital and Clinics to build
collaborative relationships with health care professionals that
reflect and support a culture of quality and safety while
assisting with the enhancement of patient and family centered
care initiatives.
• Family- Together patients and families define their family. The
word “family” refers to persons who are related in any way-biologically or legally.
Patient & Family Centered Care Policy
APPROACH:
• To integrate patient and family centered care through
inclusiveness and partnerships with patients and families as an
ongoing part of daily operations.
• Hospital routinely assesses operating practices by placing
patients and families at the center of decision making.
• All staff recognizes and engages Patient/Family Advisors as
collaborative partners in the planning, delivery and evaluation
of healthcare when serving on hospital committees/work
teams.
Patient & Family Centered Care Policy
PATIENT/ FAMILY ADVISORS:
•Patient/Family Advisors (PFA) will be selected for committee/
work group participation based upon needs and patient/ family
experiences.
•Focus and complexity of the committee/work group will
determine number of PFA’s required. Priority given to work
addressing quality and safety.
•Request and to determine work or to identify an appropriate
PFA contact is made by Family Centered Care Coordinator. They
will train and orient the PFA to Children’s Mercy practices.
Moments of Truth
• Unfamiliar observer reviews processes silently with
families or employees
• Stakeholders gathered to determine ideal process,
review observations
– Plan with the end in mind
• Changes implemented and monitored for
sustainability
• Current process takes to long; New streamlined
process under discussion
Moments of Truth
Employee and Family Shadowing Experiences
• Examples:
– Pilot Shadowing in Cardiology with Families
– Employee Shuttle Bus
– Discharge Family Shadowing Underway
Guest Services
• Implemented through Volunteer Services
• Plans developed to provide anticipated
resources to families/visitors
• First Impressions team assembled to address
common frustrations
Program Structure
Service Excellence Program
• Comprehensive, organization-wide
• Consistent approach and expectations
Required
Education
Fall 2011
• Integrates patient and family-centered approach
• Central source for reporting and driving service
excellence improvement
• Expands recognition of ‘above & beyond’ service
excellence
Service Excellence Program Structure
Service Excellence Steering Committee
Goal: To drive operational improvements with patient experience, employee
experience and community referral provider experience
Responsibilities:
•To Provide oversight of Service Excellence in the Organization
-Surveys, Training, etc
•Focus on Service Excellence Measures for Improvement
•Prioritize and Implement Recommendations made by Employees,
Patients and Families
•Recommend Department/Sections/Individuals for Recognition
•Review Department/Section Service Excellence Efforts
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Patient & Family Experience
Major Stressors for Parents
• Uncertainty regarding child’s condition
• Child’s emotional/behavior changes
• Physical/behavioral characteristics
• Loss of parental control
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Patient Experience
• Focuses on improving all aspects of the patient
experience
– Goal to move towards making every encounter the best
experience every time
– NRC Picker Survey key component
• Considers not only key drivers but highly correlated
questions
• Routine use of performance improvement tool on NRC
Picker site
– Best practices provided from other benchmark
organizations
Patient Experience
• ‘Would You Recommend’ Focus Question
– Continue to monitor ‘Overall Rating of Care’
– Information currently delivered to leaders quarterly
include:
• Stop Light Quarterly Reports
• Key Drivers
• Overall performance by area
• Comments Report
Patient Experience Team
• Team assists with developing activities/messaging
– communicating information/expectations for patient
experience
– Utilize complementary data obtained from other
sources within the organization
Patient Experience Plan
• 2013 focused efforts in patient care areas
– Each area developing plan for improvement on 2 key
drivers or highly correlated questions
– Division Chiefs and Staff Managers will be expected
to make sure information related to patient experience
gets to all providers in the division
– Should emphasize Division/Area focus, that information is going to
make clinic better, let them know where we are doing well/not so well
and improvement approach
– Communicate via medical staff meetings/department meetings and/or
huddles
– Continue to educate staff on use of data and reports
EXTRAORDINARY
Family Advisory Board Member
Play video
88
Employee Engagement
Employee Engagement
• Focus on improving all aspects of employee
experience
– Primarily through personal accountability/awareness
– Use of internal best practices to drive performance
improvement
– Concentrate on Engagement Survey (View Point)
Exemplars and Focus Groups
– Use of brief video vignettes and alternate messaging
– Messaging from Organization Leadership
Employee Engagement
• Focus Group Best Practices Key Areas
– Listening actively/being present
– Supporting/acknowledging and affirming team
members
– Lending a helping hand
– Being responsive/communicating appropriately
– Having open and candid conversations
– Being flexible and outcome oriented
Our Colleagues in Action
Dr. Jim O’Brien
Play video
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Our Colleagues in Action
Steven Blair
Play video
93
Our Colleagues in Action
Myrna Taylor, RN
Play video
94
Employee Engagement Team
• Develops focus agenda
• Makes recommendations on orientation/ ongoing
education information
• Develops and implements most effective
approach to connect with employees
– Videos and/or talking points are shared with
leaders/staff based off real life experiences
• Selects Extraordinary teams
Employee Engagement Team
• Expectations for 2013
– Leaders and staff address behaviors real time for
improvement
– Continue to drive message of personal
accountability
– Incorporate a goal related to the unit level plan
for each employee for their next review
Community Referral Experience
Community Referral Providers
• Focus to improve communication, response
times and access for community providers
• Implement systemic survey to further identify
issues and note accomplishments
• Improve quality of interactions
• Increase accountability of providers
Community Referral Providers
• Survey initiated in Fall 2012
– Overall results favorable but there remains
opportunity for improvement
– Initiating division improvement plans
• Specific projects underway
– 1-800-GO-MERCY enhancement
– Improved communication regarding patients
– Triaging / Streamlining the referral process
Measures of Success
Communication and Monitoring
MEASURING PROGRAM
EFFECTIVENESS
Measures of Success
How We Measure Our Performance
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Quality Reports
Financial Performance Reports
Project Clinic Access
Patient Experience Survey
Employee Engagement Survey
Community Referral Providers Focus Groups /
Surveys
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2
Who We Sample
PEDS Survey
# Unique Sample Units
CG Primary
6
CG Specialty
28
ED
2
Home Health
1
Inpatient General
12
Inpatient NICU
1
OP Testing
2
OP Surgery
3
Urgent Care
4
9/18/2013
103
CMHC Customized Reports
NRC Picker Data
• Many Reports Produced based on area need
– CMHC receives data file monthly with NRC
Picker results
• Highlights of commonly distributed reports
Comment Report-Overview
9/18/2013
105
Comment Report-Detail
9/18/2013
106
Service Alerts
• Upon receipt of a Service Alert from the Patient
Advocate Department managers initiate an internal
review.
• Contact is only made with the family if they have
signed their name or put their phone number in the
comment section.
• After completing the review, findings are reported to
the patient advocate so they may complete the
required documentation.
NRC Service Alerts 2012
Total Service Alerts: 142
NRC Service Alerts by Category
2012
NICU Reports
Would You Recommend
Goal = 90% Positive
• Recommended by the Service Excellence
Steering Committee
• Approved by the Quality Committee & Board
9/18/2013
112
Board Report Card
Board Service Excellence Measures
% answering positively
FY
2013
1Q
2013
2Q
2013
3Q
2013
4Q
2013
Overall Rating
of Care-Top
Score
82%
81%
81%
84%
82%
“Would you
recommend?”
88%
88%
88%
88%
88%
Pain
Management
Aggregate
78%
78%
79%
77%
79%
Data reflected though 8/12/13
FY 2014
Target
90%
FY 2014
YTD
1Q
2014
85%
85%
90%
90%*
75%
75%
% Positive vs Percentile Rank
(Snap Shot of Actual Report)
9/18/2013
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Key Drivers- Current
• CG Primary
– During your child’s most recent visit, did this provider show respect for
what you had to say?
– During your child’s most recent visit, did this provider spend enough time
with your child?
– During your child’s most recent visit, did this provider give you easy to
understand information about these health questions or concerns?
• CG Specialty
– During your visit, did this provider listen carefully to you?
– During your visit, did this provider show respect for what you had to say?
– During your visit, were you comfortable talking with this provider about
problems or concerns you had about your child's health?
Key Drivers- Current
• Emergency
– Do you think that your child received the right treatment in the emergency
room (e.g., tests, diagnosis, medications, etc)?
– How often did you have confidence and trust in the providers treating your
child?
– Did providers spend enough time with you and your child?
• Urgent Care
– Did you have confidence and trust in the provider that treated your child?
– Do you think that your child received the right treatment in this urgent care
facility (e.g., tests, diagnosis, medications, etc.)?
– Were you comfortable talking with the provider about your worries or
concerns?
Key Drivers- Current
• Inpatient General
– During this hospital stay, do you think your child got all the care he/she
needed?
– How often did you have confidence and trust in the doctors treating your
child?
– How often did doctors listen carefully to you?
• Inpatient-NICU
– Do you think that your baby was seen by all the right doctors in the NICU?
– Do you think your baby got all the care he/she needed while in the NICU?
– Did someone on the hospital staff teach you what you needed to know to
care for your baby at home?
Key Drivers-Current
• Outpatient Surgery
– How often did you have enough input or say in your child's care?
– How often did you have confidence and trust in the nurses treating your
child?
– How often did the staff do everything they could to help your child with
his/her pain?
Communication and
Monitoring
Service Excellence Scorecard Measures
Patient & Family
Experience
Overall, how would you rate
the care your child received
at the hospital?
(Goal-96% positive response)
Would you recommend this
hospital to your family and
friends?
(Goal-86% positive response)
Staff was respectful of
culture / lifestyle /
traditions?
(Goal-95% positive response)
Employee Experience
My co-workers treat each
other with dignity and
respect
(Goal-80% positive)
Do employees in my
department with different
cultural perspectives work
well together?
Community Referral
Experience
Referring Provider
Communication
(Goal -90th percent ranking)
Referring Provider Timely
Access/Treatment of Patients
(Goal-3rd available within 14
days with 50% of focus
clinics)
(Goal-year over year increase)
OSHA Reportable Injuries
per 100 employees
(Goal-3.60 OSHA benchmark)
Teamwork Across Units
(Goal-71% positive)
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1
Staff Involvement
• Transparency
– Sharing data openly regarding all areas; including improvement plans
– requiring everyone to use and report on the same tool
• Team Effort
– Effective improvement plans involve a team effort, even those not
involved on the process improvement team need to be informed of the
plan and the intended results
– This increases the likelihood of success for the organization
• Accountability
– Once plans are in place, staff should be held accountable for each of the
plan items and report regularly on progress. When progress is not being
realized as anticipated, take steps to further refine the process
• Over Communicate
Leaders Support Staff in
Attaining New Behaviors
• Rounding to Influence - method to connect
with staff & reinforce / influence positive
behaviors
– Round in the work area routinely to observe first-hand
work performance and provide real-time feedback
– Ask staff for problems. Look for problems. Help
overcome barriers
– Practice 5:1 feedback (5 positives to every 1
corrective)
5:1 Feedback
Why It Works:
• Shows the leader is engaged in and supportive of specific behaviors
• Positive is a more powerful influencer in managing resistance and
building habits (the goal is not to catch someone doing something
wrong)
• Builds a relationship of trust and respect between employees and
supervisors and among coworkers
• Enables individuals to more effectively give and receive corrective
reinforcement for a behavior that needs to be changed
When Providing Corrective Feedback:
• Be Discreet and Respectful...Provide feedback in a private manner
• Be Helpful...The goal of behavior observation is to improve individual and
team performance
Feedback and Human Error
Strong Reward
Systems
Instant Feedback &
Constant Reinforcement
Human Error Rate
300%
200%
100%
5:1 Ratio of Positive
To Negative Feedback
Most effective
in minimizing
human error rate!
Strong Punishment
Systems
BARRIERS & ACCOMPLISHMENTS
Barriers Along the Way
• Spike in scores was not sustainable
• Needed ownership at the point of care and contact with
patients/families
• Accountability of staff; Making it Matter
• Importance to front line staff including providers
• Attendance at training sessions
• Issues with goal of 90 percentile and report set-up
• Acceptance of Change from 75th percentile and color
coding
• Understanding/acceptance of sampling methodology
and response rate
Success/Accomplishments
• When education provided, significant spike in scores
• Used data to support other quality improvement initiatives
– Project Clinic Access
– Performance Reviews
– Incentive Compensation
• Using scores to improve patient experience
• Staff engagement in effort (employee to employee as much
as employee to patients vs community physicians with
employees)
• Patient and family perception of Children’s Mercy
• Community referral provider perception of Children’s
Mercy
Questions?