View Presentation - Patient Experience, Empathy Innovation Summit

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Creating a Successful Transparency Website
to Drive Physician Engagement
Susan Congiusta, DNP, RN, NEA-BC
Northwell Health Physician Partners - New York
Background
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Our Journey
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Decentralized Reports 2012, not Effective
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MD Scorecards, 1st Private Review 2013
momentum with commercial sites like ZocDoc,
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MD Scorecards, 2nd Intranet Postings 2014
Healthgrades, Yelp, Vitals
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MD Patient Experience Committee Feb 2015
Problem is no way to “Validate” transparency of such
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Extensive Communication Plan 2013 – 2015
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Celebrate Successes 2013-2016
Focus on Transparency in health care is gaining
reviews: authentic visit, quantitative validity, no
Patient Sat Reviews Preview Tool
Conclusions
criteria
Who we are
Outcomes
Objectives
1)
Teamwork – Develop a program in form and
function to improve the validity and quality of
physician ratings/reviews
2)
Communication – Establish transparency not just for
the consumer-facing program, but also for our
members on the physician-facing side to provide
and receive feedback;
3)
Innovation – Build both a consumer-facing tool that
had the sophistication of long established,
commercial rating sites, and an innovative internal
platform to allow physicians to preview patient
comments and ratings prior to posting and present
the opportunity to provide input to request an
appeal before their peers.
Transparency Go Live
August 24, 2015
980 Physicians Participate
Over 130,000 Reviews
Over 12,000 Comments
Only 29 Requested Comment Appeals
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Transformation of Care Through Technology ̶
One Patient at a Time
Betsy Stovsky, RN, MSN; Mary Joan Anderson, BSN; Jill Mayock, RN
Sydell and Arnold Miller Family Heart & Vascular Institute
Mission
The Sydell and Arnold Miller Family
Heart & Vascular Institute’s Patient
Resource & Information Center was
founded to empower, educate and
support patients and families
throughout their continuum of care.
Background
The Heart & Vascular Institute’s Resource Nurse Program is
staffed by experienced registered nurses with an average of 20
years’ experience from broad cardiovascular backgrounds.
The nurses offer empathy and expertise to patients with even
the most complex medical concerns.
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PUBLIC Access Phone Line initiated in 2003
PATIENT Access Phone Line initiated in 2011
Requests for information come from patients in all 50 states
and more than 60 countries.
Methods
PUBLIC Access Line provides:
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Information regarding cardiovascular health, diagnostic testing and
treatment options
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Information to help future Cleveland Clinic patients navigate their
care
Information is provided free of charge to both patients interested in care
at Cleveland Clinic and the community at large.
Awareness and direction to additional resources are provided through
custom content available via:
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Interactive Webchats
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YouTube videos
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Blog
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Website, which includes 600 pages of content
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Published educational material
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Patient Access Line
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Initiated to reduce avoidable readmissions
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Improve patient’s satisfaction with Cleveland Clinic experience
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Connects patients to a registered nurse 24/7
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Provides discharged patients and family with education and support
to help them prepare for and transition to home; enhance continuity
of care
Outcomes
Outcomes
In spite of a comprehensive
discharge program, many
patients
have questions
post-discharge.
Satisfaction: Chat Feedback
•
93% rated as Excellent or Good
(national average = 85%)
•
95% stated they would recommend chat to others
PATIENT Access Line
8,600 contacts (6,310 with
complete MRN data)
Timing of calls, post-discharge
36% First seven days
34% 8-30 days
31% over 30 days
31%
Over 30
days
36%
First seven
days
34%
8-30
days
Readmission Rate Among patients who called the PATIENT Access
line with documented MRN (78% of calls), readmission rate was ~
3.2%. [Average all cause hospital readmission rate is ~ 15%.]
Readmission Rate
Contact information for
patient line is given to
all patients at discharge
via:
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Verbal instruction
from their discharging
nurse
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Refrigerator magnet
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Written discharge
instructions
PUBLIC Access Line includes contact with a registered nurse
via:
• Dedicated phone line
• Webmail (secure email system)
• Online live chat
Outcomes
2015 Outcomes/Metrics
28,174 contacts to the Resource Nurse Program
( N = 25,561 in 2014)
PUBLIC Resource Access
19,574 contacts, resulting in 7,337 appointments (37%) and 5,738 visits (29%)
1430
1214
919
428
Medications
Key Findings
Care
Follow-up
Coordination appointments
and
questions
Education
about
plan of
care
Pain
control
PUBLIC Access Line empowers patients by:
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Providing emotional support
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Helping patients make informed decisions that result in
patient autonomy
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Providing education
Satisfaction rates are high, according to chat survey and
anecdotal notes
PATIENT Access Line provides support throughout continuum
of care by:
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Providing a dedicated line of communication
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Providing resources to assist patients and families with
the transition of care
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Streamlining data collection and reporting to guide
institute-wide efficiency and process improvement
Testimonials
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“You are just so helpful. No one in Arizona knew what
to tell me. It’s nice to know that I can call Cleveland
Clinic to get the answers to all of my questions.”
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“You have no idea how much this has helped me and
put my mind at ease.”
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“I have learned more from you than I did from either of
my own doctors.”
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“You make it so pleasant and so easy. Thank you!”
Patients may continue to use the online chat function to interact with a
registered nurse, as well as MyChart, a secure
internet-based communication tool.
Methods
Top 5 Caller Issues
1691
Satisfaction: HCAHPS
•
Patient satisfaction in the
OVERALL
RECOMMEND CC
RATING
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Heart & Vascular Institute is
HVI - CC Only
88
91
currently high, according to
MRN Match AND
89
92
Call <= 30 days
HCAHPS scores
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650 patients who called the
PATIENT phone line within 30 days of visit had an increased overall
score and would recommend the hospital to others.
Process Improvement Initiated
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Identify needs and modify discharge instructions and
education materials based on individual needs
•
Home recovery section added to website to address top
reasons for contact
•
Ongoing review of calls has helped streamline triage
protocols to identify urgent and non-urgent needs
•
Implemented projects have: Improved use of TED
stockings, enhanced medication compliance, improved
pain management, and initiated processes for care
coordination with various patient populations.
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Shaping the Future by Bridging Silos &
Building Relationships
Northwell Health
Office of Patient & Customer Experience & Shared Work Team
About Northwell Health
Action / Method
Valuing the “Voice”
Conclusions / Key Findings
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Office of Patient & Customer Experience sponsored a PFPC
Shared Work Team.
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Listening and valuing the “voice” of our patients and families is
the foundation of our patient/customer experience strategy
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Partnership with patents and families is essential.
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GOAL: Develop Patient & Family Partnership Councils standards
by exploring internal and external best practices.
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Patient & Family Partnership Councils fuel a patientfamily centered culture by influencing future care
delivery.
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TEAM: Employee and patient/family representatives from 7
hospitals and 1 service line served on the Shared Work Team.
Northwell Health PFPC Mission Statement:
The Patient & Family Partnership Council is a group of patients,
families, caregivers and healthcare professionals committed to
working collaboratively to enhance the health and well-being for
the people and communities we serve.
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STRUCTURE: The Shared Work Team focused on:
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Recruitment, Vetting & Tenure
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Bylaws
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Meeting Planning & Facilitation
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Partner Participation & Subcommittees
Having a dedicated, passionate shared work team led
to the creation of the Toolkit. They valued the
opportunity to hear and act on the “voice” of our patients
and families. Their commitment made this project
successful, enjoyable and it strengthened collegial
relationships.
•
PFPCs are part of the Northwell Health cultural
transformation.
Outcomes
Patients/Families as Partners
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Organization priority to enhance patient and family
experience.
Northwell Health values patients/families as partners in
care delivery.
2015 - Northwell Health Office of Patient & Customer
Experience performed a current state assessment of
Patient & Family Partnership Councils (PFPCs)
throughout the organization.
Findings include:
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Pockets of excellence existed
Hospital PFPCs varied in mission & focus
7 out of 21 hospitals had a functioning PFPC
No cohesive approach from an organizational
perspective
Antiquated corporate PFPC existed but it did not reflect
the community served
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Northwell Health PFPC
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Core Values
Collaboration
Advocacy
Respect
Effective Communication
Northwell Health PFPC
Creation of the “Northwell Health Patient & Family Partnership
Council Toolkit: Creating & Sustaining an Effective Council.”
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12/2015 - Northwell Health corporate PFPC restructured
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New Structure
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Shared Governance Model
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Members
Patient & Family Partnership Councils are powerful.
Organizations must listen and value the “voice” of
patients, families and customers.
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The Shared Work Team model is useful in executing a
targeted initiative / project
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The PFPC Toolkit can be transferrable to other
organizations with multiple sites and locations in order
to create a consistent PFPC structure.
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The Northwell Health PFPC Toolkit may be used when
establishing, maintaining or reinvigorating local or
corporate PFPCs.
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Toolkit was disseminated to all sites/service lines.
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Goal: Every Northwell Health hospital to have a site PFPC by
end of 2016.
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Toolkit outlines:
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Importance of partnership
Readiness Assessment
Implementation Timeline
Council structure
Recruitment
Membership
Orientation & On-boarding
Tenure
Bylaws
Meeting logistics
Sustainment methods
Evaluation tools
Templates & FAQs
Transferability
Sponsor: Office of Patient & Customer Experience
Site leader representatives (coordinates site PFPC)
Site patient/family representatives (member of site
PFPC)
7 Hospitals; 1 Service Line
Meeting Format
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Peer Learning / Sharing Best Practice
Topic of the Month / Content Expert Presentation
Discussion & Open Forum
Quarterly Meeting
Shared Work Team:
Executive Sponsors: Sven Gierlinger & Agnes Barden
Northwell Health Members: Kathleen Attonito, James Baker,
Ann Marie DiFrancesca, Nicole Giammarinaro, Karen
Gleason, Maria Hale, Cheryl Miranda & Michelle Rossetti
Patient & Family Members: 7 local PFPC patient/family reps
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