Six ways to keep patients in focus, and focused

Oct 31, 2016

Linking quality outcomes to financial incentives is a key part of the federal government’s movement to value-based care. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a federal reporting program designed to provide incentives for hospital performance across a range of quality metrics, which providers operating within MSSP ACOs know very well.

High-performing providers and systems receive a quality bonus, while poor performing organizations incur a penalty of up to two percent of their total annual CMS benefits. Operational processes and the service provided are important in achieving strong HCAHPS scores, but one of the most important factors is patient satisfaction.

Healthcare providers understand the need to be more transparent and patient focused. A study from Vocera revealed that 64 percent of healthcare professionals state that their organizations value patient satisfaction just as much as they do patient safety and clinical workflow improvements. But, there are six critical things to consider when it comes to quality goals and patient interaction.

1. Build a culture of shared accountability. Promoting a positive patient experience is dependent on an organization’s culture. During a recent Beryl Institute conference, leaders highlighted the importance of culture on the patient experience. In fact, certain studies back the claim that a culture of patient-centered achievement can help facilitate more efficient use of resources too.

Providers are responsible when it comes to making technologically informed decisions that helps drive enhanced patient access to care. Adopting an integrated call center, making better use of voice response technology and offering 24/7 web portal services are some ways to make things more convenient for patients.

And speaking of culture, consider reviewing a recent book entitled The Culture Cure: Transforming the Modern Healthcare System (2016) by Pamela Tripp. In it, Tripp discusses foundational principles for employee accountability around patient satisfaction (culture/work environment), financial responsibility and compliance all tied to the leadership and culture within an organization. She recommends an environmental assessment tool and the foundational principles for setting up the roots of a transformative organization.

2. Don’t forget the human element. There is no silver bullet in HIT. It would be naïve for providers to think that better ratings can be driven by mechanical processed and forget about human elements that make a big difference in high tech environments. A study from Massachusetts General Hospital suggests that 65 percent of patients perceive their care as high quality when the provider shows them empathy. Alexandria Hospital in Virginia improved their HCAHPS score from 72 percent to 88 percent in the 2015 aided by interventions that encouraged providers to sit with patients at their bedside, better use body language and pay closer attention to eye contact.

Additionally, it would help providers to couple up HCAHPS data with readmission rates and clinical quality scores. Research finds that one in every five patients discharged from the hospital experiences adverse events and it is important for hospitals to follow up, find the causes behind these readmissions and reduce them.

3. Focus on the impact zones. Making impact zones, or weak areas of clinical improvement, and priority for improvement, can really help providers achieve the required levels of consistency. Patients shouldn’t assume that 5-star hospital ratings equate to the best HCAHPS Rating. Some important areas that providers should pay attention to in the hope of negating negative consequences include:

1. Professional Liability Risk: It has been well researched and documented that patient satisfaction is tied to reduced liability risk.
2. Hospital Competition: HCAHPS gives hospitals an accurate preview of how well they are performing in comparison to their peers. Patients are attracted to a hospital that has higher impact of patient satisfaction scores.
3. Attractiveness of Care Staff: Talent Plus Research conducted a large study to determine why there was so much inconsistency in HCAHPS within different units and shifts for their clients. They found that the lowest performer on a given team had a significant correlation to low HCAHPS scores.

4. Don’t underestimate the importance of a hospital’s impression. Providers can’t discount relevant factors that contribute to the way patients think about their organizations. Chief amongst those is the timeliness and ease of communication. Better decision making with regards to the use of technology can also play a useful role in improving nursing care. Reducing noise and creating an atmosphere that promotes a sense of community really helps patients feel cared for and understood. Lee Memorial Health System’s Cape Coral HCAHPS scores rose from 57 to 68 percent by creating a physical environment that supports patients, families and community. It includes exercise stations, garden and spaces for quiet relaxation open to the public.

5. Understand that every interaction matters. Communication is the biggest HCAHPS survey area. Some of the drivers cited that influence good patient satisfaction ratings are that the patient feels they are being treated with respect and are being listened to by physicians and nurses. It also helps to have the executive management lead from the front and regularly meet staff to discuss work and safety issues. Some of these recognized hospitals have consistently been associated with superior patient outcomes, including lower patient mortality and higher nurse job satisfaction.

6. Clarify care roles and management objectives. Based on HCAHPS test data, the nurse communication section has the highest impact on patients’ overall hospital satisfaction and likeliness to recommend the hospital to others. Communication gaps could lead to serious decreases in quality of care. Other useful management driven strategies that organizations could adopt include the following:

1. Physician compacts are being used by hospitals to re-engage physicians in a collaboration of providing care to the community with set values.
2. Education on strategies to further improve practice may enhance ability to achieve HCAHPS benchmarks. These strategies could be molded by pertinent patient inputs that reflect their own perceptions of physicians.
3. Peer review processes that help educate providers and improve patient satisfaction. According to NewsRx, research stated that skilled physician communication is a key component of patient experience.