1. Working Together to Work Wonders. Patient Satisfaction Optimization Linda Shin, MPH Clinical Safety & Effectiveness

2. Working Together to Work Wonders. Team Members Sponsor: Randy Urban, MD Astrud Leyva, MD Beverly Mizell, RN Corrin Le Vasseur, MPA Deven Barriault, RN Jennifer Zirkle, RN Linda Shin, MPH Lindsay Sonstein, MD 2

3. Working Together to Work Wonders. Background UTMB measures patient satisfaction levels using Press Ganey surveys Patient satisfaction optimization team reviewed past Press Ganey survey results and identified “Blood Draw” as an area in need of improvement 3

4. Working Together to Work Wonders. What Were We Trying To Accomplish? Aim Statement Increase patient satisfaction mean scores by 1.0 point for the Press Ganey question, “the courtesy of person who drew blood’, for units 9D (Transplant) and 10C (Acute Care for Elders) for July and August 2010. 4

5. Working Together to Work Wonders. Baseline: Acute Care For Elders (ACE) Unit 5

6. Working Together to Work Wonders. Baseline: Transplant Unit

7. Working Together to Work Wonders. Process Mapping

8. Working Together to Work Wonders. Flow Diagram

9. Working Together to Work Wonders. Fishbone Diagram

10. Working Together to Work Wonders. Brainstorm Met with the stakeholders o Nursing Staff o Lab management o All inpatient phlebotomists Reviewed and analyzed patients’ comments included in Press Ganey survey results Multiple list serve queries o University Hospital Consortium o American College of Healthcare Executives

11. Working Together to Work Wonders. Matrix of Possible Interventions

12. Working Together to Work Wonders. Project Plan 1.Tent cards (English and Spanish) 2.AIDET training for phlebotomists (Acknowledge, Introduce, Duration, Explanation, and Thank You) 3.Patient education 4.Coordination of vital signs and blood draw on ACE unit

13. Working Together to Work Wonders. Secondary Interventions 1.Tent Cards Added a note for patients to score us on Press Ganey Laminated the cards Housekeeping, patient advocates, and unit nursing staff were all involved in keeping the tent cards at the patients’ bedside 2.Patient education was provided during the admission process

14. Working Together to Work Wonders. Results – ACE Unit (92.50) mean = 86.66 mean = 90.26

15. Working Together to Work Wonders. Results – Transplant Unit (80.71) mean = 88.51 mean = 85.42

16. Working Together to Work Wonders. Discussion We found significant differences in the outcomes at these two units. One of the contributing factors was the differences in the patient population. Another may be that the transplant unit was less frequently staffed by UTMB nurses. For future patient satisfaction initiatives, it will be important to have representatives from each specialty to arrive at best solutions and improvement initiatives.

17. Working Together to Work Wonders. Barriers And Challenges More agency nurses than expected worked on the Transplant Unit Tent cards were thrown away Coordination between PCTs and phlebotomists was not always feasible Delays in obtaining reliable Press Ganey survey results

18. Working Together to Work Wonders. Next Steps Work with UTMB Organizational Effectiveness, Training, and Recognition department to continue AIDET training for all inpatient nurses and new phlebotomists. Work with Patient Services to create appropriate signs/posters for each unit to increase the number of returned surveys. Provide in-service for nurses to educate patients regarding phlebotomy. Recommend to laboratory operations to utilize a standard schedule for phlebotomy activity and to coordinate with other morning activities at each unit.

19. Working Together to Work Wonders. Return On Investment Year 1 Costs$21, 179 * Benefit*--- Annual Net Benefit($21,179) Cumulative Benefit($21,179) *Satisfaction leads to patient loyalty, and increased loyalty is the single most important driver of long term financial performance. Jones and Sasser **More frequent blood draws may lead to lower satisfaction level and higher cost

20. Working Together to Work Wonders. Conclusion We CAN improve our patients’ satisfaction! Hospital stays are full of surprises and it is important to let patients know what to expect during their stay. Institutions may need specialty- and patient population- specific initiatives to address patient satisfaction.

21. Working Together to Work Wonders. Acknowledgment Susan Seidensticker Lab Management:  Bert Nash  Ricardo Segura  Theresa Friloux Patient Advocates  Tony Armenta  Jeanette Mancha Phlebotomy Team Transplant and ACE unit staff Environmental Services OETR  Bob Scott and Martha Livanec

22. Working Together to Work Wonders. Questions? “To improve is to change. To be perfect is to change often.” - Winston Churchill