Value Based Purchasing The Volunteers’ role in the Patient Experience Mary Theobald Director, Patient & Guest Relations Volunteer Services

National Attention Our Call To Action

Measuring the Perception of Patients How do we do that? HCAHPS Consumer Assessment of Healthcare Providers and Systems Produce comparable data for public reporting Create incentives for hospitals to improve Enhance public accountability and transparency

Surveys done by mail or phone Patient completes survey Surveys returned to Vendor Surveys scanned and data entered into database Reports generated Send data (patient files) to Vendor Data uploaded The Survey Process

HCAHPS Dimensions Eight HCAHPS dimensions included in VBP: All HCAHPS dimensions weighted equally within the Patient Experience of Care (HCAHPS) domain Communication with Nurses Communication with Doctors Responsiveness of Hospital Staff Pain Management Communication about Medicines Cleanliness & Quietness of Hospital Environment Discharge Information Overall Rating of Hospital

The HCAHPS survey consists of 27 questions:  16 evaluative questions about patient care:  14 never/sometimes/usually/always.  2 yes/no.  2 global ratings:  0-10 scale.  4 point scale: Definitely No to Definitely Yes.  4 screening questions.  5 demographic questions (About You). Current Survey Questions

Reporting Based on “Top Box” What is “top box”? H-CAHPS Scales AlwaysUsuallySometimesNever Definitely YesProbably YesProbably NoDefinitely No YesNo

Five new questions: ▫ Three care transitions questions. ▫ Two demographic questions. Voluntary use beginning with July 1, 2012 discharges. Mandatory use beginning with January 1, 2013 discharges. New: HCAHPS Voluntary Questions

New: Care Transitions Questions Voluntary use beginning with July 1, 2012 discharges. Mandatory use beginning with January 1, 2013 discharges.

New: Demographic Questions Not publicly reported Evaluated as part of the patient-mix adjustment

Performance and payment reductions: How is my hospital evaluated? Achievement, Improvement and Consistency (30%) ▫Achievement pts gained when performance period score is above the Achievement Threshold ▫Improvement pts gained when hospital’s score improves from the baseline period to the performance period ▫Consistency pts gained when the hospital’s lowest HCAHPS score is above the Achievement Threshold Your organization’s score = reimbursement Schedule for further reduction in DRG payments: FY % FY % FY % FY % FY %

VBP FY 2013 Performance standards

HCAHPS VBP Timelines Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q FY 2013 Baseline Period FY 2015 Baseline Period © 2012 Press Ganey Associates, Inc. FY 2014 Baseline Period FY 2013 Performance Period FY 2014 Performance Period FY 2015 Performance Period

Lack of Communication is #1 Complaint Dr. was very busy with phone calls & could have listened to me a little better I waited for treatment in the waiting room for hours. A lot of people came after me that were called 1 st. There are exceptions but this is ridiculous! The lady who took my blood never introduced herself to me, she poked me-missed then poked a second time. It hurt and she never said she was sorry. The staff let us know that there was a 3 car accident & that they were having critical patients coming in so they would get to my son as soon as they could and apologized.

New Volunteer Program - ED How can volunteers help to improve the Patient Experience?

DVS - Begin communication with key players Begin conversations with your VP of nursing and ancillary departments to let them know you have a valuable resource that can enhance the patient’s experience Find out what the current focus is for their departments Very important that you align yourself with what other departments are doing Ask to be a part of Patient Experience Committees

Educate Yourself Ask for copies of the Patient Satisfaction surveys Familiarize yourself with the questions Ask for access and training to the vendor’s database Search for comments related to the volunteers Ask that a question pertaining to the volunteers be put on the survey

Educate Your Volunteers Put together an In-service oVolunteers should be educated on the Patient Satisfaction surveys, the HCAHPS component and what it means to your hospital. oGo over each component of the survey with them. oMake sure they know that the data collected from patients is the patient’s perception of how their hospital stay was. Invest in customer service and communication training

Communicate We all want to empower our volunteers, but make sure you have shared your ideas with your colleagues and get their “buy in” before your volunteers take the reign. ▫Example-If you want them to pay particular attention to the environment and would like the volunteer to make the call to EVS, make sure the director of EVS is agreeable to it as well as the director of the unit.

Volunteers Must…. Smile Make eye contact Greet patient with appropriate name and title Actively listen to patient, repeating things back so they know you are paying attention Demonstrate compassion Demonstrate customer service standards set by the hospital Ask if there is anything they can do for the patient when leaving the room or leaving for test or treatment The volunteer that wants to tell their “stories” to the patient and/or unable to demonstrate your hospital’s core values should not be part of your team

Volunteers are vital members of the caregiver team Volunteers personalize and humanize a patient’s hospitalization Increase the numbers of volunteers on the frontline ▫Answering call lights and taking care of the non- clinical requests ▫Taking the needs of the family into consideration ▫Rounding on patients and writing something personal on the patient white board that they would want their care team to know

Roving comfort or caring carts Concierge program ASSIST Program ▫Arrange lodging ▫Companionship ▫Provide information about the area

What Message Are We Sending Behavior vs. Intent