1. Quarterly Educational Webinar September 10, 2015 1:00 pm (CDT) Sponsored by: Finding the pulse of your business Thank you for joining We will begin at 1:00 PM CDT

2.  Attendees are on ‘mute’  Allow time for questions at the end  Click on the ‘chat’ button Housekeeping

3. Today’s Objectives  Analyze updated trends in HCAHPS  Getting the most out of eMed surveys  HCAHPS Observations and Recommendations  Outpatient and Ambulatory Services (OAS CAHPS)  Emergency Department Patient Experience of Care (ED PEC)  Open for comments

4. HCAHPS Top Box Scores OCT ‘13 – SEPT ‘14

5. Revised: July 15, 2015 * www.hcahpsonline.org 50th 75th 90th

6. Revised: July 15, 2015 * www.hcahpsonline.org

7. Revised: July 15, 2015 * www.hcahpsonline.org

8. Revised: July 15, 2015 * www.hcahpsonline.org

9. Revised: July 15, 2015 * www.hcahpsonline.org

10. Revised: July 15, 2015 * www.hcahpsonline.org

11. Revised: July 15, 2015 * www.hcahpsonline.org

12. Revised: July 15, 2015 * www.hcahpsonline.org Only 4% gap between 50 th and 90th

13. Revised: July 15, 2015 * www.hcahpsonline.org

14. Revised: July 15, 2015 * www.hcahpsonline.org

15. Revised: July 15, 2015 * www.hcahpsonline.org

16. * www.whynotthebest.org [retrieved 7/22/15]www.whynotthebest.org HCAHPS “Highly Satisfied” July 13 – June 14

17. eMed Survey Reporting Tool

18. eMed Survey Reporting Tool*  Provides snapshot regarding the patient’s experience for:  HCAHPS, Home Health, Emergency Department or Outpatient Services  Available in real-time upon completion of surveys  Able to trend monthly, quarterly or annually  Query – Analyze multiple levels of data on demand * JLM Proprietary Database

19. Getting the most out of eMed reporting 1. Run high level reports to identify trends or areas for improvement 2. Utilize Top Box and Monthly reports to drill down further to discover areas of concern 3. Share information with staff and develop action plans based on findings

20. Story of AnyHospital USA  AnyHospital USA wants to evaluate their HCAHPS scores and see where there is room for improvement  Need to run reports and analyze the data on a number of levels  Run eMed survey reports to accomplish this  CMS HCAHPS National Comparison  Data Summary (Trending)  Top Box HCAHPS by Area  Top Box HCAHPS by Facility (System)  Query for further analysis

21. Login to client site https://www.emedsurvey.com Client Login: 1.Login to https://emedsurvey.com 2.Enter Username and Password (contact JLM if you do not have a username assigned.

22. Login to client site https://www.emedsurvey.com Client Login: 1.Login to https://emedsurvey.com 2.Enter Username and Password (contact JLM if you do not have a username assigned. 3.From this page, you can decide to select “Reports” or run a query from the database.

23. Running Reports https://www.emedsurvey.com Client Login: 1.Login to https://emedsurvey.com 2.Enter Username and Password (contact JLM if you do not have a username assigned. 3.From this page, you can decide to select “Reports” or run a query from the database. 4.Select type of report you want to run (CMS HCAHPS, HHCAHPS, Patient Satisfaction, etc)

24. Report Examples https://www.emedsurvey.com Client Login: CMS HCAHPS National Comparison 11 HCAHPS Composites Compares your hospital against the National Rankings (50 th, 75 th, 90 th ) CMS Mode adjusted Color coded for easy identification Identified below national average in “Communication Medications” composite

25. Report Examples https://www.emedsurvey.com Client Login: Data Summary with Trending Displays individual measures for each composite Trend by: Decimal, Percent (Average) or Top Box format Trend up to 12 months

26. Report Examples https://www.emedsurvey.com Client Login: Data Summary with Trending (cont’d) Displays each measure individually Identifies Trends Performing lower in “describing side effects”

27. Report Examples https://www.emedsurvey.com Client Login: Top Box HCAHPS Areas Breaks down HCAHPS scores by unit or location Identify largest areas for improvement Top Box scoring By area shows lower scores in Post Partum and 5 th floor

28. Report Examples https://www.emedsurvey.com Client Login: Top Box HCAHPS Facility Report Compare hospital scores across the system Specific to hospital or system Collaboration A B C D E F

29. Report Examples https://www.emedsurvey.com Client Login: Weighted Response Summary Previously known as “Top Box” report Displays question percentage scores for each type of response Very Poor Poor Fair Good Very Good Works for Inpt, ER, Outp

30. Report Examples https://www.emedsurvey.com Client Login: Quarterly Benchmark Displays Quarterly Data compared to the JL Morgan DB Based on “weighted average” decimal scores 1-5 scale Trends up to 4 quarters

31. Queries https://www.emedsurvey.com Client Login: Filter Data Select the question you want to drill down on further “Overall Rating” Search for “7” or “8” “What prevented a “9” or “10”? Run Query Analyze Results Could this be a result of scoring poorly with “Response to call button”?

32. HCAHPS Observations

33. Opportunities for Improvement*  Drill down on ‘missed opportunities’  Overall Rating – 7/8  Would NOT recommend  Account for 10 – 15% decrease of overall HCAHPS scores  Evaluate “Usually” responses  Easier to move than “Sometimes” or “Never” * Results may vary for your organization

35. Patient Satisfaction Drivers Responsiveness Pain Management Discharge Instructions Doctor / Nursing Comm. Technology Education Policies & Procedures

36. Tips for Improving Patient Satisfaction  Patient Education  Educate patients on the purpose and possible side effects of taking their medicine  Easy to understand – majority of patient’s surveyed only graduated high school or less 4 years college  Limit discharge instructions to one-page bulleted color page  Nursing / Staff Education  Address patients and their family about their health care needs during discharge  Review response to call button policies  Constantly monitor patient’s pain control  Evaluate trends to move the ‘usually’ to ‘always’ responses * www.hcahpsonline.org

37. Outpatient and Ambulatory Services (OAS) CAHPS JANUARY 2016

38. OAS CAHPS  Designed to measure the experiences of care for patients who visited a Medicare-certified hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs) for a surgery or procedure.  Produce comparable data on the patient’s perspective that allows objective and meaningful comparisons between HOPDs and free-standing ASCs on domains that are important to consumers.  CMS plans to implement a voluntary national reporting program starting in January 2016.

39. Participation Requirements  CMS will provide guidelines for survey administration similar to those implemented on other CAHPS surveys.  CMS-approved survey vendors will administer the survey on behalf of HOPDs and ASCs and submit the data to RTI International.  RTI International will analyze the data; subsequently the results will be publicly reported on a CMS website.

40. About the Survey Areas measured:  Communication and care provided by health care providers and office staff  Preparation for the surgery or procedure  Post-surgical care coordination  Patient-reported outcomes Three modes will be tested:  Mail, telephone, mixed (mail / telephone f/u)

41. Next Steps  J. L. Morgan has applied to be a certified OAS CAHPS vendor (Oct15)  Continue to monitor JLM and OAS website for more information as it becomes available More information: https://oascahps.orghttps://oascahps.org

42. Emergency Department Patient Experience of Care (EDPEC) UPDATED JULY 2015

43. ED PEC  Formerly EDCAHPS (Now Patient Experience of Care or EDPEC)  Will provide patient experience data that enables comparison of EDs across the nation and promotes effective communication and coordination.  CMS will undergo a feasibility test for the first quarter (Jan- Mar) 2016 discharges.  Test the impact on response rates of four novel data collection methods compared to standard data collection strategies.  There is no fee to participate in the test.

44. Survey Instruments  Discharged to Community: 35 questions regarding ED experience, plus 18 questions regarding the respondent’s characteristics  Admitted Stand Alone: 29 questions regarding ED experience, plus 18 questions regarding the respondent’s characteristics  Admitted HCAHPS Add-on: 10 questions regarding ED experience that should be inserted into a full HCAHPS instrument, using the most recently available version of the instrument, immediately preceding the “About You”

45. Modes Tested  An online survey  An online survey with e-mail notification of survey availability  Email notification of an online survey with mail and phone follow-up  An in-ED distribution of a paper and pencil survey with option to complete and return by mail or to call in to complete the survey via telephone

46. Participation  Hospitals can NOT volunteer for field test  Over the next several weeks, CMS will send out approximately 75 letters to hospitals notifying them that they have qualified for the feasibility test  J. L. Morgan & Associates will work with RAND to ensure all requirements for participation are met  Visit https://www.cms.gov/Research-Statistics-Data-and- Systems/Research/CAHPS/ed.html for more information Visit https://www.cms.gov/Research-Statistics-Data-and- Systems/Research/CAHPS/ed.html

47. Resources www.hospitalcompare.hhs.gov www.hcahpsonline.org www.whynotthebest.org

48. * www.hcahpsonline.org/SummaryAnalysiswww.hcahpsonline.org/SummaryAnalysis

51. Contact Us: J. L. Morgan & Associates 7057 Meadowlark Drive| Birmingham, Al 35242 205-995-4226 | Fax: 205-995-7141 www.Jlmorganandassociates.com Jeff Morgan, President 205-408-8774 Office Jeff.morgan@jlmassoc.com Jay Bishop, MSHA, CPHQ, COO 205-995-7108 Office Jay.Bishop@jlmassoc.com Tanya Harris-Haynes HCAHPS Manager 205-995-7144 Office tanya.harris@jlmassoc.com Wendy Dew Programs Director (Preventative Care / Pat Sat) 205-995-7107 Office Wendy.dew@jlmassoc.com Latrice Lawson Data Manager 205-995-7139 Office Latrice.lawson@jlmassoc.com

52. Thank you for your time! For more information, please visit www.jlmorganandassociates.comwww.jlmorganandassociates.com