Editor’s Note: This report is based on a 2018 Healthcare Analytics Summit presentation given by Amy Triola, Director of Patient Satisfaction, Wolff Center at UPMC, and Jody Madala, MPA, Senior Product Manager, UPMC Enterprises entitled, “Proactive Patient and Leadership Engagement Delivers an Improved Care Experience.”
Healthcare is a thriving industry, but its constant evolution has many healthcare organizations in flux. Faced with challenges, such as mergers and acquisitions, legal mandates, and changing patient populations, many health systems struggle to maintain patient satisfaction and keep employees and leadership happy and engaged. With some reimbursements tied to performance, including patient satisfaction ratings, organizations must improve patient satisfaction or take a hit to their bottom line. Making improvements requires creating a culture that focuses not only patient satisfaction, but on employee satisfaction and engagement as well.
While there’s no magic elixir that boosts HCAHPS scores, healthcare organizations are leveraging technology and data to modernize work already being done, build consistency into workflows, increase transparency across the organization, and drive culture change that improves patient care, and in turn, increases patient satisfaction.
Change initiatives flounder when organizations aren’t culturally ready for them. Any organization has the capacity for change and improvement, but successful quality improvement initiatives require high-level alignment about which goals are important and how to reach them. Focusing on these three action items moves organizations from goal setting to goal attainment:
Getting goals aligned is a process. Answering several questions can help healthcare organizations home in on goals:
The answers provide leadership with a framework for culture change and improvement initiatives that sets the stage for developing strategic goals.
Developing goals that filter down from executive leadership to the front line staff requires aligning those goals at the system, business unit, and department levels. Job descriptions, performance reviews, and individual leader goals should also be aligned. Every person within an organization should understand how to thrive in a culture of service excellence, and leadership should ensure staff have the tools necessary to accomplish individual and systemwide goals.
An accountability team helps organizations focus on goals and improvement activities. The first job of an accountability team is to evaluate goals for alignment with an organization’s mission and make necessary adjustments to ensure all goals move the organization forward. For example, if the overarching goal is to improve patient satisfaction, an accountability team may ask whether all departmental and individual goals work together toward that mission.
Just like improvement work never stops, accountability must be ongoing. Continual learning should be an accountability team’s mantra. Throughout change initiatives, the team should evaluate the effectiveness of different approaches and share best practices across departments, implement a means to measure and validate improvement, and align HR systems and processes to initiate and sustain culture change.
An important aspect of accountability is communication. All leaders should meet regularly with direct reports, both giving and receiving feedback. This helps leaders understand what’s going on with front line staff and how improvement initiatives are progressing, and it encourages ongoing accountability.
One way to encourage open communication is to embed rounding in care processes. Effective rounding—both at the beside with patients and with employees—improves communication and outcomes and manages patient experiences on the front end by giving staff the information they need in real time to meet patient expectations.
Rounding provides insights into strengths and weaknesses and patient and employee perceptions that can inform and drive quality improvement initiatives. Rounding also gives leaders information about lapses in nurse-patient communication, which highlights where to focus training and education efforts that align with departmental and organizational goals.
Improved rounding leads to improved communication, which leads to improved care, which ultimately leads to improved patient satisfaction. And technology to improve rounding is gaining ground in care settings.
Technology often makes healthcare better. This is true in medical practice (robotic surgery improves outcomes) and in the business of healthcare delivery (analytic software helps improve quality). And many healthcare organizations are leveraging technology and data, including rounding technology, to drive culture change.
Choosing the right tools is essential. Rounding technology should integrate seamlessly into existing nursing workflows. If it impedes patient care or consumes too much of the front line providers’ time, it won’t be effective. But with technology that enhances workflow and improves patient care and outcomes, leaders can build a proactive and accountable patient care environment and bolster teamwork throughout the organization.
Web-based survey tools for phones, tablets, and other hand-held electronic devices used during rounding drive culture change through customized and simplified patient engagement and enable personalized, compassionate care at every step in the patient journey. Rounding technology also enables a standardized approach to rounding so questions to patients are consistent.
Specifically, rounding solutions put plans of care, bedside shift reports, and whiteboard compliance information into one place where it’s easy to access. Additionally, these solutions provide a way to efficiently evaluate nurse-patient communication and leverage patient provided information to measure performance, encourage accountability, and align engagement efforts and quality initiatives.
For rounding tools to work effectively, staff must be able to use the tool and understand the data generated. A rounding tool dashboard displays data gathered from the rounding tool and elsewhere—both within and outside of the organization. The data that fuels the dashboard allows staff to see work and progress in near real time and provides benchmarking information so staff can compare their outcomes both internally and externally.
Organizations can customize dashboards to provide only the data needed to improve care. Dashboards can have several tabs, like a summary page, interview notes, interview analysis data, rounding activity detail, percent of patients rounded, and trending keywords. Each of these tabs contains different views of data. For example, as in Figure 1, a trending keywords page might display chosen keywords, like medication or pain, and the instances of those keywords. A line graph on the page might display how the keywords have trended over time, giving insight into patient care and satisfaction in specific areas, such as pain management.
A dashboard also aligns rounding information with other data, such as costs and quality scores, to show the impact of rounding over time.
Technology that shares organizational objectives makes improvement easier. To be effective, rounding technology should focus on process innovation to enhance patient care by creating an engaging user experience and leveraging robust data while integrating with current workflows. A dashboard fed by data reports performance, which provides unbiased accountability. It encourages transparency that drives culture change.
Data driven rounding technology also gives leaders vital information to measure outcomes and guide change. Creating a discipline around listening and communicating builds transparency and accountability into the rounding process.
Rounding isn’t just for patients. Leaders should also round on employees, truly listening and seeking feedback. When employees feel heard and seen, employee satisfaction improves, and employees are happier. Studies show that when employees are happy, patients are happy. According to a Health Affairs article published in 2011, environments that support nurses lead to better care, and an unhappy work environment can lead to lower HCAHPS scores. The first key to successful rounding is to listen. Patients and employees can provide vital feedback that improves care.
While rounding technology doesn’t guarantee happy employees or patients, it does benefit patients, caregivers, leaders, and entire organizations. Bedside rounding technology empowers patients to maximize their hospital experience through consistent interaction with hospital employees. It provides caregivers access to real-time census and patient satisfaction data and allows them to monitor and prioritize patient needs. And it gives leaders insights they need to be proactive in improving the care environment.
Keeping patients and employees satisfied is a challenge for all health systems, especially when organizations are growing and changing, and when satisfaction wanes, finances take a hit. To combat this problem, health system leaders are looking to technology to enhance their processes and improve satisfaction and outcomes.
Technology at its best gives leaders an edge. Rounding technology supports good communication and encourages positive shifts in culture and transparency, and that boosts both patient and caregiver engagement and satisfaction. Embedding this technology into the rounding process makes rounding more effective and efficient, which leads to measurable increases in satisfaction and puts better HCAHPs scores—and higher reimbursements—well within reach.
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