Leaders at a five-hospital organization in eastern Virginia, wanted to improve the organization’s patient experience. But existing feedback mechanisms failed to give leaders the insight they needed. They turned to NRC Health to learn where they should direct their efforts at intervention.

Within two years, the leadership team observed remarkable results, including:

• A 169% increase in patient-response rates
• The uncovering and resolution of recurring service issues that would otherwise have been impossible to detect
• A 9.9% improvement in overall satisfaction, system-wide

In 2015, the organization’s leaders saw room to improve. Overall satisfaction scores lagged behind what they knew their care staff could deliver. However, in a health system with five campuses and more than 800 physicians, leaders struggled to identify concrete steps for experiential improvement.

They needed sharper insight into the care experience. They needed to see, with clarity and specificity, exactly where the organization fell short of patients’ ideal experiences.

For this, they turned to NRC Health.

NRC Health’s patient-survey attempts to reach 100% of patients within 48 hours of their care episodes. Delivered via email, SMS, or interactive voice recognition (IVR), NRC Health.

The solution also offers patients open-ended questions, giving them the opportunity to voice their concerns beyond a simple numeric score. An AI-based process called Natural Language Processing (NLP) algorithmically sorts these comments, automatically cataloging them by sentiment and service area. This gives leaders immediate insight into patients’ specific areas of concern.

“If we received a complaint or concern through HCAHPS, by the time it got to us, our staff would barely be able to recall the incident. We wouldn’t have the information to fix it. We had to improve on that. ”

~ Health System CNO

NRC Health’s open-ended questions model proved invaluable to the health system’s efforts at experiential improvement. Its NLP technology uncovered opportunities that, with traditional feedback mechanisms, would have been impossible to detect.

FIXING FURNITURE

Simple numerical feedback scores leave no room for nuance. Without the patient’s words, opportunities for improvement can be buried within otherwise outstanding reviews.

One patient, for example, remarked that they’d enjoyed an outstanding care experience—excellent care from every clinician. But they also added a postscript: “PS, beds were awful.”

NRC Health’s feedback capability captured this comment, and alerted staff about it. Leadership reviewed age and capital-dollar spend for beds, and found they should move up the purchase of some new beds on a specific unit. The voice of our patients helped us in that priority.

RESOLVING LAB DELAYS

Traditional feedback measures typically come with long lag-times in responses. This can make it difficult to connect a patient’s experience with the specific circumstances of their encounter. NRC Health fixes that by providing feedback immediately.

In one case, a patient remarked that they’d had to wait for more than five hours for lab results. Thanks to NRC Health, leaders were able to pinpoint what had gone wrong. They found that, even though the lab had turned around the results in less than 45 minutes, a miscommunication had kept staff from relaying those results to the patient. With this information, the team was able to ensure that similar mishaps would not occur in the future.

ON-TIME DISCHARGES

Sometimes, problems that seem intractable can be easily resolved—so long as leaders have the right information.

That was the case when a patient complained about the discharge process. A doctor had ordered the patient’s discharge at 9:30 p.m. But by 11:00 p.m., the patient’s discharge paperwork still wasn’t prepared. The patient left, understandably annoyed at the delay.

What had caused the delay? NRC Health made the culprit easy to identify: a faulty printer. Staff were able to connect the printer’s malfunction to the time and date of the patient’s discharge. The printer was replaced, and future discharge delays were prevented.

FASTER ED THROUGHPUT

The survey’s NLP algorithms can also use comments to identify longitudinal trends. One problem that consistently arose in patient comments was wait times in the emergency department. NRC Health, in fact, identified these wait times as the single biggest source of patients’ complaints.

By drawing leaders’ attention to the issue, NRC Health enabled them to devise a solution. The health system implemented an immediate bedding protocol, with providers performing triage very shortly after each emergency admission. This dramatically reduced ED wait times—and produced a commensurate improvement in patient satisfaction.

One patient, for example, remarked that they’d enjoyed an outstanding care experience—excellent care from every clinician. But they also added a postscript: “PS, beds were awful.”

Though changes like this may seem small, their cumulative effect had an outsized impact on patient experience.

SHARP INCREASE IN RESPONSE RATES

When data is presented to clinicians, n-sizes are crucial for credibility. The health system’s previous feedback operations had suffered from depressed response rates from patients. Under NRC Health, however, response rates quickly crossed the threshold of statistical significance.

Volumes of patient feedback went from 7,342 per year to 19,755 per year—a 169% increase.

ED THROUGHPUT, INVERTED

The problem of wait times in the emergency department, for instance, was completely resolved. Before the implementation of NRC Health’s patient feedback capability, 88% of the health system’s ED patients had to wait more than an hour to reach the care floor. After implementing NRC Health’s patient experience solution, 85% of patients moved out of the ED within one hour.

OVERALL SATISFACTION IMPROVED

Finally, all these positive changes produced exactly what leaders were looking for: a marked improvement in overall satisfaction scores. Across all five hospitals, overall satisfaction increased by 9.9% after two years of utilizing NRC Health’s capabilities—with several hospitals seeing double-digit satisfaction improvements.

For health systems that hope to see similar results, leaders have some advice:

1. MAKE IT PERSONAL FOR STAFF

2. FIND—AND RECORD—THE HUMAN CONNECTION

Today’s patients expect empathy from their providers. Leaders teach their teams to cultivate it.

They now train clinicians to ask about aspects of patients’ personal lives, and record key details in the organization’s EHR software. This way, for instance, patients who are veterans can be thanked for their service. Patients who have recently lost a family member can be given a note of sympathy for their loss. Small gestures like this make all the difference for the patients who receive them.

3. MAKE IT EASY TO FOLLOW UP

Finally, leaders ask staff to make use of NRC Health’s data in future conversations with patients. If, for instance, a patient comments that they’ve had an excellent care experience in the past, a future provider can ask for further details. This helps enforce a sense of continuity, and gives patients an empowering feeling—the assurance that they’re being heard.