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Houston health organization changes its culture with a fresh approach

Discover how Harris Health System utilized Real-time feedback for improvement

  • Mohammad Zare, Chief of Staff, Ambulatory Care Services, Harris Health System
  • David Riddle, Administrative Director of Patient Experience, Harris Health System
  • Jill Hay, Project Manager, Ambulatory Care Services, Harris Health System

The challenges we faced at Harris Health System are similar to those at other hospitals across the nation. Among these, our physicians were trained in medical schools that heavily promote using evidence-based medicine and data with robust sample sizes to drive changes in practice. Consequently, having our physicians receive only a handful of quarterly patient experience responses from their panels had spurred a culture of inaction among those physicians. This resulted in:

  • Outcomes that had flat-lined and become stagnant
  • Physicians no longer caring about their data
  • Leadership being faced with the reality that a change had to be made

As the third-largest safety-net hospital, with 60% of our population uninsured, Harris Health System found the lack of believability in patient feedback data to be a serious issue that needed to be addressed for the health of our community. The care received needed to be exemplary, to help patients understand their treatment plans and avoid emergency-department visits.

To overcome these challenges, we turned to our experience partner and implemented real-time feedback. Utilizing real-time feedback allowed us to conduct patient outreach with greater immediacy, provided the increase in response rates that our physicians desired, and gave every patient an opportunity to be heard. Using real-time feedback, we had a 611% patient response increase in our first year (146,542 responses, up from 23,984 responses).

In addition to making us more responsive to our physician’s concerns, this gave us the ability to make unanticipated gains in population health. Diabetic HbA1c testing increased to over 95% after the changes we implemented. Often serving an at-risk population, we now have processes in place to help us identify gaps and ensure that our diabetic population has the regular testing they need.

However, our journey of accelerating improvement didn’t stop there. We quickly identified other process changes that ended up having a meaningful impact on providers, nurses, and patients. Our early wins included:

  • Changing the daily huddle and patient rooming process, which led to better patient communication
  • Building a physician-accountability infrastructure that aligned patient feedback with results achievement
  • Creating a “competitive improvement” environment and a shadowing program that further accelerated performance

To learn more about the gains we’ve made by adopting the NRC Health real-time program, please take a moment to read our Case Study.

About Harris Health System:

Harris Health System is a community-focused academic healthcare system dedicated to improving the health of Harris County, Texas, through quality care delivery, care coordination, and education. Harris Health System is comprised of three hospitals, 44 centers and clinics, and 350 ambulatory-setting physicians.