How transparency and discharge programs used together enhance satisfaction for patients
Compassionate care and the best clinical treatment have led MD Anderson Cancer Center to the number one Cancer Center in the United States. A foundation of compassionate care is to provide clear, concise, and timely communication to patients and to provide a platform for patients to communicate to their MD Anderson care team easily and quickly. The implementation and sustainability of two communication programs has helped facilitate this two-way communication between the patient and the clinical care team.
The University of Texas MD Anderson Cancer Center has initiated programs to monitor metrics, and shared inpatient and outpatient tools to improve care-continuum metrics, enabling staff and providers to improve communication and better recognize their patients’ concerns.
2022 NRC Health Symposium speaker Kathy Denton, PhD, CPHQ, SSBB, MD Anderson Cancer Center’s CPXP, explains that these programs work best if there is ongoing education and transparency internally and externally about what patients are saying about their patient experience.
Transparency of patient perceptions of their experience to our providers and care teams drive best practices and improvement efforts. Transparency combined with clear, timely, and compassionate communication with our patients are the keys to a positive patient experience.
“With more than 22,000 employees, over 147,000 patient visits, almost 10,000 clinical trials, and a million and a half outpatient visits, we have a lot of different types of patients with different experiences. The implementation of the provider star rating program resulted in an increase in the CAHPS scores from the beginning of the program when the providers started receiving their own rating reports.”
Denton explains that a success factor for the program was multiple roadshow program presentations to faculty and clinical teams for about a year prior to program implementation to educate providers, some of whom didn’t even know their patients got a survey. She says they shared with providers that patients were finding information about them anyway, so they suggested managing it as a healthcare organization, taking advantage of all the great comments and scores.
Because physicians like metrics, the organization’s leaders then pulled up Vitals, WebMD, Healthgrades, and Google and showed the physicians that their score was better, and the number of returns higher, if they used their patient-satisfaction scores.
“It is important to make the connection between the patient experience and the provider experience, so we developed an annual recognition event led by Executive Leadership to recognize providers, their teams, and patient care areas with the top patient satisfaction ratings,” Denton says.
MD Anderson also operationalized provider-patient satisfaction star cards and offered sustainable transparency by publishing scores and patient comments on faculty web pages and providing internal communications to offer encouragement. They even created a patient-satisfaction survey/provider comments review and appeals process, governed by a Transparency Governance Committee.
Patient-satisfaction Score Transparency Drives Improvement
- Improved CAHPS scores
- CMS drives transparency through star ratings
- HCAHPS star ratings are available online (at hospitalcompare.gov), and other CAHPS surveys are on the horizon
Opportunity to Control Messaging
- The competition is currently leveraging transparency to attract patients
- The program exemplifies transparency internally/externally
- The program builds trust and credibility with providers and patients
- Comments are not edited
The roadshow explained the strategy, including sharing current web URLs and ratings with providers and sharing how many other hospitals offer transparency in healthcare. This strategy included balancing the patient experience with the provider experience, focusing and transparency, recognition, and resources for improvement.
Individual provider reports included survey comments, a rich source of information that indicates more specifics about positive or negative experiences. Emails are sent with the reports, including a link to a video explanation of rationale and interpretation, resources available for improvement, and contact information for questions.
A key to the program’s success has been the open relationship between MD Anderson and NRC Health, whose representatives met weekly for the first two years and twice a month after the second year to discuss sustainability measures around internal communication, survey questions, star ratings, and metrics to support program management.
“They’ve been our hero,” says Denton. “They truly helped hold our hand and gave us a playbook to implement this program.”
How Post-discharge Programs Decrease Alert Frequencies and Improve Patient Satisfaction
Janice Finder, RN, MSN, Executive Director at the University of Texas MD Anderson, says it’s been three years since the organization started to use post-discharge phone calls. In that timeframe, they have accomplished more than 250,000 calls and have 50,000 alerts. “Patients love it; the hospital loves it,” Finder says. “It’s just a great program, and NRC Health makes it easy.
They let us know that more people pick up automated calls to talk about their healthcare experience than live calls, because they don’t want to hurt the feelings of the people that provided care but do want to share experiences for better care for others. MDAnderson had a 67% participation rate within our first year much higher than the national score. Now with cancer, people pay attention—they’re engaged. Some other hospitals have a lot less, but we were really lucky to have a high percentage.”
Finder explains that one reason for their success was their creation of a Discharge Phone Call Toolkit to provide resources and guidance on improving discharge-call results among units. The kit is designed to be shared with patients and caregivers to increase participation rates. Fliers are also displayed in break rooms, nurses’ stations, and patient rooms, and included in discharge packets to go home with patients.
Toolkit guidance is adjusted continually and includes tips like avoiding discharging patients who are still experiencing the effects of anesthesia and ensuring that discharge instructions are detailed and streamlined, with multiple departments’ discharge information on medications and wound care included. Together with improved transparency and post-discharge calls, this information has patient satisfaction up, and readmission rates down, at MD Anderson.
“NRC told us it’s going to take a couple of years, but this program will increase patient satisfaction,” Finder says. “And recently, we hit three years, 250,000 calls—and now we’re seeing the results. Those areas with high participation and low alerts have high patient satisfaction, and everybody wants high patient satisfaction.”
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