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The transformative impact of
Real-time Feedback at Dayton
Children’s Hospital

Among its customers, Dayton Children’s Hospital already had a firm reputation for excellent care. All the same, Dayton Children’s leadership wanted to improve the consistency of its clinical encounters and coach its clinical staff in communication skills. But how could the organization engage its employees? How could its leadership persuade clinicians to make a change?

Dayton Children’s leaders found all the data they needed through NRC Health’s Real-time Feedback solution.

Through Real-time Feedback’s robust data collection, hospital leadership was able to:

  • Use data transparency to rally staff around performance goals
  • Analyze patient comments to point out opportunities for coaching
  • Find unexpected domains for experiential improvement
  • Keep their main emergency department’s Net Promoter Score (NPS) averages above 81—even during a pandemic
  • And more!


System Governance | Attract & Acquire | Quality & Outcomes | Loyalty & Retention | Service Culture



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Dayton Children’s Hospital enjoys a commanding position in its local market. Situated
between Columbus and Cincinnati, Dayton Children’s serves patients from 20 different
counties in Ohio, making it a landmark destination for a large portion of the state.

With such an outsized impact in the region, Dayton Children’s has cultivated a winning reputation for outstanding care and excellent customer service. That should not suggest, however, that the hospital’s leadership was feeling complacent. In keeping with the spirit of high reliability, leadership wanted to ensure that every encounter lived up to the organization’s great reputation. They wanted to see no gaps between what patients and family members expected, and what they ultimately received.

Effecting such reliability would be a challenge for any organization—let alone one that sees more than 360,000 patients per year through its inpatient, emergency-department, and outpatient settings. To reach that goal, leadership would have to achieve total buy-in from every stakeholder involved. They would have to make a persuasive case for change.

To make their case, they turned to NRC Health’s Real-time Feedback solution.

“We set our sights high. We know that a major driver of our patient experience is the quality of our communication, and we relied on NRC Health data to make sure our provider communication was excellent.”

Jayne Gmeiner, MS, RN, Vice President for Patient Care Services and CNO, Dayton Children’s Hospital


NRC Health’s Real-time Feedback solution is an automated patient feedback solution that attempts to reach 100% of patients within 48–72 hours of their care episodes. Contacting customers via email or interactive voice recording (IVR) technology, Real-time reaches patients where they are, accelerating survey turnaround times and driving up response rates.

Furthermore, Real-time also uses open-ended question fields to solicit patients’ candid feedback. This gives patients the chance to voice their authentic concerns and give providers specific, meaningful points for improvement or praise.

In short, Real-time gives leaders timely information about their organizations’ experiential performance. And perhaps even more importantly, it gives them robust, reliable data that they can use to support strategic improvements.


Real-time Feedback had already been a part of the workflow at Dayton Children’s for some time. But in undergoing this new improvement initiative, they deployed Real-time’s data in novel ways to bolster staff enthusiasm and make changes stick.


First, to keep the patient’s perspective top-of-mind, Dayton Children’s made Real-time Feedback a central feature of daily huddles on the floor. Twice per day, every one of these short meetings started with either a notable comment from a patient or a remark on general patient-satisfaction trends at the hospital.

This helped to keep providers on-mission as they sought to maintain a consistently excellent care experience.

“We’re all about the data. Data is what helps drive change. The realtime nature of NRC’s data makes it much more compelling to our

Tami Wiggins, Senior Director of Emergency and On Demand Access, Dayton Children’s Hospital


Perhaps even more impactful was the way feedback data was presented across the system. Dayton Children’s decided to employ a strategy of full transparency: every ED provider’s NPS was made fully visible to every other employee. Providers could understand precisely where they stood among their peers.

Further, the hospital also devised customized (and private) ED Provider Scorecards, which broke down the specific domains of each provider’s performance. Seeing the numbers laid out with such clarity gave each clinician pointed, specific areas for improvement.


Nursing leadership wanted to check in with every provider, every month. But they were unsure how to guarantee an equitable approach. What would be the best way to keep
these interactions feeling fresh and meaningful?

Dayton Children’s used Real-time Feedback’s data to give the coaching program some structure. Using the experience data, nursing leadership segmented their staff into high-, middle- and low-performers. They then evenly distributed these performance tiers to each leader, so that every leader had the chance to interact with a wide variety of staff members.

This kept the coaching program feeling fresh, and fair.

“In the ED, there’s no secrets. Everyone can see everyone’s NPS; everyone can see everyone’s productivity. The visibility into the data spurs a healthy competition among our clinicians and keeps everyone performing at their best.”

Tami Wiggins, Senior Director of Emergency and On Demand Access, Dayton Children’s Hospital


Finally, Real-time Feedback also uncovered some unexpected opportunities for improvement.

By paying close attention to the Real-time data correlations, the experience team found that cleanliness was a particular sticking point with its customers. Fewer than 2% of customers rated their experience a 10 if they observed a messy patient room.

In a further twist, leaders also discovered that changing the color of a room’s floor had a significant impact on perceived cleanliness. A lighter floor consistently led to higher scores.

By refreshing their floors, Dayton Children’s leaders were able to significantly boost overall NPS—an opportunity that would have remained completely invisible without Real-time Feedback.

“Our customers are very astute and observant. We have to stay on our toes to meet their expectations. That’s why we pay such close
attention to the experience data.”

Jayne Gmeiner, MS, RN, Vice President for Patient Care Services and CNO, Dayton Children’s Hospital


In the end, these novel uses of Real-time Feedback paid off, and Dayton Children’s was able to achieve a consistent NPS of above 85.8. This is much higher than the industry average—and it’s even more remarkable, considering that this measure was taken over a period of time that included the worst months of the COVID-19 pandemic.

Still, Dayton Children’s has no intention of stopping here. No doubt, further examinations of NRC Health data will continue to yield further insight, driving an ever more excellent—and more consistent—customer experience.

“Digging into the NRC data was a fundamental part of our pursuit of excellence. It revealed opportunities that otherwise, we never would have

Tami Wiggins, Senior Director of Emergency and On Demand Access, Dayton Children’s Hospital

For more on  NRC Health solutions,
call 800.388.4264 or visit nrchealth.com/demo.