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Satisfaction up 9.9%—
The Real-time Feedback difference

Leaders at Riverside Health System, 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’s Real-time Feedback solution 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

SOLUTIONS UTILIZED
Strategy & Governance | Attract & Acquire | Quality & Outcomes | Loyalty & Retention | Service Culture

Magnifying Glass

RECURRING SERVICE ISSUES
DETECTED AND RESOLVED

169%

INCREASE IN PATIENT
RESPONSE RATES

9.9%

SYSTEM-WIDE IMPROVEMENT
IN OVERALL SATISFACTION

Opportunity

Riverside Health System prides itself on offering an outstanding experience for its patients. But in 2015, the organization’s leaders saw that Riverside had 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, Riverside’s leaders struggled to identify concrete steps for experiential improvement.

They needed sharper insight into the Riverside 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.

“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. ”

Nancy Littlefield, DNP, EVP/CNO, Riverside Health System

Solution

NRC Health’s Real-time Feedback is a patient-survey solution that reaches 100% of patients within 48 hours of their care episodes. Delivered via email, SMS, or interactive voice recognition (IVR), Real-time captures patients’ impressions while their encounters are still fresh in their memory.

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.

IMPLEMENTATION

Real-time’s open-ended questions proved invaluable to Riverside’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 Riverside 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.”

Real-time Feedback captured this comment, and alerted staff about it. Riverside’s 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. Real-time 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 Real-time, 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, Riverside’s 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 at Riverside, 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? Real-time feedback 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

Real-time’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. Real-time, in fact, identified these wait times as the single biggest source of patients’ complaints.

By drawing leaders’ attention to the issue, Real-time enabled them to devise a solution. Riverside 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 Riverside 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.”

Results

Though changes like this may seem small, their cumulative effect had an outsized impact on patients’ experience at Riverside.

SHARP INCREASE IN RESPONSE RATES

When data is presented to clinicians, n-sizes are crucial for credibility. Riverside’s previous feedback operations had suffered from depressed response rates from patients. Under Real-time, 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 Riverside’s emergency department, for instance, was completely resolved. Before the implementation of Real-time, 88% of Riverside’s ED patients had to wait more than an hour to reach the care floor. After Real-time, 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 of Riverside’s hospitals, overall satisfaction increased by 9.9% after two years of Real-time Feedback—with several hospitals seeing double-digit satisfaction improvements.

“Real-time enables us to connect a patient’s experience with specific providers on our team. That brings the patients’ words to life. It matters.”

Nancy Littlefield, DNP, EVP/CNO, Riverside Health System

Takeaway tips

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

1. MAKE IT PERSONAL FOR STAFF

Real-time’s data is only useful if leaders can effectively communicate it to the team. Too often, powerful data can get buried in dry reports that ultimately fail to motivate behavioral change among providers.

Riverside’s leaders work around this by setting aside weekly times for personal-feedback phone calls with team members. This personal attention helps clinicians internalize what patients have revealed through Real-time.

2. FIND—AND RECORD—THE HUMAN CONNECTION

Today’s patients expect empathy from their providers. Riverside’s 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, Riverside’s leaders ask staff to make use of Real-time Feedback 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 Riverside provider can ask for further details. This helps enforce a sense of continuity, and gives Riverside’s patients an empowering feeling—the assurance that they’re being heard.


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