mercy medical center - roseburg - oahhs medical center •established in 1909 by the sisters of...

Mercy Medical Center - Roseburg Debbie Boswell, CNO/COO

June 25, 2013

Mercy Medical Center

• Established in 1909 by the Sisters of Mercy

• Located in Roseburg, Oregon

– 174 licensed beds (141 operational)

– ADC 71.8

– Sole community provider

• Catholic Health Initiatives (CHI), which ranks as the nation’s second-largest Catholic health care system

• 188 physicians on staff

• Provide over $48 million in community benefits

About Us:

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The Changing Environment

A patient centered movement has been active across the

US for many years– AHRQ, IFCC, IHI, IOM, & TJC the

Institute of Medicine’s 2001 report, Crossing the Quality

Chasm: A New Health System for the 21st Century, called

for health care systems that:

– Respect patients’ values, preferences, and expressed needs

– Coordinate and integrate care across boundaries of the system

– Provide the information, communication, and education that people need and want

– Guarantee physical comfort, emotional support, and the involvement of family and friends

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How We Got Started

• Obtaining Community insight is priceless, they see things we cannot see.

• Goals:

– Have direct feedback from patients and families who have experienced care within the past year

– Continue to enhance safety and quality

– Keep the patient/family at the center of care to help improve Mercy’s patient and family experiences

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Patient & Family Advisory Council (PFAC) • Formed in January 2011

• Establish a forum for patients and families to bring their experience, expertise, insights, and perspectives

• Looked for members who are supportive of the hospital but who also have questions for us

• Supported by Mercy Leadership

• Volunteer membership

• Invitation to informational meetings sent to 12 community members

• Requested 2 year commitment

• An in-depth one on one tour and orientation before first meeting

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First Steps

• First year focus:

– Education/information/knowledge of healthcare environment

• Develop a working knowledge of hospital functions and departments to facilitate PFAC input

• Better understanding of patient experience at Mercy including the Patient Satisfaction Surveys (HCAHPS)

• Understand the regulatory nature of healthcare and review of the many agencies involved in ensuring quality

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Role of PFAC Members

We wanted them to: 1. Be Mercy Ambassadors in our Community

• Provide the information we wanted shared by a dedicated and knowledgeable community member

2. Act as Secret Shoppers

3. Hold us accountable for Patient Satisfaction

4. Review and make recommendations as requested • Waiting room areas

• Dress code

• Facility cleanliness

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Mercy Ambassadors

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• The Council members have become Ambassadors for Mercy in our community

– Members serve as a voice for the hospital; communicate the positive experience of being involved in making changes that directly impact patient experiences, improving the community perception of MMC. • Presentations to community groups

• Interviews to local media

• Presented at MMC staff Town Hall Session

• Informational table at annual

employee health fair

PFAC Members Go Undercover!

One of the greatest benefits of having a PFAC

is receiving feedback, both good and not so good

from our customers:

General Impressions:

– Cleanliness

– Signage/Wayfinding

– Staff

– Cafeteria (provided meal vouchers)

– Always looking at staff Friendliness/Helpfulness/Professionalism

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Patient Satisfaction

• Transparency of all HCAHPS scores

• Members challenged us to improve

• Reviewed and made recommendations for all departmental improvement plans

• Provided community feedback

• Mystery shopper feedback

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PFAC Activities

• Reviewed and made recommendations on proposed dress code policy changes

• Critiqued newly created hospital video with recommendations prior to implementation

• Collaborated on design of Patient Guide

• Provided insights for improving quality, safety and the patient experience

• Identified need for ICU waiting room remodel

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Successes

• Goal: Improve “Overall Rating of Hospital” top box score by 10% and percentile ranking by 30% compared to FY11

• Actual: Top box score increased by 11% and percentile ranking by 41%

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0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2nd Qtr2013

1sr Qtr2013

4th Qtr2012

3rd Qtr2012

2nd Qtr2012

1st Qtr2012

4th Qtr2011

3rd Qtr2011

2nd Qtr2011

1st Qtr2011

Top Box

Percentile

Barriers and Solutions

Barriers Solutions

• Several members resigned in first year

• Council member post CVA had difficulty with speech, feeling involved

• Member used the council as forum to vent dissatisfaction with the facility

• Hospital experiences too varied • Is the small number of members

representative of all of our patients • Inexperience with serving on Advisory

Councils • No defined term limits • Department leader availability for

presentations • Staff time

• Identified additional community members for Council

• One on one discussions after meeting, more written information

• Discussion with member regarding role of the Council – opted to resign

• Required significant education time • Revise Council to focus on specific

service lines • Increase review of experience in

application process • Set term limits up front • Continues to be a challenge with

multiple priorities • Dedicated staff to the PFAC

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Advice for Others & Lessons Learned • Clearly identify characteristics you are seeking in

council members

• Require recent (within 1 year) experience

• Interview potential members in advance

• Don’t underestimate the amount of education required for the members

• Focus on specific service line or topic

• Increase clinical staff involvement

• Clinical co-chair

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Plans for Future/Expansion

• PFAC members feel involved and meaningful contributors

• Senior leadership and corporate support

• Recognition of the importance of patient & family focus

• Plan to revise to a service line focus

• Multiple PFAC councils may be needed

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Next Steps

• Implement “necessary endings”

• Consider service line specific Councils

• Identify members with specific expertise

– Customer Service

– Community Relations

– Presentation Skills

• Next generation of PFACs will include the expansion into ambulatory and post-acute

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Contact Information

• Debbie Boswell, RN, COO/CNO

541-677-3362

debbieboswell@chiwest.com

• Kathleen Nickel, Director Marketing/Communications

541-677-2423

kathleennickel@chiwest.com

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Questions

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