Enhancing Communication Skills: A Catalyst for Organizational Cultural Transformation
Presented by William Maples, MD, Chief Medical Officer, Professional Research Consultants and Executive Director, The Institute for Healthcare Excellence, Galen Perdikis, MD, Faculty, The Institute for Healthcare
Excellence, Chadi Ibrahim, MD, Medical Director of Medical House Services, Connie O’Malley, Chief Operating Officer and Amanda LaVoie, M.S., R.D., Director of Service Excellence and Environmental
Services, Beaumont Hospital – Troy
Defining Patient Experience
www.theberylinstitute.org 2
- The Beryl Institute
Keynote Speakers
Three Pre-Conference Workshops
The Environment of the Patient Experience: Proactive Design in Practice
Lorissa MacAllister and Susan Mazer
Leading Your Patient Experience Strategy tp the Next LevelWendy Leebov, Jill Golde and Dorothy Sisneros
Breakout Sessions
April 13-15 ▪ Sheraton Dallas Hotel ▪ Dallas, Texas
Ronan Tynan
Coaching and Feedback to Enhance Communication
Calvin Chou and Laura Cooley
Cynthia Mercer Kelly Corrigan
Three Pre-Conference Gatherings
Patient Advocacy CommunityPhysician CommunityPediatric Community
Montel Williams
Networking Dinner & Reception
The Margot and Bill Winspear Opera House at the AT&T Performing Arts Center
Become a Certified Patient Experience Professional.
Applicants should have a minimum 3 years of professional experience in a patient experience related role or completion of 30 Patient Experience Continuing Education Credits (PXEs).
Learn more at www.pxinstitute.org
Housekeeping
• All participant phone lines are muted.
• The presentation will run 45-50 minutes with about 10-15 min for Q&A.
• Q&A will be conducted through the Q&A function. Please submit questions to the host for a facilitated Q&A after the presentation.
• Webinar materials and session recording will be available for all attendees. (receive an email notification with the appropriate link)
• A survey will be distributed following today’s session.
• This program is pending approval for 1 PXE
PX Continuing Education Credits
• In order to obtain patient experience continuing education credit, participants must attend the program in its entirety and return the completed evaluation.
• The planning committee members and presenters have disclosed no relevant financial interest or other relationships with commercial entities relative to the content of the educational activity.
• No off label use of products will be addressed during this educational activity.
• This activity has received no sponsorship or commercial support. No products are available during this educational activity, which would indicate endorsement.
Our Speakers
www.theberylinstitute.org 7
William Maples, MDChief Medical Officer, PRC
Executive DirectorThe Institute for Healthcare Excellence
Galen Perdikis, MDFaculty, The Institute for
Healthcare Excellence
Connie O’MalleyChief Operating Officer
Beaumont Hospital – Troy
Chadi Ibrahim, MD, Medical Director
Medical House ServicesBeaumont Hospital – Troy
Amanda LaVoie, M.S., R.D., Director of Service Excellenceand Environmental ServicesBeaumont Hospital – Troy
Communication in Healthcare
Why Communication in HealthcareDemonstrated Results
Risk Adjusted Mortality
ICU Length of Stay
Patient Experience
Overall Inpatient
50% 1 day 33%
Physician Communication
Scores
43%
• Enhance Patient Experience• Evolve a culture of safety• Enhance Employee Engagement and Satisfaction• Create a culture of mutual respect, safety, and teamwork through
communication• Decrease adverse events• Improve patient compliance with treatment plans, thereby
enhancing outcomes and decreasing rework resulting from unnecessary readmissions
• Decrease Staff Turnover• Decrease Malpractice Events• Restore joy for the practice of medicine• Build resilience to meet the ever-changing healthcare environment
Goals: 4-Hour Communication in Healthcare Curriculum
Program DesignPROGRAM DESIGN
Interactive Small Group Learning
1 Faculty per 6 Participants
Interactive/immersive training stylePeer to peer teaching (e.g. MD to MD) 1 Faculty per 6 colleaguesDidactic discussions and video Longitudinal experienceCME accredited
Mindfulness/Presence Active listening Information gathering Negotiating an agenda Connecting with patients and team Written communication Appreciative inquiry/debrief
COURSE ELEMENTS
Enhancing Communication Skills:A Catalyst for Organizational
Cultural TransformationFebruary 2016
Beaumont - Troy• 458 Licensed Beds
• 4,675 Employees
• 1,348 Physicians– Employed and Private
• 35,650 Admissions
• 93,332 EC Visits
• 3,736 Births
• 19,524 Total Surgeries
Why did we seek Communication Training?• Desire to develop a curriculum that allowed staff to
more strongly connect with patients, families and each other
• Looking for more than an initiative
• Culture shift to align with our vision
Why this concept?
• Learner centered approach• Physician and allied health learning parallel
learning• Self sustaining model
What was the need?
• Maintain a high level of safety and quality
• Improve physician patient experience scores
• Improve overall patient experience scores
• Desire to improve communication between providers
• Desire to maintain our facility as the hospital of choice
• Doing the right thing
Challenge in getting physicians on board
• Not all physicians view patient experience as important aspect of patient care
• Generally viewed as softer side of medicine• Docs don’t think they have issues with
communication• We also didn’t know where physician leaders are on
the issue• Difficult to get physicians interested in taking the
lead on the issue
Why is physician involvement important?
• It became clear that the patient experience initiative wouldn’t succeed without involving physicians
• Physicians are well respected by patients
• Physicians are well respected by others members of the team
• We have a stake in this
• Our reputation is on the line
• Improved job satisfaction
How do we involve physicians?
• The leadership must buy into it• It has to be a physician who drives it• We have to show physicians that this is a valuable skill• It is a way to help improve “how we practice
medicine”• Will not take more time!• The carrots: CME, Academic Credits, MOC credits• Start the conversation• Execution is the key!
Setting the vision
• Finding the right program
• Treading lightly with physicians
• Having the conversations are crucial
• Generating a buy in from leadership
• Leaders need to see these benefits: Improved quality of care, financially sound proposal and sustainability
• Inviting the right physician leaders to the table
• Rolling out the program in a stepwise approach
Sustaining the Vision
• Building on momentum
• Forming a team of advocates
• Creating ambassadors for the initiative
• Reaching a critical mass
• Requiring the skill
• Weaving into the culture
What does the work look like now?
• Physicians (includes mid-level providers) – Monthly classes
• Allied health staff – weekly classes
• Post-class – Letters to homes requesting stories
• Caring Connections meeting
• Recognition
Patient Satisfaction Data
2/4/2016 23
0
10
20
30
40
50
60
70
80
90
100
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15Top Box 74.8 76.1 75.2 76.4 76.9 74.7 79.5 81.5 81.3 81.7 82.2 85.5Percentile Ranking 13 19 14 21 24 13 44 62 61 64 68 87
Communication with Nurses HCAHPS Domain
April: Initial training
July: Training implementation began.
Data displayed by date of service
2/4/2016 24
0
10
20
30
40
50
60
70
80
90
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15Top Box 75.6 75.8 74.5 78.5 75.7 75.1 77.3 77.9 78.7 77.6 80.5 81.2Percentile Ranking 13 13 9 27 13 11 19 23 28 21 42 47
Communication with Doctors HCAHPS Domain
April: Initial training
July: Training implementation began.
Data displayed by date of service
Patient Satisfaction Data
2/4/2016 25
0
10
20
30
40
50
60
70
80
90
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15
Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15Top Box 68 71.2 67.3 70.3 69.8 64.9 74 77.4 76.3 73.2 76.2 76.7Percentile Ranking 30 45 27 41 38 19 57 73 69 53 68 70
Global Rating HCAHPS Domain (9s and 10s)
April: Initial training
July: Training implementation began.
Data displayed by date of service
Patient Satisfaction Data
Learnings and Results From Institutions Engaged in the Communication in
Healthcare Program
Critical Success Factors 1. Strong leadership commitment to supporting the program.
2. Curriculum developed to be significantly relevant to the practicing clinician.
3. Program designed to be financially feasible and sustainable.
4. Choose faculty to represent the diversity of the entire physician and allied health staff and are well respected by their colleagues
5. Conduct training sessions on a monthly basis to complete training for the entire faculty over a two year period
6. Physicians and allied health staff should be required or strongly encouraged to participate in the curriculum
Physician Program Evaluation Scale of 1-5
• Overall, program useful 4.1• Is good for institution 4.5• Was worth the time for me personally 4.1• Ability to help learners become actively engaged
with exercise4.5
• Ability to maintain a safe and trusting environment 4.6• Ability to help others accomplish learning goals 4.5
Patient Experience ResultsOutpatient Overall Quality of Care
% Excellent
7273747576777879
MCF
Year 1 Year 2 Year 3 Year 4 Year 5
Health System
Patient Experience ResultsInpatient Overall Level of Safety
% Excellent
01020304050607080
MCF
Year 1 Year 2 Year 3 Year 4
Health System
Patient Experience Results
505560657075808590
Doctor's Communication / Keeping Patient Informed
505560657075808590
Doctor's Involving Patient in Decision-Making Process
36414651566166
Doctor's Understanding and Caring
505560657075808590
Nurse Listen
Patient Experience ResultsOutpatient Willingness to Recommend
% Definitely Would
888989909091919292
MCF
Year 1 Year 2 Year 3 Year 4 Year 5
Health System
Value Based Purchasing – Patient Experience
3/1/2011 6/1/2011 9/1/2011 12/1/2011 3/1/2012 6/1/2012 9/1/2012 12/1/2012 3/1/2013 6/1/2013 9/1/2013 12/1/2013 3/1/20142011 2011 2011 2011 2012 2012 2012 2012 2013 2013 2013 2013 201403 06 09 12 03 06 09 12 03 06 09 12 03Scheduled Quarterly Release Mar. 2011 June 2011 Sept. 2011 Dec. 2011 Mar. 2012 June 2012 Sept. 2012 Dec. 2012 Mar. 2013 June 2013 Sept. 2013 Dec. 2013 Mar. 2014
Data Collection Dates Jul. 1, 2009 - June 30, 2010
Oct. 1, 2009 - Sept. 30, 2010
Jan. 1, 2010 - Dec. 31, 2010
Apr. 1, 2010 - Mar. 31, 2011
Jul. 1, 2010 - June 30, 2011
Oct. 1, 2010 - Sept. 30, 2011
Jan. 1, 2011 - Dec. 31, 2011
Apr. 1, 2011 - Mar. 31, 2012
Jul. 1, 2011 - June 30, 2012
Oct. 1, 2011 - Sept. 30, 2012
Jan. 1, 2012 - Dec. 31, 2012
Apr. 1, 2012 - Mar. 31, 2013
Jul. 1, 2012 - June 30, 2013
Hospital Performance 79% 78% 78% 78% 78% 80% 80% 81% 83% 83% 84% 83% 83%
U.S. Top 10% 83% 83% 83% 83% 84% 84% 84% 85% 85% 85% 85% 85% 85%U.S. Average 76% 76% 76% 76% 77% 77% 77% 78% 78% 78% 78% 78% 79%
U.S. Rank 939 of 3809 1254 of 3811 1305 of 3826 1340 of 3836 1388 of 3850 927 of 3857 997 of 3866 840 of 3891 546 of 3903 558 of 3911 432 of 3923 596 of 3938 619 of 3974State Rank 40 of 97 53 of 97 51 of 97 56 of 98 54 of 97 38 of 97 42 of 97 31 of 97 16 of 97 15 of 97 14 of 98 22 of 98 25 of 98
Communication with Nurses
Applicable to the 2013, 2014, 2015 and 2016 VBP Programs.
79%
83%83%
85%
76%
79%
74%
76%
78%
80%
82%
84%
86%
Mission Hospitals
U.S. Top 10%
U.S. Average
Hospital
Value Based Purchasing – Patient Experience
Scheduled Quarterly Release Mar. 2011 June 2011 Sept. 2011 Dec. 2011 Mar. 2012 June 2012 Sept. 2012 Dec. 2012 Mar. 2013 June 2013 Sept. 2013 Dec. 2013 Mar. 2014
Data Collection Dates Jul. 1, 2009 - June 30, 2010
Oct. 1, 2009 - Sept. 30, 2010
Jan. 1, 2010 - Dec. 31, 2010
Apr. 1, 2010 - Mar. 31, 2011
Jul. 1, 2010 - June 30, 2011
Oct. 1, 2010 - Sept. 30, 2011
Jan. 1, 2011 - Dec. 31, 2011
Apr. 1, 2011 - Mar. 31, 2012
Jul. 1, 2011 - June 30, 2012
Oct. 1, 2011 - Sept. 30, 2012
Jan. 1, 2012 - Dec. 31, 2012
Apr. 1, 2012 - Mar. 31, 2013
Jul. 1, 2012 - June 30, 2013
Hospital Performance 72% 71% 71% 69% 71% 72% 71% 75% 76% 78% 81% 80% 78%
U.S. Top 10% 76% 76% 76% 76% 76% 76% 76% 77% 77% 77% 77% 77% 77%
U.S. Average 69% 69% 69% 70% 70% 70% 70% 70% 71% 71% 71% 71% 71%
U.S. Rank 914 of 3807 1200 of 3810 1233 of 3826 1895 of 3836 1260 of 3850 1039 of 3856 1368 of 3864 513 of 3889 430 of 3900 251 of 3906 114 of 3921 151 of 3934 285 of 3969
State Rank 30 of 97 42 of 97 42 of 97 63 of 98 50 of 97 38 of 97 47 of 97 15 of 97 8 of 97 5 of 97 1 of 98 1 of 98 3 of 98
Pain Management
Applicable to the 2013, 2014, 2015 and 2016 VBP Programs.
72%
78%
76%77%
69%
71%
68%
70%
72%
74%
76%
78%
80%
82%
Mission Hospitals
U.S. Top 10%
U.S. Average
Hospital
Value Based Purchasing – Patient Experience
Scheduled Quarterly Release Mar. 2011 June 2011 Sept. 2011 Dec. 2011 Mar. 2012 June 2012 Sept. 2012 Dec. 2012 Mar. 2013 June 2013 Sept. 2013 Dec. 2013 Mar. 2014
Data Collection Dates Jul. 1, 2009 - June 30, 2010
Oct. 1, 2009 - Sept. 30, 2010
Jan. 1, 2010 - Dec. 31, 2010
Apr. 1, 2010 - Mar. 31, 2011
Jul. 1, 2010 - June 30, 2011
Oct. 1, 2010 - Sept. 30, 2011
Jan. 1, 2011 - Dec. 31, 2011
Apr. 1, 2011 - Mar. 31, 2012
Jul. 1, 2011 - June 30, 2012
Oct. 1, 2011 - Sept. 30, 2012
Jan. 1, 2012 - Dec. 31, 2012
Apr. 1, 2012 - Mar. 31, 2013
Jul. 1, 2012 - June 30, 2013
Hospital Performance 59% 60% 60% 63% 66% 69% 69% 69% 71% 70% 72% 76% 75%
U.S. Top 10% 68% 68% 69% 69% 69% 70% 70% 71% 71% 71% 72% 72% 72%
U.S. Average 60% 61% 61% 61% 61% 62% 62% 63% 63% 63% 64% 64% 64%
U.S. Rank 2036 of 3805 1815 of 3807 1896 of 3822 1181 of 3833 700 of 3846 413 of 3854 440 of 3862 515 of 3888 369 of 3899 475 of 3906 335 of 3920 158 of 3934 208 of 3967
State Rank 76 of 97 71 of 97 70 of 97 51 of 98 28 of 97 15 of 97 14 of 97 18 of 97 11 of 97 12 of 97 10 of 98 3 of 98 3 of 98
Communication about Medicines
Applicable to the 2013, 2014, 2015 and 2016 VBP Programs.
59%
75%
68%
72%
60%
64%
58%
60%
62%
64%
66%
68%
70%
72%
74%
76%
Mission Hospitals
U.S. Top 10%
U.S. Average
Hospital
Value Based Purchasing – Patient Experience
Scheduled Quarterly Release Mar. 2011 June 2011 Sept. 2011 Dec. 2011 Mar. 2012 June 2012 Sept. 2012 Dec. 2012 Mar. 2013 June 2013 Sept. 2013 Dec. 2013 Mar. 2014
Data Collection Dates Jul. 1, 2009 - June 30, 2010
Oct. 1, 2009 - Sept. 30, 2010
Jan. 1, 2010 - Dec. 31, 2010
Apr. 1, 2010 - Mar. 31, 2011
Jul. 1, 2010 - June 30, 2011
Oct. 1, 2010 - Sept. 30, 2011
Jan. 1, 2011 - Dec. 31, 2011
Apr. 1, 2011 - Mar. 31, 2012
Jul. 1, 2011 - June 30, 2012
Oct. 1, 2011 - Sept. 30, 2012
Jan. 1, 2012 - Dec. 31, 2012
Apr. 1, 2012 - Mar. 31, 2013
Jul. 1, 2012 - June 30, 2013
Hospital Performance 85% 84% 85% 86% 87% 88% 88% 88% 89% 88% 88% 90% 90%
U.S. Top 10% 88% 88% 88% 88% 88% 88% 89% 89% 89% 89% 90% 90% 90%
U.S. Average 82% 82% 82% 82% 83% 83% 83% 84% 84% 84% 85% 85% 85%
U.S. Rank 845 of 3806 1227 of 3808 972 of 3824 721 of 3834 518 of 3849 384 of 3856 432 of 3865 493 of 3890 346 of 3902 585 of 3911 656 of 3923 270 of 3936 330 of 3973
State Rank 25 of 97 40 of 97 32 of 97 19 of 98 13 of 97 9 of 97 8 of 97 7 of 97 8 of 97 15 of 97 15 of 98 4 of 98 5 of 98
Discharge Information
Applicable to the 2013, 2014, 2015 and 2016 VBP Programs.
85%
90%
88%
90%
82%
85%
82%
84%
86%
88%
90%
92%
Mission Hospitals
U.S. Top 10%
U.S. Average
Hospital
Staff Satisfaction
0102030405060708090
100
Respect between MD andAHS
Service from colleagues Treat others with respect
Year 1 Year 2 Year 3
Percentile Ranking Nationally
0%
10%
20%
30%
40%
50%
60%
70%
80%
2012
2013
* Very near / approaching bucket
Reduced the use of Propofol (ICU)
0
100
200
300
400
500
600
Propofol Bottles Removed
Bottles Removed,Coli
Linear (BottlesRemoved, Coli)
Reduced Length of Stay (ICU)
Oct'09
Nov'09
Dec'09
Jan'10
Feb'10
Mar'10
Apr'10
May'10
Jun'10
Jul'10
Aug'10
Sep'10
Oct'10
Nov'10
Dec'10
Jan'11
Feb'11
Mar'11
Apr'11
May'11
Jun'11
Jul'11
Aug'11
Sep'11
Oct'11
Nov'11
Dec'11
Jan'12
Feb'12
Mar'12
Apr'12
May'12
Jun'12
ALOS 4.8 2.9 4.6 5.4 3.1 5.1 3.4 3.1 2.9 3.6 3.6 3.8 3.6 2.4 3 4.2 3.8 3.7 3.6 3.2 2.2 3.3 2.3 3.5 2.6 2.9 3.8 2.6 3.0 3.2 2.3 2.7 2.5Median 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6 3.6Goal 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0 3.0
0
1
2
3
4
5
6
MSI
CU
-Av
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ngth
of S
tay
(APA
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**ADT data x3mos
FY11 Flu
FY10 Flu
IHI Projects
Intensivist Model
ABCDE Work
FY12 Flu
Risk Adjusted Mortality
>500 FEWER Deaths per Year than 2010
Questions
www.theberylinstitute.org 42
William Maples, MDChief Medical Officer, PRC
Executive DirectorThe Institute for Healthcare Excellence
Galen Perdikis, MDFaculty, The Institute for
Healthcare Excellence
Connie O’MalleyChief Operating Officer
Beaumont Hospital – Troy
Chadi Ibrahim, MD, Medical Director
Medical House ServicesBeaumont Hospital – Troy
Amanda LaVoie, M.S., R.D., Director of Service Excellenceand Environmental ServicesBeaumont Hospital – Troy
PX Continuing Education Credits
• This program is pending approval for 1 PXEs
• In order to obtain PXEs, participants must attend the program in its entirety and complete evaluation.
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