Improving the Patient and Family Experience in Virginia Hospitals: 2018 Senior Leadership Exercise #1 VHHA Center for Healthcare Excellence February 21, 2018
Housekeeping • Slides were sent this morning • Webinar is being recorded • Please use the “telephone” option – Audio pin prompt • All participants are muted • Raise your hand • Ask a question
Agenda 01 Provide Overview of the Senior Leader Exercise #1 02 Discuss Objectives and Benefits 03 Put into Practice: Sentara Martha Jefferson Hospital
Today’s Speakers Jonathan Davis Carrie Brady President Program Consultant Sentara Martha Jefferson Principal Hospital C.Brady Consulting
Strategic Focus 2018 Focus 2017 Focus #1 Establish structure Senior Leader Engagement for shared learning 2017 Focus #3 Establish network of 2017 Focus #2 service excellence peers Content creation and dissemination
VHHA Board of Director Commitments Supporting patient and family engagement best practices and elevating patient experience scores in Virginia. 1) Partnering with patient and families as advisors 2) Enhancing leadership engagement with staff 3) Seeking collaborative opportunities with hospitals across the state
Ask every Virginia hospital CEO and the senior leaders of their choice to identify staff who were recently patients or have had family members Senior Leader Exercise #1 who were recently patients, ( yes, there will be a #2 ☺ ) and invite them to participate in a group discussion about their experience.
Objectives and Benefits
Value of Staff Discussions • Staff have a unique perspective • Engaging staff directly aligns incentives and enhances impact of improvement efforts
Patient and Staff Experience Are Related
Critical Importance of a Learning Culture HCAHPS Average HSOPS VARIABLE r 0.30* 0.25* Feedback and Communication about Error 0.34** 0.23 Handoffs and Transitions 0.34** 0.21 Management Support for Patient Safety 0.35** 0.28* Nonpunitive Response to Error 0.46** 0.38** Organizational Learning/Continuous Improvement 0.39** 0.31* Overall Perceptions of Patient Safety 0.45** 0.37** Staffing Supervisor/Manager Expectations and Actions Promoting 0.40** 0.30* Safety 0.33** 0.21 Teamwork Across Units 0.47** 0.37** Teamwork Within Units 0.42** 0.33** Patient Safety Grade 0.41** 0.33* HSOPS Average
Suggested Guidelines Consider having the conversation over a group breakfast, lunch or coffee. Create a safe environment for participants to share openly. Assure participants that their identities will be kept confidential . Arrange for a staff member to take notes on the conversation .
General Discussion • Ask meeting participants to share top of mind impressions, including: - things that went well in their experience - opportunities for improvement • Compare to experiences at other hospitals
Domain Specific Discussion • Inquire about experiences with key issues including: – s Communication – Patient Education – Responsiveness – Transitions of care • Ask if there are any other important issues they observed, including quality and safety concerns
Listen for Innovation • Ask staff what suggestions they have to address the opportunities for improvement – What would be the ideal process for patients and staff? – What changes to the process would make the “right thing” easier to do for staff? • Ask what stood out as the best part of the experience and why – Could that be delivered consistently? (e.g. reverse teach back)
After the Meeting • Document the findings and distribute to improvement leaders • Follow up with participants – Inform them what is being done with the information they shared – Invite participants to get involved in improvement efforts • Provide a mechanism for staff to share on an ongoing basis
Building on the Momentum • Consider how to incorporate staff experiences as patients/family members into improvement efforts on an ongoing basis, for example: – Staff meetings – Leadership retreats – Patient and family advisory council discussions – Senior Leader Rounding on staff
Sentara Martha Jefferson Hospital: CEO Patient Experience Exercise VHHA February 21, 2018
Sentara Healthcare We improve health every day. • 127-year not-for-profit mission • 12 hospitals; 2,727 beds; 3,799 physicians on staff • 12 long term care/assisted living centers • Extended stay hospital • 4 Medical Groups (~900 providers) • 440,000 - member health plan • Sentara College of Health Sciences • $4.3B total operating revenues • $5.9B total assets • 27,000+ members of the team • AA/Aa2 bond ratings 19
Sentara System and Service Areas 20 20
Sentara Martha Jefferson Hospital “It is our aim to make this • Opened August 28, 2011 institution a blessing to • 540,000 square feet this community…” • 84-acre campus ~Dr. J. Hamilton Browning, Martha • 1,699 parking spaces Jefferson Hospital Founder, 1906 • 176 private beds • $50 million capital campaign 21
Sentara Commitments Culture of Always – Caring Tradition • Always keep you safe • Always treat you with dignity, respect and compassion • Always listen and respond to you • Always keep you informed and involved • Always work together as a team to provide you quality healthcare 22
It’s all about people. 8/31/08 23 www.sentara.com
WHY I round…. • Patient Rounding • Environmental Rounding Be Purposeful Vs. Wandering Staff Rounding • - Ask for problems impacting What is working well operationally- (safety, customer service, equipment related) - Look for problems impacting operations What are your barriers to a successful day: that employees may have created a “work around” too - Seek opportunities to catch recognize staff doing something right and relay patient feedback - Know why and what you are rounding on…safety huddle, expectations, etc. - Connect with employees, find opportunities to coach and thank them for their daily efforts, manage up with patients. 4
VHHA CEO Challenge • Employee Story #1- A SMJH employee, was invited to our Culture of Always committee to discuss her recent hospitalization. There were aspects of her care that were very good (Registration); however, the post-surgery/nursing care experience, overall, was not good . She provided the following examples: the transporter, from PACU to the floor, was curt with her and wouldn’t help her move t o the hospital bed; one of her nurses didn’t know where “anything was in the room.” Another nurse came in and commented that it was the first time they had taken care of a patient with her type of surgical procedure. The patient said the nurse’s com ment made her worry whether she was on the appropriate unit or not. When the nurses learned she was an employee her care improved since she was one of the family. Given the type of surgery, the patient voiced her concern and distress about being transported through the main lobby at discharge. • Actions- – CoA members thanked the patient for her willingness to come share her experience. – The opportunities for improvement around communication and customer service were included into an organization wide Caring Always class. – Teachable moment: Do not burden or frighten the patient by expressing “first time caring for that procedure” • Treating every patient as if they are a member of the family • Discharge processes are being reviewed organization wide. – 4
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