Press Ganey Scores

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Press Ganey Scores

• Research on Promptness in Returning Calls,
  Helpfulness on the Telephone, and Wait Before
  Going to an Exam Room

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Outline

• Topics
• Press Ganey report and data analysis
• Peer group benchmarks
• Promptness in returning calls
• Helpfulness on the telephone
• Wait before going to an exam room
• Solutions and suggestions

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Press Ganey Hospital Pulse Report 2007 Patient
Satisfaction

• The Good News
• Perhaps surprisingly, patients are often very
  complimentary when writing comments on their
  patient surveys. In fact, almost half of all
  patient comments are positive.
• Patients are three times more likely to write a
  positive comment about their nurse or physician
  than a negative comment.

• The Not So Good News
• Communication between hospital staff and
  patients continues to need improvement.
• Communication is a key driver of satisfaction.
• Patients want more attention and credence given
  to their personal needs.
• quotes from Pulse Report on www.pressganey.com

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Press Ganey Hospital Pulse Report 2007 Patient
Satisfaction

• What Is Most Important
• The top priority for improving hospitals, from
  the patient perspective, is the ability to
  respond to their concerns and complaints.
• A hospitals ability to provide attention to the
  patients needs is the strongest predictor of a
  facilitys overall performance score on the
  HCAHPS public reporting tool. HCAHPS, or
  Hospital Consumer Assessment of Healthcare
  Providers and Systems, was developed under the
  direction of the Centers for Medicare and
  Medicaid Services (CMS). Beginning with
  discharges in July 2007, hospitals are required
  to participate in HCAHPS to receive full CMS
  reimbursement.
• quotes from Pulse Report on www.pressganey.com

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Press Ganey Data

• Survey Standards for DHJ
• (from Director John Hayes)
• average of 125 surveys per month sent to
  patients 198 surveys sent in a the last two
  months
• 9 average returned rate or about 11 surveys
  returned per month
• taken from reports on www.pressganey.com

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Time-Series Analysis Promptness in returning
calls
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Time-Series Analysis Promptness in returning
calls
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Time-Series AnalysisHelpfulness on the telephone
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Time-Series AnalysisHelpfulness on the telephone
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Time-Series AnalysisWait before going to an
exam room
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Time-Series AnalysisWait before going to an
exam room
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Peer Group Benchmarks(six-month average
means) data taken from www.pressganey.com
Press Ganey Question n Mean (DHJ) All Sites Mean (Peer Groups)
Helpfulness on the Telephone [phone]
Promptness in Returning Calls 113 63.9 84.4
Wait Time Before to Exam Room 130 70.2 81
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Promptness of Return CallsProblems in
Communication and Perception

• Patient Issues
• patients want immediate resolution of their
  concern
• staff members are not offering the answer that
  patients want
• patients perceive that staff members are not
  meeting their needs due to cultural differences

• Staff Issues
• there is not enough time or staff to return calls
  promptly
• patients are not available when staff members
  call
• patients are not providing telephone numbers
  where DHJ can easily reach them
• patients perceive reasonable delays in callback
  times as poor service

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Cost of Perceived Poor Service

• Patient Dissatisfaction
• loss of current and new patients
• misunderstandings about services leads to a loss
  in JPS reputation
• cost of a patients complaint equals loss in
  dollars ()
• - lawsuits and other legal
• proceedings

• Steps in Patient Complaint
• patient contacts Patient Relations
• Director notifies staff
• staff member researches complaint and conducts an
  inquiry
• staff member calls and meets with patient to
  present answers
• resolved on the spot noted in files

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Helpfulness on the Telephone

• Staff Issues
• reduced staff affects morale and productivity and
  leads to less helpfulness on the telephone
• good time management is needed
• universal telephone system
• - calls in queue patients get
• lost in call tree and are holding for 15
  minutes or longer
• - need an enhanced single
• telephone system to support
• a large volume of calls

• Patient Issues
• patient seeks help right away for all concerns
• patients believe that JPS owes them high quality
  service at no cost
• patients perception of how issues they have are
  handled or answered can be either
• - helpful or
• - not helpful

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Patients Perception of Helpfulness

• Helpful
• needs met and responses correspond to patients
  questions
• receives a call back within 2 hours
• receives a follow-up call from their doctor
• appointments are available same day

• Not Helpful
• does not receive a call back in a timely manner
• staff members are not answering when phones ring
• providers are not hearing what patients are saying

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Helpfulness on the Telephone Survey of DHJ Staff
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Helpfulness on the Telephone Survey of DHJ Staff
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Helpfulness on the Telephone Survey of DHJ Staff
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Helpfulness on the TelephoneSurvey of DHJ Staff
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Wait Before Going to Exam Room Staff Issues

• Registration
• check-in time taking an average of 5-8 minutes
• slow internet access
• - A2K takes less time per
• patient than Net Access
• - dropped transactions
• can take gt5 minutes

• Steps in Registration
• give educational information to patient
• verify demographic/ask questions
• scan/verify insurance
• consent/HIPAA forms
• receive co-pay
• put on armbands

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Wait Before Going to Exam Room Clinical Staff
Issues

• MDs show up late
• providers take too long between patients
• providers take time teaching residents as well as
  treating patients
• providers may handle emergency procedures and
  schedules fall further behind

• physicians do not have quick access to patient
  clinical information
• medical records are not available at time of
  visit
• support staff members are sometimes shared
  between providers

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Wait Before Going to an Exam Room Patient Issues

• patient shows up late
• patient does not have proper information
• pediatric patients require different forms
• non-compliant or difficult patients require more
  time to register and treat
• patients hate waiting and leave without being
  seen by a provider
• patients take smoking and bathroom breaks and
  staff needs to search for them

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Wait Before Going to an Exam Room Patient Issues

• patient visit type changes from a simple
  follow-up to a longer medical procedure
• patients miss follow-ups and require referral
  appointments, but referrals are hard to get since
  there are not enough specialists
• patients schedule appointments but will show up
  at a walk-in clinic they prefer walk-ins over
  appointments
• DNKA rate (DHJ) 23 for April 2007
• - 2,484 patients scheduled and 571 DNKA
• YTD rate (DHJ) 19
• - 12,430 patients scheduled and 2,349 DNKA

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Solutions and SuggestionsPromptness in
returning calls

• patient liaison/advocate position
• use of automated Televox callback system to its
  fullest extent
• clearly inform patient of when to expect a return
  call
• clarify patients expectations of what DHJ can
  immediately do for them
• Quotes from staff members
• need to specify on survey how long the wait for
  return phone call is we
• may be calling back in a reasonable
  timeframe from a medical standpoint,
• but some (most) pts. are unrealistic
  in their expectations. Waiting longer
• than 5 mins. is too long for some
  and they will give low marks
• pt. wants an instant/complete answer to their
  call regardless of the issue.
• Some things are not resolved in 15-30
  mins. maybe before the end of
• the day.

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Solutions and SuggestionsHelpfulness on the
telephone

• hire a dedicated phone operator (PBX)
• create a better mix in the staffing model
• re-enforce customer service behavior with staff
• patient orientation to learn DHJ processes
• provide discharge instruction sheet and
  informational handouts to patients

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Solutions and Suggestions Helpfulness on the
telephone

• Quotes from some DHJ staff on tone of voice
• a caring tone is low and well modulated,
• with an underlying smile in tone
• when you express and transmit through your
• voice that you really care in a soft
  tone, you
• identify yourself with patients concerns
  and
• issues

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Solutions and Suggestions Wait before going to
an exam room

• Controllable
• physicians starting work on time
• getting patients in and out of exam rooms faster
• improve current practice management system to
  create faster registration times

• Uncontrollable
• self-service kiosks similar to the ones in
  airports
• improving Net Access software to make it more
  user-friendly

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The Bottom Line

• Press Ganey 2007 Report
• The Press Ganey Hospital Pulse Report Patient
  Perspectives on American Health Care finds
  patients want care that is safe, complete, and
  delivered in a manner that respects their
  personhood.
• Responding to concerns with compassion and
  sensitivity is essential to providing quality
  patient care.
• The bottom line is, if hospitals listen to what
  patients are saying then they can offer them
  better quality health care.
• quotes from Pulse Report on www.pressganey.com

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The Bottom Line for DHJ