Optimizing a Care Experience Model Jeff Critchfield & Aiyana Johnson
TRUE NORTH Zuckerberg San Francisco General 5/17/2018 2 Hospital and Trauma Center
Zuckerberg San Francisco General 5/17/2018 3 Hospital and Trauma Center
Zuckerberg San Francisco General 5/17/2018 4 Hospital and Trauma Center
2017 ACHIEVEMENTS Meaningful Data 12 dashboards Access to Data • Disseminated monthly • Inpatient, Specialty, Food & Nutrition, Environmental Svcs Real-time Patient 2216 Responses feedback • Available in threshold languages • Higher response than HCAHPS Zuckerberg San Francisco General 5/17/2018 5 Hospital and Trauma Center
2017 ACHIEVEMENTS Service Response 91 % rate w/in 24 Recovery hours • 1-Poor or 2-Fair triggers alert to designated leader Caring Leader 73 % Framework Adoption • Attended workshop, identified key behavior & rounding Zuckerberg San Francisco General 5/17/2018 6 Hospital and Trauma Center
2017 LESSONS LEARNED 1. Focus must be supported by performance and aligned with operational priorities. MD RN Environment Food Communication Communication Cleanliness Taste 26% 73% 76% 79% 2. Departmental level engagement is required for sustained improvements. Zuckerberg San Francisco General 5/17/2018 7 Hospital and Trauma Center
2018 STRATEGIES 8 3 The ZSFG Way Advancing Equity Advancing Equity Improving Value and Patient Improving Value and Patient Outcomes Outcomes Ensuring Flow and Access Optimizing Care Experience Ensuring Flow and Access Financial Stewardship Optimizing Care Experience Building for the Future Optimizing Workforce Care & Development The ZSFG Way Implementing an enterprise-wide Building for the Future Electronic Health Implementing an enterprise-wide Electronic Health Record Record Zuckerberg San Francisco General 5/17/2018 8 Hospital and Trauma Center
BACKGROUND 2016 2017 2018 Structure Focus Alignment Priority MD Environment Communication Capacity RN Food Performance Communication • Improvement driven • Leveraging daily • Created CEX dept. by first and lasting management system Adopted ICARE • impressions Align with dept. level • improvement work 5/17/2018 9
PROBLEM STATEMENT HCAHPS Likelihood to Recommend 90 80 80 77 70 73 60 50 40 30 20 10 0 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 2016 Avg 2017 Avg Target Since July 2016, we have seen stagnate HCAHPS “likelihood to recommend” patient experience scores due to misalignment between the focus of CEX improvement activities, and ZSFG operational priorities. Zuckerberg San Francisco General 5/17/2018 10 Hospital and Trauma Center
TARGET AND GOALS TARGET GOAL By 6/30/2019, increase the # 12 by 30 by of departments at 100% ICARE Dec 2018 June 2019 bundle compliance from 0 to: By 6/30/2019, increase % 80% by 80% by positive responses for HCAHPS June 2019 June 2019 “Likelihood to Recommend” from 78% to: Zuckerberg San Francisco General 5/17/2018 11 Hospital and Trauma Center
COUNTERMEASURES No. Countermeasure Date Status update 1 Develop ICARE status sheet question 1/30/18 Complete and incorporate into daily management system module 2 Define ICARE bundle measurement 1/30/18 Complete 3 Care Experience team to meet with 30 6/30/18 Complete targeted clinical and ancillary departments to identify PEX metrics Zuckerberg San Francisco General 5/17/2018 12 Hospital and Trauma Center
2018 ACHIEVEMENTS • Quantification of ICARE - “ICARE Bundle” Identification and implementation of an ICARE Key Behavior. Key Behavior Incorporation of a status sheet question regarding ICARE. Status Sheet Identification of a patient experience (PEX) watch or driver metric. PEX Metric Zuckerberg San Francisco General 5/17/2018 13 Hospital and Trauma Center
2018 ACHIEVEMENTS • Increasing ICARE Bundle Compliance Zuckerberg San Francisco General 5/17/2018 14 Hospital and Trauma Center
2018 ACHIEVEMENTS • Leveraging daily management system to reinforce ICARE and align with departmental improvement activities. Daily Management System Roll-Out Wave 1 Wave 2 Wave 3 Wave 4 Wave 5 JANUARY TO MARCH TO JULY TO OCTOBER TO JANUARY TO FEBRUARY JUNE SEPTEMBER DECEMBER MARCH 83% 73% Adoption Adoption Zuckerberg San Francisco General 5/17/2018 15 Hospital and Trauma Center
NEXT STEPS • Disseminate data to those who do the work to create further accountability and transparency: • Data dashboards redesign • Care Experience Data Review Committee restructure • Update real-time patient experience questions • Transition HCAHPS survey vendors. Zuckerberg San Francisco General 5/17/2018 16 Hospital and Trauma Center
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