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Metrics in a Small Hospital
It is Possible
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Metrics in a Small Hospital
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Metrics in a Small Hospital
Your Presenter
Rev. Mr. T. Patrick Bradley, MA, BCC
Director, Pastoral Care
Cheyenne Regional Medical Center
214 E. 23rd Street
Cheyenne, Wyoming
307-633-7586
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ObjectivesYou will
• Understand the need for good metrics.• Have ideas on how to develop metrics.• Understand the need for good
resources.• Have ideas on who you should cultivate
as resources.
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How Small is Cheyenne Regional?
• Licensed for 212 beds.• Only Level II Trauma Center in
Wyoming.• Includes a hospice and a Skilled
Nursing Facility (SNF).
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Why Metrics• To overcome the perception that we
just go in and pray with people.• We are a county hospital. This
sometimes creates the impression that spiritual care is not part of the mission.
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Let’s Get Going!
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What Metrics?• Number of patients seen?• How long you spend with patients?• How many patients do you pray
with?• How many bibles did you distribute?NO!
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These Metrics• Where are you most likely to be called?• How much time do you spend on a
typical call?• What kind of situation are you called to
assist with?• What time are you most often called?• How satisfied are nurses with your
services10
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Developing Good Data• 6 years!• Loose leaf notebook• Basic computerized system
– Only on certain computers– Needed a geek to get data
• Now on our intranet home page
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Computer Guru
WITHOUT HELP YOU WILL GO UP IN FLAMES
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How Did We Do It?
14© 2010 Cheyenne Regional Medical Center
From “Metrics in a Small Hospital: It is PossiblePresented at the NACC National Conference
March 21, 2009Rev. Mr. T. Patrick Bradley, MA, BCC
Director, Pastoral Care
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Service Entry Form• Chaplain name is automatic.• Patient name for follow up.• Location, ER, ICU, Surgical, etc.
– Drop Down Menu• Code Blue, Patient Request, etc.
– Drop Down Menu• Date is automatic.
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Service Entry Form cont.• Time In is time pager went off.• Length of Visit from Time In.• Helpful check boxes.• Comments: A way for the on call
chaplain to pass information to the day shift chaplains.
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What Data Does This Give Us?
StatisticsChartsGraphs
Material For Presentations
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Sample Output to Excel Spreadsheet
Date Chaplain Location Code Time-InLength of
VisitOptions Hours
12/31/09 David Heaney 82 - Palliative Recent Change 10:30:00 AM 0.5Business Hours
12/31/09 Theresa Odhiambo 32 - Surgery Recent Change 9:30:00 AM 0.5Business Hours
12/31/09 Theresa Odhiambo 51 - Pediatrics Recent Change 10:00:00 AM 0.25
Business Hours
12/31/09 David Heaney 82 - Palliative Staff Request 1:15:00 PM 0.5Business Hours
12/31/09 Beth Wright 62 - Tele Recent Change 1:50:00 PM 0.25Business Hours
12/31/09 Mary Beth Melcher 10 - ER STEMI Alert 5:30:00 PM 2On Call Hours
12/30/09 Christian Robbins 42 - Ortho-Neuro Family Request 10:15:00 AM 0.25
Follow Up Needed
Business Hours
12/30/09 Roserita DuFresne 41 - TCU Other 2:15:00 PM 0.75Business Hours
12/30/09 Beth Wright 82 - OncologyStaff Request 2:15:00 PM 0.5Business Hours
12/30/09 Beth Wright 82 - OncologyStaff Request 1:00:00 PM 0.25Follow Up Needed
Business Hours
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Find an Expert to help with this phase!
OR
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Where Did Our Referrals Come From in 2009?
As we expected
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Why Were We Called In 2009?
SURPRISE!
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How Many Calls or Referrals
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Number of Calls: Business Hours
What did we do different in December 09?
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Number of Calls: On Call Hours
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Average Time Spent: On Referrals
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Average Time: By Type of Referral
How we gathered data evolved.
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Business hours calls are routine referrals.After hours calls are emergencies.
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What type of referrals do chaplains receive during business hours (7:00am - 4:00pm)?
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What type of referrals do chaplains receive during on call hours (4:00pm-
7:00am)?
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What do these two charts tell us?
★Most of our night calls are for emergencies
★Most of our day calls are for referrals
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What type of Referrals Do Chaplains receive most?
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What Else Did We Do?A Staff Survey
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Survey Monkey• Eight Questions• All Staff• Optional• Anonymous
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Questions 1 - 41. What is your profession?
2. How would you rate the availability of chaplains
in your setting?
3. How would you rate the cooperation and
teamwork between chaplains and nurses in your
setting?
4. How would you rate the communication between
chaplains and nurses in your setting? 34
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Survey Questions 5-85. How often do you make a referral to a chaplain?
6. Do you read chaplain progress notes?
7. What Unit Do You Work On?
8. (Optional) Do you have any comments or
suggestions for the chaplains? Is there anything that
the chaplains could do to improve the service they
provide?
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What Were the Results?• We only had 139 people take the
survey.• Not a good sample.• What did we learn?
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Some Results• Who took the survey?
– 84% were clinical
• Where did they work?– Dibs and Dabs from all over.
• The manager on Women & Children pushed the survey– 21% were from Women & Children
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More Results• 51% seldom or never make a referral
to a chaplain.• Only 35% ever read our progress
notes.
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Their Suggestions• A stronger presence on our ARU and
TCU floors.– I assigned an intern to each of those
units 4 hours twice a week.
• Nothing else but complements on what we do.
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How Did We Use This?• We have made a concerted effort to
be more visible on all floors.• We are now attending staff meetings
when possible to increase visibility.• We check in with nurses to see who
we might see before we round.
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What Did That Gain Us?• Referrals are up.• Patient Satisfaction with Spiritual and
Emotional needs being met is up.• How did we verify that?
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Team Seven: Sensitivity To My Needs
© 2006 Chip Caldwell & Associates, LLC. All Rights Reserved.
Increased referrals to Pastoral Care.
Increased percentage of patients asked if they have emotional or spiritual needs.
Increased rounding for emotional/spiritual needs:
Improved format for documenting spiritual/emotional needs in Care Manager
Overall ImprovementsOverall Improvements
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© 2006 Chip Caldwell & Associates, LLC. All Rights Reserved.
Team Seven: Sensitivity To My Needs
90-Day Check InBaseline Data (Tele & Oncology)
number Negatives positives
38 31 7
Follow Up Data (Tele & Oncology)
number positives
74 19 55
60-Day Check InBaseline Data (Tele & Oncology)
number Negatives positives
38 31 7
Follow Up Data (Oncology Only)
number positives
24 19 5
60-Day Check In
90-Day Check In
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Team Seven: Sensitivity To My Needs
Percentage of Increase in Patients asked about their spiritual and emotional needs:
Baseline data = 18% of patients surveyed were asked
60 Day Check In = 21% of patients surveyed were asked
90 Day Check In = 74% of patients surveyed were asked
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© 2006 Chip Caldwell & Associates, LLC. All Rights Reserved.
Team Seven: Sensitivity To My Needs
Pastoral Care Findings:Referrals Med/Surge
MonthTotal Referrals
Staff Referrals
Patient/ Family Referrals
Dec-09 10 8 2Nov-09 15 13 2Oct-09 15 10 5Sep-09 8 6 2Aug-09 5 2 3Jul-09 5 3 2
Referrals Telemetry
MonthTotal Referrals
Staff Referrals
Patient/ Family Referrals
Dec-09 33 18 15Nov-09 20 13 7Oct-09 4 1 3Sep-09 3 0 3Aug-09 6 3 3Jul-09 5 3 2
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Team Seven: Sensitivity To My Needs
% of Increase Staff Referrals on Med/Surg
Peaked at 300% in November*
* December referrals down due to lower census
% of Increase Staff Referrals on Telemetry
September to Dec = 400%
Percentage of Staff Referrals to Pastoral Care
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Team Seven: Sensitivity To My Needs
Patient Satisfaction Trend Telemetry
Response to the Press Ganey Inpatient Survey Question“Degree to which the hospital staff addressed your emotional needs”
Month Received 2009
Month Received 2009
Sept Oct Nov Dec
Mean Score 87.1 94.4 89.7 90.6Percentile Ranking 83 99 96 98
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Why Did We Do This?• It gave us statistics in a format that
MBAs, MHAs and CPAs understand.• It focused us on what we really do.• It gave us a healthy accountability.• It shows how we contribute to
patient satisfaction.
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Who Cares?• We must be assertive• Show the data to your:
– Director– Vice President– CEO– CFO
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Brag!• To the managers you help the most• To the charge nurses• To nursing managers• To the Director of Nursing• To the VP of Nursing• To anyone you have lunch with
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Let’s ShareWhat do you think would be good metrics?
• Cost of an average call to a Code One/Blue!
• Average time on a Code One/Blue by chaplain.
• Mean – Median – Mode statistics by type of referral.
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What Is Your Facility?• Hospice• Nursing Home• Trauma Center• Cancer Center• Small Hospital• Large Hospital
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Metrics in a Small Hospital:It is possible
Your Presenter
Rev. T. Patrick Bradley, MA, BCC
Director, Pastoral Care
Cheyenne Regional Medical Center
214 E. 23rd Street
Cheyenne, Wyoming
307-633-7586
