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Case Study Quality and Performance
Robert Wood JohnsonUniversity Hospital
Presented by:Rick BekanichPete BrenkoshAmandadeep KaurDee Walski
Outline
Background on Robert Wood Johnson Hospital
Customer satisfaction as it pertains to quality health care
Has the organization been cited for poor quality ?
Are there any ongoing quality initiatives at the hospital?
Has the organization been cited for exceptional quality?
Introduction
Robert Wood Johnson was founded in 1884
Located in New Brunswick NJ Academic medical center Partnerships between research
facilities, teaching hospitals and clinics
Over 1,300 physicians and surgeons are affiliated with the hospital which includes the NCI- designated Cancer institute of New Jersey, the Child Health Institute of New Jersey and The Bristol Myers Squibb Children's Hospital
Provides full range of health care
Specialties include cardiac care, heart surgery and transplants, cancer care, pediatrics and maternal -fetal medicine
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Earned significant national recognition for clinical quality and patient safety
Ranked (NO. 36) heart surgery (NO.40 ) cancer and (NO. 50) for respiratory disorders according to U.S News & World report’s 2009 ranking of “America’s best hospitals”
Harvard University identified RWJUH as one of the top 10 hospitals in the nation for clinical quality
Exist to promote, preserve and restore the health of our community
Mission “ Excellence Through Service”
Who Is a Customer?
Actual , Potential or future user of the hospital or service
Hospital customer different from regular customer
Forced to be a customer Customer interacts with all parts of
staff
What Is Customer Satisfaction?
Customer satisfaction is a person’s feeling of pleasure or disappointment in relation to his/her expectations
Customer satisfaction is ability to meet expectations of the patients
Exceed the customers expectations to make him/her highly satisfied
High satisfaction creates a bond with hospital
High patient loyalty
Customer Satisfaction And Quality Healthcare Metrics
Good quality medical care (successful surgeries)
How are you treated by staff? Do they seem caring ? How long do you have to wait ? How good is the food ?
Source: Consumers Digest Leapfrog Dec 04
Has the organization been cited for poor quality?
Issue of patient feedback systems at healthcare institutions
Major reforms of Health insurance industry & health care delivery system ongoing trends toward greater transparency of quality of care & patient satisfaction are likely to accelerate.
Private insurers adopt quality metrics, including Patient Satisfaction, as measures of performance and value, advancing pay to performance of an organization.
Health insurance is moving toward reimbursement based on Quality. Organizations that don’t quickly improve performance will be at a competitive disadvantage.
What areas are specifically poor?
Lack of effective feedback system made it difficult for patients to comfortably communicate with hospital about last visit.
Hospital was not able to understand the concerns of patients and staff.
Consumers/Patients
Paying higher cost of health care
Shopping for value
Use Hospital Compare – Federal Gov’t database for quality and patient satisfaction
Use Hospital Compare – Federal Gov’t database for quality and patient satisfaction
Trends Hospitals put even greater emphasis to listening to
voices of patients.
Direct correlation between high satisfied caregivers and satisfied patients that in turn leads to easier recruitment and retention of qualified doctors, nurses and technicians.
Press Ganey research – Hospitals with high satisfaction ratings are the most successful financially. Satisfied patients will recommend the hospital to family and friends through “ word of mouth”.
Source: Press Ganey
Patient Feedback- Hospital Pulse Report 2009
PatientSurveys
Feedback Forms
Measuring Customer Satisfaction
DeptC
DeptB
DeptE
DeptD
Dept A
DeptF
DeptG
Paper or Email
RWJ - Patient Relations
How is quality measured for this particular product/service/process?
Problems with this type of quality measurement
Paper base system› Costly› Time Consuming› Hard to collect info from all touch points› Not completely anonymous› Turn around response not quick enough
Problems could escalate Patients already discharged Employees solve problems on their own
Management did not have enough information to address customers’ questions and concerns
Survey Item Priority Rank
Response to concerns and complaints made during your stay 1
Degree to which hospital staff addressed your emotional needs 2
Staff effort to include you in decisions about your treatment 3
How well the nurses kept you informed 4
Promptness in responding to the call button 5
Communication Issues
National Inpatient Priority Index
Source: Hospital Pulse Report Press Ganey 2009 Survey items are correlated to patient ratings of “Likelihood of your Recommending
this hospitals to others”
Represents the experiences of 2,985,690 patients treated at 2,021 hospitals nationwide between Jan 1 and Dec 2008
Source: Hospital Pulse Report Press Ganey 2009
Solutions for issues Patient Voice Employee Engagement
Patient Voice
“Patient Voice provides RWJH with a real-time picture of what is happening in patient care, where problems are occurring, and how long problems are taking to resolve”.
Patient Voice
Patient Voice provides RWJ Hamilton’s patients with a completely anonymous and confidential forum for submitting feedback and asking questions
Customers can give their feed back during their stay or when they return back to their home
They can visit the hospital’s website to submit their feedback and questions directly to the hospital’s Patient Relations Manager, who oversees the feedback management system
The patient relations manager then reviews each submission, and if necessary, routes the feedback to the staff member who is responsible for providing a timely and appropriate response
Employee Engagement
RWJH believes that their employees know what our mission is, live the mission, and work together as a team to accomplish that mission.”
Due to employee involvement employee feel that they are more engaged in an organization and less likely to search for another opportunity
RWJH rewards their employees with RWJ Dollars which can be used in the cafeteria, gift shop or to purchase gift cards.
The senior leaders of RWJH take advantage of Managing up program with hand-written notes that personally recognize employees for acts of kindness and extraordinary service.
Benefits of the solution Source: allegiance.com
Since implementing advanced engagement technology more than four years ago, they have continued to enjoy increasing patient satisfaction scores. Our excellent service has been recognized through numerous awards, including the Press Ganey Summit Award presented to the hospital’s Cancer Institute.
Quality Awards
2004 Malcolm Baldrige National Quality Award
2004 Governor’s Award for Performance Excellence-Gold
2004 Consumers' Choice Award
Malcolm Baldrige National Quality Award
Named after Malcolm Baldrige, 26th Secretary of Commerce
Established in 1987 to enhance competitiveness and performance.
Started with Manufacturing, service companies and small businesses.
Expanded to Non-profit organizations and Healthcare in 1999
80 companies have won the award since 1988 Information courtesy of
http://www.baldrige.nist.gov/
Performance Criteria
Baldrige Assessment
Results Scoring Guidelines
Baldrige Results
15/30 program, which guarantees that patients coming into the emergency department will see a nurse within 15 minutes and a physician within 30 minutes
Emergency department patient satisfaction is at 90%, exceeding the national benchmark
New Jersey’s fastest growing hospital for the last five years and improved its market share while closest competitor’s share declined
Charity Care Dollars increased from $5 million in 1999 to $23 million in 2003
Governor’s Award for Performance Excellence-Gold
Presented by Quality New Jersey (QNJ) Highest and Most respected state-based
Quality Award The award is comprised of six sectors
› Healthcare› Education› Service› Manufacturing› Environment› Government
Consumers' Choice Award
Survey’s for the award conducted by the Consumer’s Choice Institute
Surveys conducted in Major Canadian and U.S. Cities
Winners are determined by Consumers and not by panel of judges.
Its purpose is to publicly identify establishments that have been voted by the consumer as their choice for excellence.
Information courtesy of www.consumerschoiceaward.com
Questions?????