Implementation of Standardized Patient Surveys Helps to Improve Patient Satisfaction Scores
Posted - 2018-06-11
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Bane Care Management LLC operates 14 Skilled Nursing Facilities, three Adult Day Health Centers and two Assisted Living Facilities in Massachusetts. The Bane Care facilities located on the South Shore of Massachusetts use the CoreQ patient experience survey, a set of five measures for skilled nursing care centers and assisted living communities to use to assess satisfaction among patients, residents, and their families. The Bane Care Management leadership team and frontline staff including admission, nursing, and social work noted a variance in survey results among the facilities and began to investigate the variance to improve their CoreQ score.
The Bane Care Management team looked at the overall CoreQ Score for calendar year 2017 to ascertain the benchmark of the top 10% performers in the 300+ skilled nursing facility database. The top 10% performers averaged a 91% overall CoreQ Score. The overall CoreQ Score average for all skilled nursing facilities in the database was 84%. All of the Bane Care Management facilities scored at or above the overall average, however, the team wanted to improve their score to be in the top 10% performer tier.
Using the Quality Improvement Initiative Provider Plan/Process Improvement Plan (PIP) Template to identify area(s) for improvement, the Bane Care Management team came up with action plans/interventions, and as a pilot, implemented these interventions at the Bare Care facilities on the South Shore. The identified interventions would help improve the patient experience right from the very beginning of the patient’s admission to the South Shore facilities. They investigated what was working well across their facilities, compiled these practices, and shared them with each facility. For example, some of the higher performing facilities informed the patient and family/caregivers about what to expect at the facility and addressed any concerns/comments as close to real time as possible. In addition to informing patients about what to expect at the onset of admissions, the team also implemented an Admissions Survey and a Discharge Survey to collect and track data about what the patient was experiencing throughout the stay at the skilled nursing facility, also addressing any comments/concerns from the surveys in real time.
The Admissions and Discharge surveys were used for an in-depth data analysis. The Bane Care Management team tracked and trended three main questions from each survey:
- Did the Skilled Nursing Facility personnel explain what to expect during your stay?
- Overall rating of the Nursing staff so far.
- Overall rating of the Rehab Staff so far.
- Did you receive and understand your discharge instructions (medications, care needs, follow up appointments, etc.)?
- Overall rating of care given.
- Likelihood of you recommending this facility to others.
The feedback from the patients’ comments in the Admission Survey was revealing for the Bane Care Management team and led to process improvement in many facilities. While each facility in the pilot thought that they had a standard process that involved explaining what the patient should expect during their stay at the skilled nursing facility, this process was not a consistent practice with all staff. Many patients commented in the Admission Survey that they did not feel that the staff consistently explained what to expect during their stay at the facility. Data from the Admission Survey was used as an impetus to create a Frequently Asked Questions (FAQs) sheet to help staff explain and to help the patient understand what to expect during their stay at the facility. The FAQ sheet is also a helpful tool for family/caregivers that are visiting the patient on what to expect during the skilled nursing facility stay.
After implementing the surveys and incorporating staff and patient suggestions, most of the Bane Care Management facilities participating in the pilot are now scoring in the mid to upper 90% out of a 100% total score for most metrics. Feedback from the surveys are shared with each facility, so that all can benefit from the great ideas from staff and patient comments at the other facilities. Although some of the facilities still need to see more improvement to get up to the 90% mark, they are working very hard at striving for that goal and sustaining the outcomes. Additionally, the team will be tracking the quarterly CoreQ Scores and are waiting for the January – March 2018 results to be posted and emailed to us.
Since implementing the pilot, the survey process is beginning to become a standard practice among all Bane Care Management facilities and the number of completed surveys each month is shared with all facilities as well as the results/scores.