Improving Patient Experience (And HCAHPS) With Clarus™
Much has been said about the increasing power of the consumer. With review websites such as Yelp and TripAdvisor, the customer experience across a wide range of industries has become democratized – businesses must satisfy their customers to retain them and grow.
This hasn’t always been the case. Merely 10-20 years ago, consumers over-relied on brand recognition when traveling, for example, knowing nothing better than to look in the Yellow Pages or chase the nearest golden arches in pursuit of a reliable experience. Those days are long gone – consumers can pore through insights and sentiment to make informed decisions.
While healthcare can trail traditional business from a marketing or administrative technology perspective, it has not been exempt from the same democratization. Today doctors, hospitals and healthcare systems at large are evaluated for more than the results of their care – on things like communication, ‘bedside manner’ and more. But in healthcare, patient experience reviews are even more important, because they also drive funding and reimbursement – critical components in keeping a hospital running.
HCAHPS is one such review metric, compiled upon patient discharge. Much like public ‘reviews’ the Hospital Consumer Assessment of Healthcare Providers and Systems is a standardized benchmark of Key Performance Indicators based on 27 questions asked of patients. The questions boil down to 10 measures, including ‘summary measures’, defined as follows:
- Doctor and nurse communication with patients
- Staff responsiveness to patient needs
- Pain management
- Communication about medicine
- Communication at discharge (information to help sustain health or continue treatment)
Of the summary measures, three are directly tied to communication – clearly the biggest concern in the report. A fourth measure, responsiveness, largely coincides with communication, making the patient-physician relationship, through responsive care and thorough communication, the dominant factor in the survey.
Why is HCAHPS important?
HCAHPS is most important for its associated value on health outcomes. But as a measurement, it’s important to incentivizing improved patient experiences highlighted by good nurse and physician communication with patients. Increasingly, hospitals are departing from financial metrics as a sole indicator of good administration and diversifying the evaluation with HCAHPS scores. In facilities such as those operated by North Carolina’s Vidant Health, a $1.6 billion hospital system, the scores now drive small incentives for employees. Given the importance of the underlying benefits associated with positive HCAHPS scores, this is a practice likely to proliferate.
In addition to direct employee performance incentives, HCAHPS has broader financial implications on hospitals and healthcare systems at large. Key to the financial metrics is the Value-Based Purchasing (VBP) program administered by Centers for Medicare & Medicaid Services. Simply put, this links Medicare’s payment system to hospital quality metrics largely assessed by patients. It was authorized in the Affordable Care Act. HCAHPS makes up the Patient and Caregiver Centered Experience of Care/Care Coordination Domain (PEC/CC), which amounts for 25% of a hospital’s Total Performance Score (TPS) in 2016, down slightly in emphasis from 30% in 2015.
The Medicare payments influenced by HCAHPS scores through the above process account for the largest share of Medicare spending – affecting payments for inpatient stays across 3500 facilities nationwide.
The pay for performance model for hospitals is widely lauded as a productive evolution from volume-based metrics. And with its significant emphasis on patient experience, with up to 60% of the measurement being communication-driven, hospitals must seek ways to communicate better with patients. Hospital budgets depend on finding better, more visible and evident means for communicating with their patients.
Expand Your Communications Channels
Doctors and nurses seeking to improve communication for the sake of patient health outcomes, quality and experience scores should diversify the channels through which they communicate. ‘Bedside manner’ has long been the colloquial term for such intangible interaction, but doctors and nurses can’t rely on such unpredictable sentiment, given the imperative for quantifiable measurement with financial implications.
One new communication channel to the patient experience has been the use of electronic media. With the proliferation of entertainment and informational displays, patients can now access important communication digitally. And with innovative displays to accompany ever-evolving biometrics data, some forms of communication can be automated. We’re truly entering an age of informed patients, before, during and after care.
Glassboards as a Channel
Doctors and nurses can leverage glassboards as a channel in the effort to improve communication. Glassboards make simple but important communication such as medication instructions multi-sensory. And in cases where patients can interact with glassboards, doctors and nurses can leverage the memory and retention benefits of multi-modal stimuli in communication. These memories can be important for recall during HCAHPS assessment. The sentiment is confirmed by doctors such as Elizabeth Chabner Thompson, MD, MPH: “To reinforce important information to patients, staff should both write instructions and repeat them verbally, giving patients time to respond with questions.”
Glassboards, specifically the Clarus Healthboard product, can be augmented with essential or supporting design elements in two formats – removable and permanent. The ColorDrop™ technology, for example, enables permanent branding, layout or formatting to be ‘printed’ on the glass, creating a fusion of confidence-building brand intimacy and informative elements such as forms, fields or gridlines. The Transition feature, popular in many healthcare settings, allows doctors and nurses to add, remove and otherwise tailor a board’s backdrop to the patient experience. It’s a simple solution that beautifully tailors patient communication within the context of their care.
With any written medium in a healthcare facility, privacy is paramount. A patient’s approval of doctor and nurse communication could be negatively impacted by poorly erasing surfaces. Traditional writing surfaces, such as whiteboards have porosity that traps dry-erase marker, ink and other contaminants including bacteria making them too risky for healthcare – their aesthetics alone could negatively impact HCAHPS scores.
Illustrative surfaces, such as glassboards are also essential to effective communication with patients who don’t speak English or the languages in which doctors and nurses are proficient. Patients who speak languages different from their caregivers are likely to score HCAHPS communications metrics poorly if they are unable to understand instructions, diagnoses and more. Glassboards present the opportunity to illustrate or simply ‘write out’ concepts, supporting spoken dialogue and enabling patients to discern messaging after the doctor or nurse has left the room.
One HCAHPS challenge identified by the American Hospital Association is the correlation of worsening patient conditions out of the control of caregivers and the corresponding HCAHPS measures. Lost in the stress, pain and grief can be the effort put forth by doctors and nurses to communicate. Glassboards, their pictures worth a thousand words, deliver long-lasting reminders of the communication effort in the midst of varying outcomes.
Glassboards are the ideal medium for doctors and nurses to express their efforts in communication through illustrated and written content. They bring color, personality, and brand equity to the hospital room. And because doctors and nurses should utilize all available channels to connect with patients, glass is an essential medium for optimal communication.
Patient Experience Matters
With 60% of HCAHPS scores based specifically on or influenced by communication, hospitals must invest in the mediums and methodologies to better connect with patients. And given that 25% of VBP Medicare is driven by HCAHPS, hospitals can’t afford to neglect critical communication channels. Glassboards, for their antimicrobial composition, privacy advantages and superior aesthetics, form, and function are the only practical writing surfaces in healthcare facilities. And with their potential to drive long-term value in patient care, the one-time investment in a glassboard will return dividends many times over, both qualitative and quantitative.