Case Study: SSM Health St. Louis University Hospital

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SSM Health St. Louis University Hospital

• Academic Medical Center – 356 Beds• Key Statistics:

– Employees: 1,908– Admissions: 17,001 annually– Emergency visits: 43,484– Outpatient visits: 91,712– Surgeries: 9,018

• Located in St. Louis City County• Key Characteristics:

– Safety Net Hospital– Teaching Hospital– Level 1 Trauma Center– Known for transplant, cardiovascular, stroke, GI, and

other tertiary care services

Courtesy & Respect Pilot Overview

“Assist SSM SLUH with the development of a courtesy and respect training pilot for their care partners, phlebotomists, environmental services team associates, transport staff, ED techs, and front desk staff with the goal of improving patients’ experiences.”

Metrics: Courtesy & respect items on the Press Ganey survey for:

• Environmental Services• Phlebotomy• “Nurse”• Staff

CCRT – Courtesy, Care & Respect Team

• Identified high performers in each area to lead the design work

• Defined what courtesy & respect means to them

• Named the team – CCRT

• Determined the approach (HEARTS)

• Highly engaged group with ongoing

involvement

International Institute of Saint Louis

• Many new immigrants & refugees working at St Louis University Hospital

• Worked with the Institute in design to help this approach work across cultures

Our HEARTS are Here

Training

Courtesy and Respect Workshop

20-25 Staff Attendees Who are Not on Work Assignment

Courtesy & Respect Training Comments & Ratings

• General comments and suggestions

– Great and informative workshop, I hope it is implemented to all staff

– Definitely get the nurses and doctors involved

– Thank you for having the workshop

• What will you do differently?

– Keep good eye contact

– The workshop made me more aware of my attitude towards others. Encouraged me to smile and interact more.

– Knock and pause before entering room, sit down with patient

– Be more positive, use open-ended questions

– Be more respectful and attentive

– Continue to be present and accessible

– I just want to continue to be happy, positive, always smile, and continue to be a light here at SLU hospital.

* Average Rating 9.1 out of 10!

Care Team Coaching

Individualized, Positive, & Confidential

Care Team Coaching• Individualized 1:1 sessions on the unit/in the department

• Staff on their regular assignment with affording maximum patient interactions Does not interfere with patient care or normal job duties

• Built on best practices in communication & patient experience

• Each participant receives a customized plan for how to improve their communication based on their own personal strengths and opportunities

Cohort Analysis – EVS Staff

Toolkits were developed to support EVS Leaders in focusing on these inconsistencies and opportunities with their staff.

Care Team Coaching :Train the Trainer Pathway

Identify, Vet, Recruit Coaches & Coordinator

Begin Communication

DTA Begins Coaching

Training Workshop for Coaches

Communication Continues

DTA Continues Coaching

Coaches in Training Observe DTA Coaching

Communication Continues

DTA Continues Coaching

Coaches in Training Coach with DTA Observing

Communication Continues

DTA Continues Coaching

SLUH Coaches Coach

Communication continues

Pilot Metrics – Percentile ComparisonBaseline for Discharge Dates: 12/1/2015 – 11/30/2016Pilot for Discharge Dates: 12/1/2016 – 4/30/2017

1112

910

9

1314

9 9

18

0

5

10

15

20

25

Friendliness/courtesy of thenurses

Staff attitude toward visitors Courtesy of person took blood Staff concern for your privacy Courtesy of person cleaning room

Pilot Metrics Percentile Baseline vs. Pilot Comparison(Baseline: 12/1/2015 - 11/30/2016 (n-size ~4400)

Pilot: 12/1/2016-4/30/2017 n-size ~2100)

Baseline Pilot

EVS Focus Prior to Courtesy & Respect Pilot

• Did not have a “Courtesy” question, prior to SSM’s purchase of SLUH

– Hospital used Tenet’s internal SMART Survey

– Transitioned to Press Ganey December, 2015

• Housekeepers were employed by 3 different EVS Contractors in one year (2015)

– Each had their own methods of improving Patient Experience

– Focused on AIDET exclusively

EVS Focus Prior to Courtesy & Respect Pilot

• Hire the right people, focus on their ability to deliver excellent customer service, as the #1 qualification

• Post Patient Satisfaction Scores, and discuss in daily pre-shift huddles

• Trophies given out Monthly to the specific units with the Highest Score, and Most Improved– Deliver trophies, filled with candy

to the Unit, along with tray(s) of cookies. Trophies are kept on the unit until the next month

Leader Rounding at SLUH - PurposeEquip leaders to efficiently and effectively round on both their

frontline staff and their patients and families.Training

Patient & Employee Rounding

Press Ganey Data

Rounding Tracking App

1:1 Data Sessions

Armside assistance with Press Ganey Data

Reinforces training

1:1 CoachingPositive, affirmative, supportive

Focused on patient & employee rounds

Reinforces training

Rounding – Key Questions: Inpatients1. When you press the call light, what happens?

2. Tell me about your care team. Is there anyone who has been particularly helpful to you today that we can recognize?

3. How would you describe the cleanliness of your room and bathroom? Tell me about your housekeeper… Who has been your housekeeper?

4. How has your pain been? How have we been managing your pain? What, if anything, do you think would help make it better?

5. If you had one suggestion for us what would it be? Or “What is one thing we can do to improve?”

Results of Rounding

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EVS Current Focus • Using Sodexo’s FOSS & CARES customer

service platforms to train employees– Crosswalk to HEARTS

• Posting Patient Satisfaction Scores by Unit, highly visible, discuss with staff at all daily huddles

• Continuing to hire the right people.

• 100% implementation of “Cues of Clean”– VIP fold and Gold Seal on TP

– Tent Cards, with Housekeeper’s name

– Sanitary strip over toilet

– $25 Gift cards to employees who are mentioned by name on PG Comments

EVS Current Focus• Picture Perfect

– How the rooms and restrooms should look and be setup after every discharge cleaning

– Laminated and placed on each Housekeeping Cart

• ENGAGE Treasure Chest – Small items Housekeepers can give to

their patients (such as playing cards, notepads, small stuffed animals, etc.)

– Gives Housekeepers another tool to allow them to engage with their patients

• EVS Managers round daily on patients• EVS Managers round monthly with each

of the Nurse Team Leaders, Assistant Directors and Charge Nurses

Janiece Gray, MHA, BSW, CPXP

CEO, Founding PartnerDTA Associates, Inc.

Questions & Answers

James Galloway

Director of Housekeeping, SSM Health Saint Louis University Hospital

Next…

Lunch12:15 PMRiverside

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