Six Sigma Approach to Effective Communication to Improve Patient Safety and Satisfaction

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<p> 1. Six Sigma Approach to Effective Communication to ImprovePatient Safety and Satisfaction Lois Yingling, RN, MSN, CPHQ Patient Safety Officer, Florida Hospital Winter Park Memorial HospitalWCBFs 9th Annual Lean Six Sigma and Process Improvement Healthcare Summit May 12, 2010 2. 2008 Florida Hospital Orlando1908 Florida Sanitarium 3. Founded by Seven-day Adventist Church in1908 Faith based health system committed to providing whole person care 2188 acute care beds on seven campuses in tri-county area Childrens Hospital under construction will be 8th hospital Over 16,000 employees Over 1900 physicians on staff Over 2900 volunteers 4. The Hospital That Winter Park Built Civic minded citizens shared a vision for a community hospital 1951 non-profit Memorial Trust Organization incorporated to accept donations Fifty-eight bed WPMH opened in 1955 at a cost of $660,000 One-hundred beds added in 1960 5. The Hospital That Winter Park Built Medicare Participation 1966 Columbia partnership 1994 to 2000 Purchase by FH in 2000 Dr. Phillips Baby Place opened June 2007 New tower for Dr. Phillips Baby Place due to open Mothers Day 2010 6. Current State 2010 330 beds after May 2010 225 physicians on staff 1,428 employees 215 Volunteers 15,872 annual admissions 39,319 annual ED visits 9,109 annual surgeries 2,377 annual deliveries 7. DMAIC Define 8. Opportunity Statement: The Top Box Winter Park Nurse Communication Score for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) in September 2009 is 71% (25th percentile). The Top Box for Willingness to recommend is 65% (40th percentile)*Top Box = Always 9. Goal: Improve *Top Box Nurse Communication to 80% (80th Percentile) Improve *Top Box Willingness to Recommend to 69% (50th Percentile)*Top Box = Always 10. Why is focus on communication? Communication root cause of 66% of all Sentinel events (The Joint Commission) Sentinel Event unexpected occurrence causing death or harm or the risk thereof signaling need for immediate investigation 11. Why is communication important? Improve Safety for all patients Nurse communication is perceived as a key driver of Willingness to Recommend in our organization Willingness to Recommend key accountability 12. Scope: 50% of eligible patients randomly selected to receive a survey in the mail Metrics limited to patients who respond to the survey in the designated time frame (window is 8 weeks) Response rate is 31 to 33% 13. HCAHPS: Standardized survey designed &amp; tested by AHRQ &amp; DHHS to measure patient perceptions of hospital care for comparison to other hospitals in 2002 Endorsed by NQF in 2005 Implemented by CMS in 2006 14. HCAHPS: Public reporting 2008 Hospital submission voluntary Medicare payment reduced by 2 percentage points if choose not to submit 15. HCAHPS Aspects of Care: *Communication with nurses &amp; physicians Responsiveness of staff Cleanliness &amp; quietness *Communication about medication *Discharge information Overall rating Willingness to recommend* Communication Metrics in control of nursing 16. D MAIC Measure 17. TOP Box Nurse Communication Linear Trend Model S ource: HCAHPS February through S eptember 2009 0.72 Variab le A ctual F its 0.70 A ccuracy M easuresNurse Communication MA PE 3.66600 0.68 MA D 0.02390 M SD 0.00072 0.66 0.64 0.62 0.60 February March April May June July August September 18. Trend Analysis Plot for Percentile Nurse Communication Linear Trend Model S ource: HCAHPS February through S eptember 2009 Variab le 0.25 A ctual F its A ccuracy M easures 0.20 MA PE 42.5704 MA D 0.0455 M SD 0.0025Percentile 0.15 0.10 0.05 February March April May June July August September 19. Top Box Willingness to Recommend Linear Trend Model S ource: HCAHPS February through S eptember 2009 Variab le 0.65 A ctu al F its 0.64Willingness to Recommend A ccu racy M easu res 0.63 MA PE 3.64435 MA D 0.02205 0.62 MSD 0.00058 0.61 0.60 0.59 0.58 0.57 0.56 February March A pril May June July A ugust September 20. Trend Analysis Plot for Percentile Willingness to Recommend Linear Trend Model S ource: HCAHPS February through S eptember 2009 Variable 0.40 A ctual F its A ccuracy Measures 0.35 MA P E 20.5667 MA D 0.0516 MSD 0.0035Percentile 0.30 0.25 0.20 February March April May June July August September 21. Top Box Medication Communication Linear Trend Model S ource: HCAPS February through S eptember 2009 Variab le 0.62 A ctual F its 0.60Medication Communication A ccuracy M easures MA PE 5.10400 0.58 MA D 0.02708 M SD 0.00094 0.56 0.54 0.52 0.50 0.48 0.46 February March April May June July August September 22. Top Box Discharge Information Information Linear Trend Model Source: HCAHPS February through September 2009 0.82 Variable A ctual F its 0.80 A ccuracy Measures MA PE 4.82035 0.78 MA D 0.03562DC Information MSD 0.00177 0.76 0.74 0.72 0.70 February March April May June July August September 23. AICDM Analyze 24. Stake Holder Analysis Minimal Modest Moderately StronglyStake Holder Engagement Engagment Neutral Engaged Engaged Influence strategy Intentional Rounding byAdministration X Administration Accountability to administration for Assigned Intentional Rounding byClinical Directors X Clinical Directors Accountability to administration for Assigned Intentional Rounding by Non-Non-Clinical Directors X Clinical Directors Accountability to Directors for Daily IntentionalNurse Mangaers X Rounding on units Accountability to NMs for Daily IntentionalAssistant Nurse Managers X Rounding on units Accountability to...</p>

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