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Navy Patient Satisfaction Survey

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					            The Monitor:
Making The Patient Satisfaction Survey
 Part of Healthcare Decision-Making


         Ms. Aletha Bullock, M3/5 PPM
          Ms. Amy Smith, IMS Health
                 May 10, 2011
                             Outline
Background
PSS Reports to the CEB
Regions Quarterly Report Template
PSS Data Analysis
    Satisfaction by Demographic Group
    Mission Group Drill Down
    Patients Comments
    Issues Summary
    Way Forward
    FY10 PBB Response Rate Report
Best Practices
PSS in Enterprise Decision-Making
The Monitor System Training Guide
Questions and Answers
Backup Slides


                                         2
                Background
Navy Medicine Patient Satisfaction Survey (PSS) was
launched on 14 Mar 2007 to provide timely,
actionable data for health care decision-making
MTFs began incorporating PSS in Action Plans
during the 2009 business planning process
PSS added to the 2009 Strategic Goals process for
Patient Safety, Quality of Care, and Access to Care
Regions ownership of PSS reporting was established
by the Navy Medicine Corporate Executive Board
(CEB) in March 2010 to ensure enterprise-wide
accountability, and responsibility for achieving
Strategic Goals
                                                  3
              PSS Reports to the CEB
REPORT SCHEDULE                    BUMED                   REGION
Weekly                      Top 5 Providers by “B”
                            MEPRS Cost Code

Quarterly (Month 1)         Peer Groups
(Jan., Apr., Jul., Oct.)    Analysis

Quarterly (Month 2)         Mission Groups
(Feb., May., Aug., Nov.)    Drill-down

Quarterly (Month 3)                                  Performance
(Mar., Jun., Sept., Dec.)                            Improvement Quarterly
                                                     Report
Annually                    Year-end Summary;
                            Private Sector
                            Healthcare Benchmarks;
                            Patients‟ Comments
                            Summary
                                                                             4
               Regions Quarterly Report
                                  Template
Date:
Region:
Overall Response Rate:
Question(s) with Satisfaction below 80%:


Branch Clinics/MEPRS Cost Codes with Question(s) Satisfaction below 80%:




Corrective Actions Implemented:   (Example: Increase FTEs, Staff training; Upgrades to
automated phone system; etc.)




Successes/Challenges Resulting From Previously Implemented Actions:



                                                                                   5
            PSS Data Analysis

Analyze data by question for Peer and Mission
Groups to determine where patient satisfaction falls
below 80%
Evaluate PSS data at the MEPRS code level; assess
demographic information to tailor corrective actions
to meet unique needs of customers
Monitor patients‟ comments for issues requiring
immediate attention
Implement region level corrective actions; report
results of those actions to the CEB on a quarterly
basis.
Share and implement best practices across Regions
                                                       6
              PSS Data Analysis
                       Go to Green
Regions corrective actions implemented to date
   SOPs
   Realignment of resources
   Pharmacy process improvements
   Staff training includes greater focus on patients‟ hot buttons
Other Benefits
   Identified corrective actions needed to improve other Navy
    Medicine data systems




                                                                 7
                          Satisfaction
                     by Demographic Group
                           Encounter                                                   Facility
            Non-Enrolled     TRICARE Prime      Unknown                 Non-Enrolled    TRICARE Prime      Unknown
Age Group Female    Male     Female  Male    Female  Male   Age Group Female    Male    Female  Male    Female  Male
   0-4    100%      84%       87%    87%      86%     87%      0-4     88%      92%      88%    89%      87%     88%
  5 - 14   87%      89%       89%    89%      88%     89%     5 - 14   91%      89%      90%    92%      90%     90%
 18 - 24   85%      89%       85%    89%      81%     84%    18 - 24   88%      91%      90%    92%      86%     87%
 25 - 34   85%      84%       84%    85%      84%     86%    25 - 34   87%      87%      86%    89%      87%     89%
 35 – 44   86%      88%       86%    88%      86%     89%    35 - 44   90%      92%      90%    92%      90%     92%
 45 – 64   91%      92%       91%    92%      89%     90%    45 - 64   93%      94%      94%    95%      92%     94%
   65 +    94%      94%       94%    95%      93%     94%      65 +    97%      97%      96%    97%      95%     96%

                           Ancillary                                                   Access
            Non-Enrolled    TRICARE Prime       Unknown                 Non-Enrolled   TRICARE Prime       Unknown
Age Group Female    Male    Female   Male    Female  Male   Age Group Female    Male    Female Male     Female  Male
   0-4     83%      50%      67%     72%      72%     73%      0-4     91%      83%      75%    81%      77%     78%
  5 - 14   77%      70%      74%     74%      77%     76%     5 - 14   81%      80%      80%    82%      81%     81%
 18 - 24   78%      83%      77%     81%      76%     81%    18 - 24   80%      84%      80%    85%      74%     78%
 25 - 34   76%      79%      74%     81%      77%     83%    25 - 34   77%      78%      76%    79%      77%     80%
 35 - 44   81%      83%      79%     84%      81%     88%    35 - 44   81%      82%      80%    82%      81%     83%
 45 – 64   87%      88%      85%     87%      87%     90%    45 - 64   87%      88%      87%    88%      86%     87%
   65 +    92%      92%      90%     91%      92%     94%      65 +    92%      92%      92%    91%      90%     92%

                         Net Promoter
            Non-Enrolled     TRICARE Prime      Unknown
Age Group Female    Male     Female   Male   Female  Male    • Based on Full Deployment
   0-4    100%     100%       83%     86%     78%     79%
  5 – 14   87%      84%       84%     84%     82%     83%
                                                                26 MTFs throughout Navy Medicine
 18 – 24   82%      91%       85%     91%     75%     82%
 25 – 34   75%      77%       72%     79%     77%     81%    • Data source: “The Monitor,”
 35 – 44   82%      85%       82%     84%     83%     87%
 45 – 64   89%      92%       92%     94%     89%     89%
                                                                Navy Medicine Patient Satisfaction Survey 2010
   65 +    96%      96%       96%     96%     95%     96%
                                 Mission Group Drill-Down
                                   Marine Corps Clinics
                                                                                       NH Camp Lejeune                                     NH Beaufort
                                                            BMC Camp        BMC Camp    BMC Courthouse    BMC Bldg 15     BMC French      NBHC MCRD
                                  Question
                                                           Geiger MCB      Johnson MCB     Bay MCB            MCB          Creek MCB      Parris Island
                                                          Sep 10 Mar 10   Sep 10 Mar 10 Sep 10 Mar 10    Sep 10 Mar 10   Sep 10 Mar 10   Sep 10 Mar 10
                      Overall Satisfaction                 80%     87%     79%     64%   70%    70%       82%    87%      72%      81%    82%       94%
                      Response Rate                        1%       1%      1%      1%    3%     2%        1%     1%       2%       2%     1%        1%
                      Verified personal information        13%     25%     32%     40%   21%    38%       26%    29%      10%      18%    19%       31%
                      Provider listened                    93%    100%     95%     80%   85%    88%       92%    93%      91%      94%    90%       92%
                      Explanation of treatment             93%    100%     82%     40%   85%    83%       96%    93%      88%      89%    88%       92%
 Encounter




                      Explained study results              92%     75%     79%     75%   87%    60%       86%    83%      71%      67%    96%      100%
                      Explanation of follow up plan        86%     75%     81%     60%   69%    60%       91%    92%      81%      82%    97%      100%
                      Discussed medications                82%     50%     75%     50%   69%    50%       75%    78%      77%      77%    81%       83%
                      Management of your pain              67%     75%     81%     60%   67%    33%       71%    71%      67%      69%    91%      100%
                      Satisfied with care received         87%    100%     82%     60%   80%    75%       89%    86%      88%      89%    97%      100%
                      Case Management services            100% 100%       100% 100%       0%     0%      100% 100%       100% 100%
                      Phone service when scheduling                        80%     50%   50%    67%      100% 100%         0%            100%    100%
 Access




                      Ease of scheduling                  100%   100%      83%     50%   80%    100%     100% 100%        60%      67%    80%     67%
                      Consideration of your schedule      100%   100%      80%     50%   60%    67%      100% 100%        60%      67%   100%    100%
                      See Provider(s) when needed         100%   100%      86%     50%   100% 100%        67%    50%      50%      67%   100%    100%
                      Pharmacy wait-time                  100%             80%     50%   50%     0%       67%    50%     100% 100%       100%    100%
 Ancillary Services




                      Pharmacy staff support              100%            100% 100%      75%    50%       75%    50%      83%     100%   100%    100%
                      Laboratory staff support            100%   100%     100% 100% 100% 100%            100% 100%       100% 100%        75%    100%
                      Laboratory visit                    100%   100%     100% 100% 100% 100%            100% 100%       100% 100%        67%    100%
                      Radiology staff support             100%   100%     100% 100% 100% 100%            100% 100%       100% 100%       100%
                      Radiology visit                     100%   100%     100% 100% 100% 100%            100% 100%       100% 100%       100%
                      Coordination of services received   100%   100%      86%     50%   67%    33%      100% 100%        50%      50%    80%     67%
 Facility




                      Needs and expectations met          100%   100%      86%     50%   67%    67%       83%    75%      67%      67%    67%     67%
                      Comfort of the facility             100%   100%      86%     50%   83%    67%      100% 100%        80%      67%    83%    100%

Cumulative FY10 Data Period: 16 Dec 2009 to 30 Sept 2010                                                                                                  9
Data Source: Monitor                                                                         Questions with no 4 or 5 responses shown in GREY
                                 Mission Group Drill-Down
                                   Marine Corps Clinics
                                                                                     NH Camp Pendleton           NMC San Diego
                                                                                                                               NH Twentynine
                                                          NHC Quantico    BMC MCB BMC Camp Del         BMC San    BMC MCAS                   NHC Hawaii
                                  Question                                                                                         Palms
                                                                         CampPendleton Mar MCB        Onofre MCB   Miramar
                                                          Sep 10 Mar 10 Sep 10 Mar 10   Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10
                      Overall Satisfaction                88%    90%      77%    89%     75%   100%    78%    85%   85%    91%    83%     91%    86%    89%
                      Response Rate                       10%    10%       4%    4%       2%    1%      3%    3%    12%    11%     8%      7%     9%     7%
                      Verified personal information       24%    17%      16%    27%     12%    14%    20%    24%   26%    32%    29%     34%    28%    16%
                      Provider listened                   93%    93%      89%    89%     86%   100%    84%    85%   94%    93%    92%     96%    91%    92%
                      Explanation of treatment            93%    94%      91%    96%     91%   100%    91%    88%   93%    92%    92%     95%    91%    91%
 Encounter




                      Explained study results             86%    83%      83%    86%     82%   100%    83%    81%   88%    86%    85%     88%    84%    84%
                      Explanation of follow up plan       90%    89%      88%    91%     84%   100%    84%    82%   90%    88%    90%     92%    86%    86%
                      Discussed medications               84%    82%      75%    72%     60%   100%    81%    77%   84%    83%    84%     85%    81%    82%
                      Management of your pain             86%    87%      85%    88%     72%   100%    86%    85%   87%    86%    83%     86%    82%    83%
                      Satisfied with care received        92%    93%      91%    93%     88%   100%    81%    81%   93%    92%    89%     92%    89%    90%
                      Case Management services            71%    100%     50%   100%     50%           83%   100%   93%    90%    87%    100%    84%    88%
                      Phone service when scheduling       83%    91%      50%   100%    100%           83%   100%   94%    91%    82%     83%    86%    94%
 Access




                      Ease of scheduling                  80%    88%      75%   100%    100%   100%    89%   100%   96%    97%    81%     83%    81%    93%
                      Consideration of your schedule      85%    95%      75%   100%    100%   100%    86%   100%   96%    95%    86%     94%    83%    94%
                      See Provider(s) when needed         72%    89%      75%    67%    100%   100%   100%   100%   93%    94%    82%     88%    62%    91%
                      Pharmacy wait-time                  89%    70%      50%           100%           83%    50%   84%    84%    77%     72%    88%    86%
 Ancillary Services




                      Pharmacy staff support              94%    93%      50%           100%           83%    50%   89%    85%    92%     93%    94%    92%
                      Laboratory staff support            93%    100%    100%           100%           88%   100%   96%    94%    95%     95%    96%    96%
                      Laboratory visit                    93%    100%    100%           100%           88%   100%   98%    97%    95%     96%    94%    95%
                      Radiology staff support             89%    100%    100%           100%          100%   100%   98%    96%    96%    100%    92%    94%
                      Radiology visit                     94%    100%    100%           100%          100%   100%   97%    96%    96%    100%    95%    93%
                      Coordination of services received   93%    97%     100%   100%    100%   100%    90%   100%   97%    97%    93%     95%    93%    93%
 Facility




                      Needs and expectations met          90%    93%     100%   100%    100%   100%    82%   100%   96%    96%    93%     94%    95%    96%
                      Comfort of the facility             94%    98%     100%   100%    100%   100%    82%   100%   96%    98%    94%     95%    96%    98%

Cumulative FY10 Data Period: 16 Dec 2009 to 30 Sept 2010                                                                                                  10
Data Source: Monitor                                                                            Questions with no 4 or 5 responses shown in GREY
                                          Mission Group Drill-Down
                                           Training Center Clinics
                                                                               NHC Great Lakes             NHC Annapolis      NHC Quantico        NMC San Diego
                                                                                NBHC NCTC
                                                                   NBHC NCTC                   NBHC NTC NBHC Bancroft BMC OCS        NBHC The      NBHC NTC
                                           Question                              INPR Great
                                                                   Great Lakes                 Great Lakes     Hall      Brown Field Basic School   San Diego
                                                                                   Lakes
                                                                   Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10 Sep 10 Mar 10
                               Overall Satisfaction                83%    91%    79%     89%    70%   80%     84%    96%    85%    96%  67%  81%        88%    92%
                               Response Rate                        1%     1%     1%      1%     1%    1%     4%      3%    4%      5%   2%  2%         11%    10%
                               Verified personal information       79%    80%    26%     39%     8%   11%     17%    32%    24%    36%  11%  10%        39%    42%
                               Provider listened                   86%    100%   85%     87%    83%   82%     95%    98%    98%   100% 85%   91%        94%    95%
                               Explanation of treatment            89%    100%   85%     85%    81%   79%     95%    98%    95%   100% 82%   91%        94%    95%
 Encounter




                               Explained study results             83%    92%    80%     86%    72%   72%     89%    91%    88%    89%  78% 100%        90%    90%
                               Explanation of follow up plan       84%    93%    86%     90%    76%   76%     92%    96%    92%    94%  83%  89%        92%    92%
                               Discussed medications               86%    88%    81%     90%    63%   71%     95%    92%    79%   100% 53%   57%        87%    88%
                               Management of your pain             88%    92%    76%     86%    77%   76%     92%   100%    88%    94%  71%  71%        88%    87%
                               Satisfied with care received        87%    94%    86%     87%    78%   78%     95%    94%    95%    94%  78%  80%        94%    94%
                               Case Management services            69%    67%    100%   100%   100%   100%   100%   100%    75%   100%                  91%    93%
                               Phone service when scheduling       54%    67%    100%   100%   100%   100%    95%    88%    88%    80%                  94%    92%
 Access




                               Ease of scheduling                  87%    89%    92%     92%   100%   100%    96%    91%   100%   100%                  93%    93%
                               Consideration of your schedule      80%    91%    92%     92%   100%   100%    96%    92%   100%   100%                  92%    92%
                               See Provider(s) when needed         90%    100%   78%     88%   100%   100%    96%    91%    80%   100% 33%              89%    90%
 Facility Ancillary Services




                               Pharmacy wait-time                  88%    88%    93%    100%   100%   100%   100%   100%   100%   100% 50%              80%    78%
                               Pharmacy staff support              76%    90%    93%    100%    80%   100%   100%   100%   100%   100% 100% 100%        95%    95%
                               Laboratory staff support            79%    83%    82%     90%   100%   100%   100%   100%   100%   100%                  95%    96%
                               Laboratory visit                    74%    80%    78%     88%   100%   100%   100%   100%   100%   100%                  96%    96%
                               Radiology staff support             77%    80%    100%   100%   100%   100%   100%   100%   100%                         95%    97%
                               Radiology visit                     80%    80%    100%   100%   100%   100%   100%   100%   100%                         97%    97%
                               Coordination of services received   82%    92%    94%     93%    86%   100%   100%   100%   100%   100%   100%   100%    96%    94%
                               Needs and expectations met          88%    91%    84%     89%    88%   100%    96%    90%    88%   100%    75%    50%    96%    96%
                               Comfort of the facility             75%    92%    84%     89%    88%   100%   100%   100%    88%   100%    50%   100%    96%    97%

Cumulative FY10 Data Period: 16 Dec 2009 to 30 Sept 2010
Data Source: Monitor                                                                                     Questions with no 4 or 5 responses shown in             11
GREY
                                  Patients’ Comments
8,000                                                           500
          6,853                                                            441
7,000                                                           450
                                                                400
6,000
                  5,209                    Provider (Doctor)    350
5,000                                                                                                   Encounter/Appt
                                           Facility and Staff   300
                          3,574                                                                         Provider (Doctor)
4,000                                                           250
                              2,690        Encounter/Appt                                               Facility and Staff
3,000                                                           200
                                           Access                                119 114                Access
                                                                150
2,000                                      Appt Wait Time                                  85   68
                                                                100                                     Pharm Wait Time
1,000                                                           50
                                      90
   0                                                             0
        FY10 Top 5 Positive Comments                                   FY10 Top 5 Negative Comments




                                                                                                5,861
        • Based on Full Deployment
           26 MTFs throughout Navy Medicine
        • Total Comments = 29,309
        • Total Comments by Quarter:                                                                      Total Negative

           Q1 = 2,379                                                                                     Total Positive

           Q2 = 8,842
           Q3 = 8,681
           Q4 = 9,407                                                 23,448
          Issues Summary
Verifying personal information
Seeing provider when needed
Pharmacy wait time

Greater emphasis on services provided for
beneficiaries at Marine Corps and Training
Center Branch Clinics
              Way Forward
Continue implementing strategies to address
drivers of patients’ concerns
Encourage maximum support and participation
of PSS
   Implement strategy to incentivize commanders
    support
                       FY10 PBB
                   Response Rate Report
                      Surveys     Surveys      Return    Full Award Full Award  PBB
              Qtr
                       Sent       Received      Rate      Weight     Potential Award *
               1          2,994        1,052   35.14%       5.6%       $ 42,183      $ 41,620
 NNMC          2         11,940        4,123   34.53%       5.7%       $ 42,808      $ 41,926
Bethesda       3         13,723        4,812   35.07%       6.5%       $ 48,612      $ 47,620
               4         14,585        4,787   32.82%       6.0%       $ 44,690      $ 43,902
               1          2,386         400    16.76%       4.5%       $ 33,617      $ 11,610
   NH          2         12,858        2,129   16.56%       6.1%       $ 46,099      $ 18,615
Pensacola      3         12,063        2,165   17.95%       5.7%       $ 42,732      $ 18,739
               4         15,442        2,614   16.93%       6.3%       $ 47,316      $ 18,568
               1          4,162         501    12.04%       7.8%       $ 58,640      $   183
NH Camp        2         11,896        1,487   12.50%       5.7%       $ 42,650      $   208
Pendleton      3         12,723        1,613   12.68%       6.0%       $ 45,070      $   138
               4         15,794        1,961   12.42%       6.5%       $ 48,394      $    61



    * Award value is sum of awards for individual branch clinics within Parent AOR
                 Best Practices
Addition of an appointment center
Addition of Pharmacy Check-in Window
Setting and monitoring performance metrics needing
improvement
Regional involvement with Commanders to ensure staff
training; one-on-one guidance
An automated system to announce prescription availability and
boards that list -“ready to pick-up” prescriptions
Initiate a “2-hour prescription drop-off” option via a check-in
kiosk
Prominently display PSS poster images on exam room doors
so it’s the last thing patients see on their way out
Display 8X10 images of posters at check in desks
PSS in Enterprise Decision-Making
PSS is a component of the NAVMED Patient and
Family Centered Care and Quality of Care Strategic
Goals
PSS Access metrics used to determine need for a
quality improvement Access to Care Action Plan in
MTF annual Business Plans
PSS results used to monitor Business Plan execution
in the achievement of targeted satisfaction goals




                                                      17
“The Monitor" System
   Training Guide
https://navymedicinemonitor.med.navy.mil

                                           19
                  https://navymedicinemonitor.med.navy.mil




                                                              Enter to access
Enter to access                                               BUMED Dashboard &
Patient Surveys                                               User Manager
                                                              Functions




                                                             Enter to access FAQs
Pending
completion of
Provider Survey




                                                                          20
         Account Roles and Access Levels

                         Branch      MTF     MTF                                  Region       Region
Roles      Providers                                    Director   MTF Staff                              BUMED        BUMED PM*
                        Clinic OIC   CDR   POC/Staff*                              CDR       *POC/Staff




Access       Clinic      Clinic              MTF                      MTF        Region       Region       BUMED          BUMED
 Level     Dashboard   Dashboard           Dashboard               Dashboards   Dashboard    Dashboard    Dashboard      Dashboard



            Provider    Provider            Clinics                  Clinics      MTFs         MTFs        Region         Region
            Reports     Reports            Dashboard                Dashboard   Dashboards   Dashboards   Dashboard      Dashboard



                                            Provider                             Clinics      Clinics       MTFs          MTFs
                                            Reports                             Dashboard    Dashboard    Dashboards    Dashboards



                                                                                                           Clinics         Clinic
                                                                                                          Dashboard      Dashboard



                                                                                                                          Provider
                                                                                                                          Reports




                                                                                                                         21
BUMED Login is located inside the Reports and Data module on The Monitor
Homepage. It allows users to:
1) Create accounts to gain access to special reports
2) Reset their password
3) View special reports

4) Also allows administrators to login to manage user accounts.




                                                                  Click to create a
                                                                  new account




 Administrator‟s Login
                                                                                      22
      After clicking the “Create Your User Name” link, the screen below allows the
      user to create a username. The username has a minimum of 7 characters.
      After the user enters their username, they click the „Next” button.




1. Enter your newly
created username
                                               2. After creating
                                              your username, click
                                              the “Next” button




                                                                                23
        In the section below, the user must select a user role associated with their
        assigned level of responsibility and the location of that role.



Drop Down
Menu


Select Region




                                                                        Drop Down Menu for MTF in
 Drop Down Clinic Menu in selected
                                                                        selected Region
 MTFs

                     Operations Manager role is for      Provider ID as CHCS
                     individuals designated to analyze
                     data.



                                                                                                    24
        After the user creates a username, the user will see the profile information screen. The profile
        information screen allows the user to input information that will determine their access level to the
        BUMED Login (Reporting Module).




Select A Branch
of Service




Select Rank
Drop Down Menu
                                                                                           Input First and
                                                                                           Last Name Only
                                                                 Office Phone Number                     25
         The third section of the profile information screen is called the “User UserID and Password”. In
         this section, the user must create a password, enter their .mil email address and create a security
         question and answer.
                                                                           Enter a security question. This
The username is populated from the                                         allows the user to reset their
“create Username Screen”                                                   password



Create a
password that
meets DoD
security standards


Enter your .mil
email address




         Enter an answer to
         your security question                            Click “Create User” button when all of
                                                           the information in the profile is
                                                           complete                                          26
    The following screens will be seen once the user has confirmed that they would like to submit their
    account request to the Administrators. The “Complete” screen will be seen first. This screen
    notifies the user that their account has been successfully created. The next screen will be a
    message from the Navy Medical Monitor Support Center.



1




2




                                                                                                    27
                ?
Question & Answer
     Session


                    28
Back-Up Slides
 FY11 PSS
Questionnaires

				
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