Innovation in Physician Communication

Transforming Communicationsby Leveraging CareNavigator

Karie Ryan, RN, MS, BSN Chief Nursing Informatics Officer

Health First

Melbourne, Florida

Who we are...

Cape Canaveral Hospital

Palm Bay Hospital

Health First Health Plans

Outpatient & Wellness

Health First Medical Group

Holmes Regional Medical Center

VieraHospital

http://www.health-first.org/hospitals_services/pbch/index.cfm

• Physician Communication Dimension = HCAHPS Questions 5, 6, & 7

• HCAHPS questions group doctors together

• By design, HCAHPS data cannot be physician-specific

National actual top-box scoresFederal Fiscal Years 2008 through 2012

• FFY 2008-2012, Physician Communication had the least improvement among all 8 HCAHPS dimensions.

• FFY 2008-2012 top-box scores for the Physician Communication dimension increased 1 point. The other 7 HCAHPS dimensions had an average top-box score increase of 4.3 points.

Don’t let the perfect be the enemy of the good

• Skylight feedback questions do not replace HCAHPS

• HCAHPS is a reliable and valid survey

• Skylight: convenience sample, selection bias...

• Each Skylight alert comes from an individual and is a real-time service recovery opportunity

• Supplement quality initiatives with physician-specific data from Skylight

Physician Inclusion

• Palm Bay Hospital began by asking questions about hospitalists

• October 2012 all physicians were included

• May 2013 physician feedback forms are automatically assigned via ADT interface

Question Selection

• Palm Bay Hospital used Communication Assessment Tool (CAT) questions for hospitalists feedback.

• Questions were then modified prior to rolling out to all physicians in the hospital

Measuring patient views of physician communication skills: development and testing of the Communication Assessment Tool. http://www.ncbi.nlm.nih.gov/pubmed/17574367

Assessing patient perceptions of hospitalist communication skills using the Communication Assessment Tool (CAT). http://www.ncbi.nlm.nih.gov/pubmed/21162155

Clearly tying data to individual physicians

The Feedback section of the Health Dashboard identifies specific physician names

Each question includes the specific physician’s name

Workflow & Process

• Palm Bay Hospital routes physician communication alerts to the charge nurse and nurse director

• Uniqueness = Chief Medical Officer wants physician-specific data

Sample alert message via email

Sample alert message via pager

#:4836902 Room 228: How would you rate Dr. Ahmed’s bedside manner?: Poor

Palm Bay Hospital began with a hospitalist PowerPoint video, bios, & surveys

In October 2012, Palm Bay Hospital included all physicians in the Skylight initiative

Next Steps

• Continue defining process for follow up• Spread best practice• Measure impact in HCAHPS across

facilities• Utilize functionality for other HCAHPS

domains.

Question & Answers

Karie Ryan, RN, MS, BSN

Chief Nursing Informatics Officer

Health First