Quality of Life Interventions to Influence PHM Outcomes: Early Lessons

from Two Studies…and some musings

March 24, 2015

Ronni Schorr, Vice President of Brand and StrategyRachel Permuth, PhD, National Director of Research

Factors that Affect Health: PHM Approach

Help!

Determinants of Health

Determinants of Health and their Contribution to Premature Death, Adapted from McGinnis, et al., 2002

Determinants of Health: Areas of Sodexo’s Influence

Sodexo Wellness Offers + Environment Change

Sodexo Wellness Offers + Environment Change

Sodexo Dieticians, MSWs, SNFs, Interface with Hospitals and Primary Care

Sodexo Dieticians, MSWs, SNFs, Interface with Hospitals and Primary Care

Sodexo FMInfection Control within Hospitals + Communities

Sodexo FMInfection Control within Hospitals + Communities

Sodexo Foundation, Philanthropy, STEM, Diversity & Inclusion

Sodexo Foundation, Philanthropy, STEM, Diversity & Inclusion

Confidential and proprietary to Sodexo. Do not share or post without proper consent.

Quality of Work Life Study, Front-Line Workers: Initial FindingsRachel Permuth, PhD, MSPH National Director of Research, Sodexo

Quality of Work-Life, Productivity and Front-Line Worker Well-Being: A Feasibility Study Designed to Inform a Quality of Work-Life Training Module

Study Goals

6

Study Design –

Using Two Hospital Sites

Sample:

•Site 1•

N =118

•

Response Rate=74%•

85% female / 15% male

•Site 2•

N=170

•

Response rate =81% •

71% female / 29% male

•2-day on-site data collection across 3 shifts•Surveys available in English and Spanish•Survey administered via paper & web-based •Employees received $15 gift card for participation

7

Key Outcome Measures

Satisfied with job (very satisfied) - 28% both groups

Likely to look for a new job (very likely)

■

ES 19% vs FS 15%

Injury requiring medical attention

■

ES 24% vs FS 7%

Injury requiring only first aid, but DID disrupt work

■

ES 17% vs FS 7%

Missed work due to illness/injury

■

ES 57% vs FS 57%

■

ES –

3 days vs FS -

2.4 days

Come to work sick or not feeling well

■

ES 54% vs FS 46%

■

ES –

3 days vs FS –

2.2 days

Satisfied with job (very satisfied) – 25% both groups

Likely to look for a new job (very likely)

■

ES 26% vs FS 10%

Injury requiring medical attention

■

ES 21% vs FS 13%

Injury requiring only first aid, but DID disrupt work

■

ES 21% vs FS 14%

Missed work due to illness/injury

■

ES 44% vs FS 51%

■

ES –

2.25 days vs FS -

2.6 days

Come to work sick or not feeling well

■

ES 61% vs 52% FS

■

ES-

2.9 days vs FS -

2.4 days

Site 1 Site 2

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Results in Brief –

Factors Correlated with Outcomes

9

10 –

Focus on

Key Take-aways

Must think about INTERVENTIONS for Behavior Change beyond the Individual Level

INDIVIDUAL

ORGANIZATIONAL

ENVIRONMENTAL

POLICY

Case Study on Post Discharge  at Georgetown University 

Medical Center

Ronni Schorr Vice President of Brand and Strategy

What Our Clients are Telling Us

“As reform and other forces are changing our landscape, reimbursement,

and the way we delivery care, we must find new ways of doing business and

adapting to this climate to ensure success.”- Sodexo C-Suite Client, Hospital Systems

Elements of Sodexo’s Readmissions Platform

■Hospital specific Service Response Center

■Offering a unique focus on the Patient Experience

■

New & Pre-Admission Calls

■

Discharge Follow-up

13

Sodexo’s Readmissions Initiative

Provides a proven and financially beneficial

program to improve patient experience and reduce hospital readmissions.

Provides a proven and financially beneficial

program to improve patient experience and reduce hospital readmissions.

• Addresses the need for hospitals nurses and staffs to focus on mission critical interactions

• Offers an integrated hub of communication that enables the hospital to monitor, process and analyze large amounts of service data.

• Outperforms the industry standard in its speed to answer (89% VS 85% in calls answered in < 20 seconds).

• Streamlines process, increases service accessibility (24/7 human interface), visibility and high degree of accountability

Benefits of Sodexo SRC

15

SRC: the Backbone of Readmissions Reduction, based on Social Support Theory

As reform and other forces change the healthcare landscape, reimbursement, and the delivery of care, Sodexo and our clients need to identify new ways of doing business and adapting to ensure success.

■

Instill Focused Care Management Priorities

■

Leverage Analytics to Drive Value

■

Become an Influencer with the Patient

■

Proactively Reinforce

16

The Social Support Theory: Four Types of Supportive Behaviors

Source: http://www.med.upenn.edu/hbhe4/part3-ch9-key-constructs-social-support.shtml17

High-Level Evaluation Strategy

■

Decreases unnecessary hospital readmissions

■

Improves health for discharged patients

■

Supports a positive hospital image in community

■

Provides a consistent experience throughout the hospital system

■

Connects the patient to the appropriate hospital professional for a expedited hand-off

■

Increases patient satisfaction and the overall experience

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Readmissions Program through the SRC

■

SRC contacts patients who were discharged from the hospital the day before

■

Asks a series of questions to determine if patient is at risk for readmission.

■

Triages medical issues to appropriate person on the care management team

■

Supports patient for nonclinical issues (i.e., transportation)

■

Collects and reports patient and aggregate metrics back to the hospital

19

Results of Pilot

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Readmission Rates by 40% within 6 months

Patient Experience

Patient Satisfaction

Follow-up Requests

21

Development of a Patient & Organizational Segmentation Tool: Personix™

March 24, 2015

Personix™

Definition –

Hospitals/Patient Segment

Sodexo Healthcare

attitudinal segmentation tool

aimed at understanding & serving

consumers, employeesand end-users globally

through fact-based siteassessment processes

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page 24

Personix™

Patients Model Hospital experience = Fear

DEFLECT FEAR

TACKLE FEAR

INNER FOCUS REACH OUT

Loners Acceptors

Worriers

Self-Centrics MinglersAttentionSeekers

page 25

“MY nurse made sure I had food, she would hold the tray for me and have extra juice, she knew when not to bother me”

“It took a few days to learn what was going on, I finally figured out there was a coffee cart and you could get magazines from it too”

“Staff in the hospital are often too busy to smile”

“There is nothing to do but stare at white walls and wait… at least when the food comes you have something to look forward to”

“Distractions are necessary, you need to cheer up”

“Think about anything else than the reason you are here”

Am I really 

taken care of?

Am I really 

taken care of?

DEFLECT FEAR

AttentionSeekersAttentionSeekers

Attention Seekers Profile: Personix™

Patients model

25

Personix™

Patients

Loners AcceptorsWorriers

Self-Centrics MinglersAttention-Seekers

FEAR OF THE INSTITUTION

DEFLECT FEAR

INN

ER F

OC

US R

EAC

H O

UT

TACKLE FEAR

Vitality

Recognition

Conviviality

Security

Attention‐Seekers

Listen to me

Fear

is avoided mainly by any form 

of distraction and human contact as 

long as it breaks the routine 

proposing emotional relief

“Am I

really taken care of?”

MinglersBond with me

Fear

is actively fought thanks 

to the support of other people, 

inside and outside the hospital

“Am I supported by the right 

human net?”

Self‐Centrics

Singularize my stay

Fear

is a not frontally addressed 

but rather put aside in a effort to 

concentrate on centers of self‐

interests

“Am I getting what I want?”

LonersRespect my loneliness

Fear

is amplified by isolation (wanted 

or not), both feed on each other, this 

depression is endured with a certain 

resolve and resignation

“Am I

getting enough privacy?”

Acceptors

Fear

is kept under‐control on the 

condition as long as a 

comprehensible pathway is clearly 

defined and followed

Follow my plan

“Am I

correctly informed and 

progressing?”

Worriers

Fear

is hardly managed at all and 

requires a severe dose of rational 

explanations and comfort to trigger 

recollection process and bring stability

Regain my balance

“Am I

going to get through 

this?”

In a hospital, at any given moment 

in time, patients’

attitudes can be 

distributed according to 6 clusters

Implications of Personix™

for Hospitals:

27

Confidential and proprietary to Sodexo. Do not share or post without proper consent.

Thank You! Questions?

Ronni Schorr, Vice President of Brand and StrategyRonni.Schorr@sodexo.com

Rachel Permuth, PhD, National Director of Research, Principal Epideimologist

Rachel.Permuth@sodexo.com