Innovation in Physician Communication Transforming Communications by Leveraging CareNavigator

1. Innovation in Physician Communication Transforming Communicationsby Leveraging CareNavigator Karie Ryan, RN, MS, BSN Chief Nursing Informatics Officer Health First Melbourne, Florida

2. Holmes Regional Medical Center Viera Hospital Who we are... Palm Bay Hospital Cape Canaveral Hospital Health First Medical Group Health First Health Plans Outpatient & Wellness

4. Physician Communication Dimension = HCAHPS Questions 5, 6, & 7 HCAHPS questions group doctors together By design, HCAHPS data cannot be physician-specific

5. National actual top-box scoresFederal Fiscal Years 2008 through 2012 • FFY 2008-2012, Physician Communication had the least improvementamong 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.

6. 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

7. 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

8. 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

9. 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

10. Workflow & Process • Palm Bay Hospital routes physician communication alerts to the charge nurse and nurse director • Uniqueness = Chief Medical Officer wants physician-specific data

11. Sample alert message via email Sample alert message via pager #:4836902 Room 228: How would you rate Dr. Ahmed’s bedside manner?: Poor

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

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

15. Next Steps • Continue defining process for follow up • Spread best practice • Measure impact in HCAHPS across facilities • Utilize functionality for other HCAHPS domains.

16. Question & Answers KarieRyan, RN, MS, BSN Chief Nursing Informatics Officer Health First