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Listening to the Voice of the Patient to Improve the Patient Experience
What was the challenge, opportunity or issue faced?
Hearing the voice of your patients is key to improving experiences, but it is difficult to do. At HackensackUMC Palisades, patient comments reflecting their perspectives were scattered between internal data sources, surveys, social media and doctor review websites. Recognizing that they urgently needed to identify what areas needed improvement, what actions to take and how to prioritize action plans considering their patients’ perspective, Hackensack sought a solution that would meet their patients’ and staffs’ needs.
What did you do to address it?
Hackensack UMC Palisades turned to NarrativeDx, a healthcare-specific comment-processing engine that turns unstructured data into actionable insights and delivers it in user-friendly dashboards. Results are automatically aggregated into a web-based dashboard that shows key themes emerging from patient comments in relation to scores for each CAHPS domain.
According to Bridget Alston, Director of Patient Experience, this technology was “like having a data scientist on our team. I have been able to shift from hours behind a desk collecting and analyzing comments to being out where I need to be with patients, staff and physicians. The system gives us actionable insights that we can prioritize and put into practice.” During the first year of implementation, HackensackUMC Palisades was able to build a baseline from 2,000 patient comments, out of which they identified retrospective and real-time emergent trends that reflect patients’ perspectives of care experiences over time.
What outcomes were achieved?
After analysis of the data, the team responsible for patient experience was able to take the patient’s narrative into account to make measureable improvements. Patient experience leaders could identify key trends, drill down into comments, and pinpoint issues to make informed decisions and directly improve outcomes. Some examples include:
- Inpatient room quietness and room comfort emerged as the most critical topics of negative comments by the patients. 88% of all negative comments mentioned room quietness and 87% of all negative comments mentioned room comfort. Patients had specific comments to reflect their dissatisfaction with “room temperature” and “visitor and other patient noise.” Seeing the evidence in the words of the patients, hospital leadership utilized this information to incorporate specific questions into their rounding process to help identify and address any issues related to room comfort or quietness in real time. Within a quarter, the top box score for Quietness increased above the hospital’s percentile goal for the year. Negative comments regarding room temperature decreased quarter over quarter.
- Doctor helpfulness as well as empathy and compassion emerged as the key drivers of “Always” responses to the question about doctor courtesy and respect. The analysis benchmarked physicians as a cohort within the facility and the dashboard allowed the patient experience director to drill down into comments about individual physicians. The comparative analysis and drill-downs gave the director the necessary evidence basis to share with the CMO those physicians that were identified as displaying positive, impactful behaviors based on the accounts of their patients.
- The dashboard allowed the patient experience director to drill down into comments about individual nurses as well. The comparative analysis allowed the director to share the specific behaviors noted by the patients that made the high-performing nurses stand out from the patient’s perspective. The leaders re-enforced the positive behaviors to reward the high-performers and to coach all unit staff to help them better understand what is important to the patients.
- By taking specific action on all other areas of patient experience, the hospital’s scores improved on 21/26 HCAHPS measures within three months of implementation.
About HackensackUMC Palisades
HackensackUMC Palisades is located in North Bergen, NJ, and serves a population of 400,000 in Hudson and South Bergen Counties. The non-profit Medical Center is a member of the Hackensack University Health Network, and it features a 202-bed hospital and The Harborage, a 247-bed nursing home and rehabilitation center. HackensackUMC Palisades is the largest employer in its service area with more than 1,300 employees and it has an annual operating budget of approximately $150 million. It has been recognized as one of Modern Healthcare’s 100 Best Places to Work in Healthcare.
The NarrativeDx Patient Experience Management Platform is a HIPAA compliant, cloud-based solution that uses healthcare specific, patent-pending natural language processing to detect patterns in verbatim patient feedback from multiple sources, including patient satisfaction surveys, leadership rounding as well as social media and doctor review sites.