|Patient Experience Case Study - California Health Care SNI|
See the opportunities and challenges organizations face in addressing the patient experience.Case Studies provide real stories of current efforts, including programs being initiated, practices being implemented, and outcomes being targeted and/or achieved. Case studies are presented as both an opportunity for learning from others as well as a spark for further ideas on how we work to improve the patient experience. If you have a case study to share please contact us.
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What was the challenge, opportunity or issue faced?
As part of California’s current Medicaid Waiver pay-for-performance incentive program, all of the state’s primary care clinics owned and operated by California’s public healthcare systems recently rolled out a standardized patient experience survey (the Clinician and Group CAHPS survey, or CG-CAHPS.) This common rollout was recognized as an ideal foundation for orchestrating joint improvement activities centered on patient experience in primary care.
What did you do to address it?
Each clinic was asked to assign a local program management team consisting of at least one person in each of the following roles: Management Sponsor, Language of Caring Facilitator and Data & Quality Improvement Contact. In addition to gathering baseline CG-CAHPS data for the group, we also administered a brief Staff Pulse Survey, which allowed clinic staff and providers to provide feedback on their experience of working in the clinic.
The program had two key components:
The program concluded after 9 months with an all-day Capstone Event where clinic teams and patients showcased their implementation and improvement efforts, reviewed results, and outlined plans for sustainability.
What were the outcomes?
The ensuing CG-CAHPS Improvement Network was a year-long collaboration aimed at enhancing the skills of staff and providers to effectively and reliably communicate empathy and caring, as well as increase their capacity for conducting evidence-based quality improvement in the area of human experience.
At the post-measure, the aggregate CG-CAHPS scores revealed an overall pre-to-post increase on the Staff Communication items. Aggregate Provider Communication results were varied, with some scores remaining the same or decreasing. The aggregate results on the Staff Pulse Survey revealed an increase in scores on all questions. The data suggest that the program was effective in improving communication and empathy conveyance among clinic staff: clerks, receptionists, and clinical/medical assistants.
Although it is always difficult to be certain about the impact of a single program given the complexity of health care environments in the public health care systems’ clinics, our pre and post CG-CAHPS and Pulse Survey data were supported by ample anecdotal evidence gathered from the clinics throughout the implementation activities. The four systems that participated in our Network were eager to work on accelerating improvement using CG-CAHPS as the common metrics platform. They recognized the focus on empathy conveyance skills as an appropriate vehicle for improvement in their safety net environments and saw improvements in staff communication and the overall clinic climate.
The seed has been planted and the majority of the clinics plan to continue affirmatively focusing on the communication with their patients and among staff in order to sustain and deepen the gains achieved through this program.
About California Health Care SNI
Established in 1999, the California Health Care Safety Net Institute (SNI) is committed to advancing community health for California’s low-income and uninsured populations. Their work builds on the belief that California’s public healthcare systems are uniquely well-qualified and dedicated to addressing the health needs of vulnerable individuals and at-risk communities, within the context of California’s rich racial and ethnic diversity.
About Language of Caring
Language of Caring is a partnership of Wendy Leebov, Jill Golde and Dorothy Sisneros—a powerhouse trio who share a passion for reshaping healthcare organizations to become communities of caring. Their track record as healthcare leaders, organization development professionals, instructional designers, strategists and coaches is without equal. They’ve enlisted and certified a talented team of physician leaders, nurse leaders, trainers, team-builder, and culture change professionals who share their passion for this work and serve as coaches, strategy partners and facilitators with clients engaged in implementing Language of Caring programs.