Patient Care Study - University of Phoenix...Survey Method The patient version of the survey was conducted online within the United States by Harris Poll on behalf of University of

Presented by:

Patient Care Study

Page

Survey Method 3

Report Notes 4

Executive Summary 5

Detailed Findings 12

Impacts on and Barriers to Quality Patient Care 12

Skills, Training, and Evolving Role 22

Facility Attributes and Measures 33

Appendix 39

Table Of Contents

2

Survey Method

The patient version of the survey was conducted online within the United States by Harris Poll on

behalf of University of Phoenix between June 23-27, 2016 among 2,022 U.S. adults aged 18 and

older, 960 who identified as being a patient with the past 3 months. Figures for age, race/ethnicity,

education, region, and household income were weighted where necessary to bring them into line

with their actual proportions in the population. Propensity score weighting was also used to adjust

for respondents’ propensity to be online.

For purposes of this report, US adults who have had medical care in the past 3 months will

be referred to as “recent patients.”

The healthcare professionals version of the survey was conducted online within the United States

by Harris Poll on behalf of University of Phoenix between June 23 – July 1, 2016, among 250

registered nurses and 253 healthcare administrative staff, who have worked in healthcare for 2

years or more. Each group was weighted to the full-time working population.

For purposes of this report, registered nurses will be referred to as “RNs” and healthcare

administrative staff employees will be referred to as “admin staff.”

3

Report Notes

Throughout this report:

An asterisk (*) signifies a value of less than one-half percent and a dash (-) represents a

value of zero

Statistically significant differences by subgroups of interest are shown in call-outs on

the detailed finding slides. Note that due to space limitations, not every significant

difference is displayed; some that were thought to be less interesting or telling were

omitted. Full survey results are available for other subgroups.

Percentages may not all add up to 100% due to weighting, computer rounding, and the

acceptance of multiple responses.

4

Executive Summary

5

Impact on Care

• A strong majority of RNs and admin staff cite factors which have a major impact on the quality

of care given to patients that are actually in their control, including connecting with the patient

on a personal level (74%, 63%), the ability to answer questions patients have (72%, 69%),

properly training new staff (78%, 72%), and staff communications (73%, 66%).

• Recent patient generally see these aspect as having a major impact on the quality of

care received.

• One aspect rated frequently as a “major impact” is sanitation of the facilities. While all three

groups see this as impactful (68% RNs, 66% Admin staff, 71% recent patients), there may be

limits to how much RNs and admin staff can actually control this.

Executive Summary

6

Barriers to Care

• While over 2 in 5 RNs and admin staff cite aspects such as training of new staff (48%, 45%)

and staff communication (48%, 41%) as barriers to giving patients quality care, recent

patients are less likely to cite these obstacles (11%, 16%, respectively).

• A pain point that all three groups equally cite as a barrier is patient wait time, with roughly 2 in

5 each citing this (39% RNs, 37% admin staff, 35% recent patients).

• While a similar percentage of RNs and admin staff also cite “the overall process of

moving patients through the system” as a barrier (39% and 35%), recent patients are

less likely to see this aspect as an issue (15%).

Executive Summary

7

Skills and Training

• About 3 in 10 RNs (31%) believe they are fully prepared to adapt to the changes that occur in

the healthcare industry—and just over 1 in 3 admin staff (37%) are.

• Still, the vast majority of both feel at least somewhat prepared (94% and 93%).

• While most RNs and admin staff say they are offered training in critical areas such as safety

procedures (85%, 93%) and devices (84%, 88%), far fewer say broader aspects of their job

such as stress management (53%, 56%) and decision making (52%, 45%) are offered.

• When offered, large majorities of RNs and admin staff participate in various trainings,

including safety procedures (92%, 79%), device training (87%, 69%), and customer service

skills (73%, 82%).

• Surprisingly, even when offered, just over half of RNs and admin staff take training on

decision making (54%, 59%).

Executive Summary

8

Relevant and Essential Skills

• For roughly 3 in 4 RNs, problem solving (76%), patient management (76%), and customer

service skills (72%) are most essential for staying relevant in healthcare.

• For about 7 in 10 admin staff, customer service (71%), problem solving (67%), and

technology skills (68%) are key to staying relevant.

• Verbal skills tops the list for both RNs and admin staff as an essential day 1 skill for anyone in

their role (64% , 62%), while problem solving skills (55%, 47%) and customer services skills

(47%, 55%) also bubble to the top.

• For over half of RNs (53%) patient management skills are a “Day 1” essential.

• And these skills are valuable, because over 4 in 5 RNs and admin staff agree that in the past

2 years (84% each) and next 5 years (84%, 86%) non doctors have played and will be playing

a larger role overall in the management of patient care.

Executive Summary

9

Evolving Role

• Nearly half of RNs and admin staff say their role has seen an increased involvement with

information systems in the past 2 years (47%, 46%), and 2 in 5 say they have had to take a

greater leadership role at their facility (39% each).

• Nearly half of RNs say they have seen an increased role in the management of overall

patient care planning (49%).

• Looking to the next 5 years, roughly 1 in 2 RNs and admin staff say they see their role

changing with an increased involvement with regulations (50%, 45%) and information

systems (46%, 48%).

• About half of RNs say they will see an increased role in the management of overall

patient care planning (51%) and focus on patient’s emotional well-being (45%).

• About 9 in 10 RNs and admin staff believe their facility should focus on preparing them with

leaderships (90%, 88%).

• Fewer agree their facility currently does a good job at this (62%, 74%).

• Nearly 7 in 10 registered nurses strongly agree that good people skills are just as important

as technical skills when giving quality care (68%).

Executive Summary

10

Facility Attributes and Measures

• About 2 in 3 RNs and admin staff say patients should be very concerned about the quality of

care given (69%, 65%).

• 2 in 3 RNs cite physical safety (63%) as another area for patients to be very concerned.

• Mirroring earlier sentiments that sanitation had a major impact on the quality of patient

care, 3 in 5 RNs and admin staff cite contamination as an aspect that patients should be

“very concerned” about (58%, 55%).

• Less than half of RNs and admin staff cite customer service as an area to be this

concerned about (47% each).

• Treatment success (79%) and patient-related injuries (71%) are the most frequently cited

“very important” facilities measures by RNs, while admin staff place a greater emphasis on

medical record errors (76%) and patient complaints (69%).

• Large majorities of RNs and admin staff say their facilities measure various aspects of the

patient experience—including patient complaints (89%, 81%), number of patient-related

injuries (87%, 77%), and patient satisfaction survey (89%,79%).

Executive Summary

11

Facility Future

• Large majorities of RNs and admin staff agree that their facilities adapt well to the changes

occurring in the healthcare industry (79%, 82%) and that the future of healthcare is largely in

the hands of the staff (81%, 78%).

• Furthermore, roughly 3 in 4 RNs and admin staff believe in the past 2 years healthcare has

become less hospital centric (74%, 79%)—and nearly 9 in 10 see that trend continuing for the

next 5 years (88%, 85%).

Detailed Findings –

Impacts on and

Barriers to

Quality Patient Care

12

Just under half of U.S. adults have received some kind of medical care in

the past three months.

A small majority of those in their 50s and 60s have, while roughly 2 in 5 younger adults have.

1% 2% 0% 1% 0% 0%

54%57% 59%

63%

49% 47%

46% 42% 41%37%

51% 53%

Total(n=897)

20s(n=222)

[B]

30s(n=296)

[C]

40s(n=384)

[D]

50s(n=357)

[E]

60+(n=720)

[F]

Yes

No

Decline to answer

Received any kind of medical care at a hospital, clinic, or

doctor’s office in the last three months

BASE: QUALIFIED RESPONDENTS

Q5 Have you received any type of medical care at a hospital, clinic (e.g., medical or medical retail clinic), or doctor's office in the last three months?

D BCD

FEF


Q710 How much of an impact do you believe each of the following aspects have on the overall quality of care given to patients? 14

60%

69%

59%

66%

57%

69%

63%

68%

62%

72%74%

79%

Problem resolutionAbility to answer questions patientshave

Connection with patients on a personal level (i.e., don’t treat them as a number)

Patient safety (e.g., proper safetyprocedures, using safe equipment)

Summary Of Major Impact

Patient Interaction

B

B

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)

15

47%

56%54%

64%

46%

65%66%

72%

49%

60%

73%

78%

Documented processes (i.e., step-by-step instructions for how to handle

various situations)

Risk management/error reductionStaff communication (e.g., consistentprotocol, procedures)

Proper training of new staff


Staff and training


Q710. How much of an impact do you believe each of the following aspects have on the overall quality of care given to patients?

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)

16

27%31%

45%48%

32%

40%39%

46%

33%

40%

48%47%

Check-out processCheck-in processOverall process of moving patientsthrough the system

Length of wait for patient


Process-related


Q710. How much of an impact do you believe each of the following aspects have on the overall quality of care given to patients?

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)


Q710. How much of an impact do you believe each of the following aspects have on the overall quality of care given to patients? 17

41%

49%

71%

44%

53%

66%

40%40%

68%

SecurityUse of the latest technologiesSanitation of facilities (e.g., cleanliness, lack ofcontamination)


Facility-related

A

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)

18

16%

7%

18%

11%

25%26%

41%

31%

19%24%

31%32%

Ability to answer questionspatients have

Patient safety (e.g., proper safetyprocedures, using safe equipment)

Connection with patients on apersonal level (i.e., don't treat them

as a number)

Problem resolution

Barriers

Patient Interaction

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)


Q715 Based on your experience in the healthcare industry, which of the following, if any, do you believe are currently barriers to patients receiving quality care? Please select all that apply.


Q715 Based on your experience in the healthcare industry, which of the following, if any, do you believe are currently barriers to patients receiving quality care? Please select all that apply. 19

5%8%

11%16%

30%28%

45%41%

19%

25%

48%48%

Risk management/error reduction Lack of documented processes(i.e., step-by-step instructions forhow to handle various situations)

Proper training of new staff Staff communication (e.g.,consistent protocol, procedures)

Barriers

Staff and Training

A

Recent patients are

much less likely to

view staff and

training issues as

barriers to getting

quality care.

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)

20

10%10%15%

35%

12%13%

35%37%

10%

16%

39%39%

Check-out process Check-in process Overall process of movingpatients through the system

Length of wait for patient

Barriers

Process related


Q715 Based on your experience in the healthcare industry, which of the following, if any, do you believe are currently barriers to patients receiving quality care? Please select all that apply.

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)


Q715 Based on your experience in the healthcare industry, which of the following, if any, do you believe are currently barriers to patients receiving quality care? Please select all that apply. 21

4%5%8%

11%

30%

17%

7%

19%21%

Security Risk management/error reduction Sanitation of facilities (e.g., cleanliness, lackof contamination)

RN

(n=250)

Admin Staff

(n=253)

Recent patients

(n=960)

Barriers

Facility Related

A

Admin staff are

more likely to cite

risk management

as a barrier


Skills, Training,

and Evolving Role

22

0 1%6%

6%

63%56%

31%37%

RN (n=250) Admin Staff (n=253)


Q800. How prepared do you personally feel to adapt to the changes that occur in the health care industry with regard to your role? 23

Fully prepared

Somewhat prepared

Not very prepared

Not at all prepared

Fully/Somewhat Prepared [NET]

94% 93%

F


Q740 Does your facility offer any training for the following areas related to the patient experience?

Trainings Offered

24

45%

56%

44%

70%

60%

88%93%

52%53%56%

65%68%

84%85%

Decision making skillsStress management(e.g., dealing with high

pressure situation)

Organization skillsCustomer service skillsFull process knowledge(e.g., cross training onother aspects of the

facility)

Device training (e.g.,new technology,

machines)

Safety procedures(e.g., patient handling,

fire exits)

RN

(n=250)

Admin Staff

(n=253)

BASE: TRAINING IS OFFERED

Q743 Which of the following training opportunities offered by your facility have you participated in? Please select all that apply.

Trainings Participated In

(among those where the training is offered)

25

59%

72%

64%

82%

73%69%

79%

54%

64%60%

73%

67%

87%92%

Decision making skills Stress management(e.g., dealing with high

pressure situation)

Organization skills Customer serviceskills

Full processknowledge (e.g., cross

training on otheraspects of the facility)

Device training (e.g.,new technology,

machines)

Safety procedures(e.g., patient handling,

fire exits)

n=146 n=168

RN Admin Staff

n=234 n=217 n=226 n=206 n=173 n=171 n=106 n=139 n=129 n=133 n=106 n=129

37%

29%

22%

37%

26%

22%

18%

18%

0%

0%

47%

49%

44%

16%

26%

19%

17%

16%

1%

1%

Employee management skills

Basic insurance understanding

Operations management

Physical fitness (e.g., strength training,stamina, energy)

Negotiation skills

Math/statistics skills

Basic budgeting skills

Public speaking skills

Other

None


Q810. Which of the following skills do you feel will be essential to stay relevant in healthcare? Please select all that apply.

Skills Needed to Stay Relevant

26

76%

76%

72%

68%

67%

66%

66%

64%

51%

67%

59%

71%

61%

68%

40%

40%

56%

43%

Problem solving skills (e.g.,improvising with available resources)

Patient management skills

Customer service skills

Verbal communication skills

Technology skills (e.g., mobiledevices, computers, medical

devices)

Triage skills (e.g., identifying,classifying, and redirecting people or

situations to a proper path)

Teaching skills (e.g., to train otheremployees, patients)

Organization skills

Written communication skills

RNs(n=250)[A]

Admin Staff(n=251)[B]

B

B

B

B

C

C

62%

55%

47%

44%

43%

35%

25%

23%

20%

17%

15%

14%

12%

12%

11%

9%

6%

6%

2%

1%



Problem solving skills (e.g., improvisingwith available resources)

Organization skills

Technology skills (e.g., mobile devices,computers, medical devices)





Risk management skills


Triage skills (e.g., identifying, classifying,and redirecting people or situations to a…



Negotiation skills




Other

None


Q805. Think back to when you first were hired in your current role. Which of the following skills, if any, do you think are essential to be effective in the job on ''Day 1''? Please select up to five.

Day 1 Essential Skills to be Effective

27

64%

55%

53%

47%

40%

40%

37%

30%

20%

16%

9%

8%

7%

7%

6%

5%

5%

2%

1%

1%


Problem solving skills (e.g., improvisingwith available resources)



Organization skills

Triage skills

Technology skills (e.g., mobile devices,computers, medical devices)


Risk management skills






Negotiation skills




Other

None

RNs(n=250)[A]


4% 5%1% 4%

11%12%

15% 10%

43%47%

40% 43%

41%37%

44% 43%

Registered Nurse (n=250) Admin Staff (n=253) Registered Nurse (n=250) Admin Staff (n=253)


Q745 How strongly do you agree or disagree with the following statements? 28

Strongly agree

Somewhat agree

Somewhat disagree

Strongly disagree

Strongly/Somewhat Agree [NET]

84% 84% 84% 86%

F

In the next five years, I think non doctors will play an

increasingly larger role overall in the management of

patient care.

Compared with two years ago, I think non doctors are

playing a larger role overall in the management of

patient care.


Q815. Which of the following, if any, describes how your role has changed in the last 2 years? Please select all that apply.

Ways Role has Changed

29

49%

47%

39%

37%

37%

33%

32%

32%

28%

17%

7%

2%

35%

46%

39%

31%

31%

42%

25%

14%

42%

25%

14%

2%

Increased management of overall patient careplanning

Increased involvement with information systems

Expected to take greater leadership role at myfacility

Increased requirement to innovate in addressingissues

Increased focus on the patients' emotional well-being as well as physical

Increased involvement with regulations

Increased involvement in direct patient care

Doing tasks that have traditionally been done by adoctor

Increased involvement with privacy issues

Increased interaction with the community we serve

N/A-My role has not changed substantially

Other

Registered Nurse(n=250)[A]


B

A

A

B


Q820. Which of the following, if any, describes how you expect your role to change within next 5 years? Please select all that apply.

Ways Role Will Change

30

51%

50%

46%

45%

44%

41%

38%

34%

30%

25%

2%

11%

26%

45%

48%

26%

36%

31%

22%

23%

27%

37%

4%

18%

Increasingly greater role in the management ofoverall patient care planning

Increasing involvement with regulations

Increasing involvement with information systems

Increasing focus on the patients' emotional well-being as well as physical

Increasingly greater leadership role at my facility

Increasing requirement to innovate in addressingissues

Doing tasks that have traditionally been done by adoctor

Increasing involvement in direct patient care

Increasing interaction with the community we serve

Increasing involvement with privacy issues

Other

N/A- I don't think my role will change substantially

RNs(n=250)[A]


Privacy issues are expected to change the admin staff role in

the next 5 years, say nearly 2 in 5 admin staff.

B

B

B

B

A

0 2% 4% 6%10%

10%14%

20%

55% 55%47%

39%

35% 34% 35% 35%

RNs (n=250) Admin Staff (n=253) RNs (n=250) Admin Staff (n=253)



Strongly agree

Somewhat agree

Somewhatdisagree

Stronglydisagree


90% 88% 62% 74% A

F

I think facilities should focus on preparing healthcare

professionals with greater leadership skills.

I think my facility does a good job preparing its

healthcare professionals with leadership skills.

2% 4% 1%4%

6%

2%

40%27%

28%

54%63%

68%

When a physician is not available, I feelcomfortable giving medical care appropriate to my

skill level to a patient.

Nurses are underappreciated for the role they playin giving medical care.

Good people skills are just as important astechnical skills in giving quality care to patients.

BASE: RNS (N=250)


Strongly agree

Somewhat agree

Somewhat disagree

Strongly disagree


94% 90% 96%

More than half of RNs strongly agree they feel comfortable giving medical care appropriate to their skill

level when a physician is unavailable.


Facility Attributes

and Measures

33


Q735 In your opinion, how concerned, if at all, should a patient be with each of the following aspects of their visit?

Patients Should Be “Very Concerned”

34

47%

55%55%54%

65%

47%

53%

58%

63%

69%

Customer service (e.g., friendlinessof staff, helpfulness)

Security of private information (e.g.,medical records, financial

information)

Contamination (i.e., ''getting sick'' inthe hospital)

Physical safety (e.g., proper care,safety procedures, safety codes)

Quality of care (e.g.,competent/attentive staff, pre-

emptive action, error prevention)

RN

(n=250)

Admin Staff

(n=253)

Nearly 3 in 5 cite contamination as

an aspects patients should be “very

concerned” about.


Q725 How important are each of the following measures and statistics when it comes to determining the quality of patient care?

Aspects “Very Important”

35

47%46%

53%54%

69%

76%

62%

83%

40%42%44%45%

56%

62%

71%

79%

Problem/issue ticketresolution (e.g.,maintenance of

equipment,computer tech

support)

Elapsed timebetween admission

and discharge

Average waiting timefor patients to be

admitted

Patient satisfactionsurvey

Patient complaintsMedical recorderrors (e.g., typos,

incorrectinformation)

Number of patient-related injuries

Treatment success

A

A

RN

(n=250)

Admin Staff

(n=253)


Q730 Does your facility keep measurements or statistics on each of the following with regard to the patient experience?

Aspects Measured (Summary of Yes)

36

67%

58%59%

79%81%

73%77%

69% 70%69%64%

89%89%

72%

87%

65%

Problem/issue ticketresolution (e.g.,maintenance of

equipment,computer tech

support)

Elapsed timebetween admission

and discharge

Average waiting timefor patients to be

admitted

Patient satisfactionsurvey

Patient complaintsMedical recorderrors (e.g., typos,

incorrectinformation)

Number of patient-related injuries

Treatment success

B B

B

RN

(n=250)

Admin Staff

(n=253)

3% 4% 2% 4%

18% 14% 16%19%

56%

47% 50% 43%

23%

35% 31% 35%

RNs (n=250) Admin Staff (n=253) RNs (n=250) Admin Staff (n=253)



Strongly agree

Somewhat agree

Somewhat disagree

Strongly disagree


79% 82% 81% 78%

F

I think the future of healthcare is largely in the hands of

support staff.

My facility adapts well to changes in the healthcare

industry.

A

2%6% 3% 5%

23% 15%

9%10%

46% 53%

51%51%

29% 26%

37% 34%

RN (n=250) Admin Staff (n=253) RN (n=250) Admin Staff (n=253)



Strongly agree

Somewhat agree

Somewhat disagree

Strongly disagree


74% 79% 88% 85%

F

Compared with two years ago, I think health care is currently less

hospital-centric, with more decisions and patient care taking place

outside hospital walls.

In the next five years, I think health care will become

increasingly less hospital-centric, with more decisions

and patient care taking place outside hospital walls.

Appendix–

39

RN and Admin Staff Demographics

40

Type of Setting RNs

(n=250)

Admin Staff

(n=253)

HOSPITAL (NET) 70% 35%

Hospital - non E/R 54% 21%

Hospital - E/R 16% 14%

Multi-practice office/medical co-op 2% 18%

Single practice office 1% 19%

Clinic 8% 10%

Nursing home/Managed care facility 7% 6%

Emergency care/Urgent care facility 1% 4%

Other 10% 7%

Number of Patients (per week)

RNs

(n=250)

Admin Staff

(n=253)

0-100 27% 25%

101-200 11% 14%

201-300 5% 12%

301-400 2% 5%

401-500 9% 4%

501+ 16% 25%

Don't know 29% 14%

MEAN 652.0 679.0

Years of Service RNs

(n=250)

Admin Staff

(n=253)

0-1 years - -

2-4 years 15% 20%

5-9 years 29% 24%

10-14 years 18% 25%

15-19 years 9% 14%

20+ years 29% 16%

MEAN 14.1 12.1

Documents

Patient Care Study - University of Phoenix...Survey Method The patient version of the survey was conducted online within the United States by Harris Poll on behalf of University of