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Case Study Quality and Performance Robert Wood Johnson University Hospital Presented by: Rick Bekanich Pete Brenkosh Amandadeep Kaur Dee Walski

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Case Study Quality and Performance

Robert Wood JohnsonUniversity Hospital

Presented by:Rick BekanichPete BrenkoshAmandadeep KaurDee Walski

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Outline

Background on Robert Wood Johnson Hospital

Customer satisfaction as it pertains to quality health care

Has the organization been cited for poor quality ?

Are there any ongoing quality initiatives at the hospital?

Has the organization been cited for exceptional quality?

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Introduction

Robert Wood Johnson was founded in 1884

Located in New Brunswick NJ Academic medical center Partnerships between research

facilities, teaching hospitals and clinics

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Over 1,300 physicians and surgeons are affiliated with the hospital which includes the NCI- designated Cancer institute of New Jersey, the Child Health Institute of New Jersey and The Bristol Myers Squibb Children's Hospital

Provides full range of health care

Specialties include cardiac care, heart surgery and transplants, cancer care, pediatrics and maternal -fetal medicine

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Earned significant national recognition for clinical quality and patient safety

Ranked (NO. 36) heart surgery (NO.40 ) cancer and (NO. 50) for respiratory disorders according to U.S News & World report’s 2009 ranking of “America’s best hospitals”

Harvard University identified RWJUH as one of the top 10 hospitals in the nation for clinical quality

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Who Is a Customer?

Actual , Potential or future user of the hospital or service

Hospital customer different from regular customer

Forced to be a customer Customer interacts with all parts of

staff

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What Is Customer Satisfaction?

Customer satisfaction is a person’s feeling of pleasure or disappointment in relation to his/her expectations

Customer satisfaction is ability to meet expectations of the patients

Exceed the customers expectations to make him/her highly satisfied

High satisfaction creates a bond with hospital

High patient loyalty

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Customer Satisfaction And Quality Healthcare Metrics

Good quality medical care (successful surgeries)

How are you treated by staff? Do they seem caring ? How long do you have to wait ? How good is the food ?

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Source: Consumers Digest Leapfrog Dec 04

Has the organization been cited for poor quality?

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Issue of patient feedback systems at healthcare institutions

Major reforms of Health insurance industry & health care delivery system ongoing trends toward greater transparency of quality of care & patient satisfaction are likely to accelerate.

Private insurers adopt quality metrics, including Patient Satisfaction, as measures of performance and value, advancing pay to performance of an organization.

Health insurance is moving toward reimbursement based on Quality. Organizations that don’t quickly improve performance will be at a competitive disadvantage.

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What areas are specifically poor?

Lack of effective feedback system made it difficult for patients to comfortably communicate with hospital about last visit.

Hospital was not able to understand the concerns of patients and staff.

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Consumers/Patients

Paying higher cost of health care

Shopping for value

Use Hospital Compare – Federal Gov’t database for quality and patient satisfaction

Use Hospital Compare – Federal Gov’t database for quality and patient satisfaction

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Trends Hospitals put even greater emphasis to listening to

voices of patients.

Direct correlation between high satisfied caregivers and satisfied patients that in turn leads to easier recruitment and retention of qualified doctors, nurses and technicians.

Press Ganey research – Hospitals with high satisfaction ratings are the most successful financially. Satisfied patients will recommend the hospital to family and friends through “ word of mouth”.

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Source: Press Ganey

Patient Feedback- Hospital Pulse Report 2009

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PatientSurveys

Feedback Forms

Measuring Customer Satisfaction

DeptC

DeptB

DeptE

DeptD

Dept A

DeptF

DeptG

Paper or Email

RWJ - Patient Relations

How is quality measured for this particular product/service/process?

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Problems with this type of quality measurement

Paper base system› Costly› Time Consuming› Hard to collect info from all touch points› Not completely anonymous› Turn around response not quick enough

Problems could escalate Patients already discharged Employees solve problems on their own

Management did not have enough information to address customers’ questions and concerns

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Survey Item Priority Rank

Response to concerns and complaints made during your stay 1

Degree to which hospital staff addressed your emotional needs 2

Staff effort to include you in decisions about your treatment 3

How well the nurses kept you informed 4

Promptness in responding to the call button 5

Communication Issues

National Inpatient Priority Index

Source: Hospital Pulse Report Press Ganey 2009 Survey items are correlated to patient ratings of “Likelihood of your Recommending

this hospitals to others”

Represents the experiences of 2,985,690 patients treated at 2,021 hospitals nationwide between Jan 1 and Dec 2008

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Source: Hospital Pulse Report Press Ganey 2009

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Solutions for issues Patient Voice Employee Engagement

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Patient Voice

“Patient Voice provides RWJH with a real-time picture of what is happening in patient care, where problems are occurring, and how long problems are taking to resolve”.

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Patient Voice

Patient Voice provides RWJ Hamilton’s patients with a completely anonymous and confidential forum for submitting feedback and asking questions

Customers can give their feed back during their stay or when they return back to their home

They can visit the hospital’s website to submit their feedback and questions directly to the hospital’s Patient Relations Manager, who oversees the feedback management system

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The patient relations manager then reviews each submission, and if necessary, routes the feedback to the staff member who is responsible for providing a timely and appropriate response

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Employee Engagement

RWJH believes that their employees know what our mission is, live the mission, and work together as a team to accomplish that mission.”

Due to employee involvement employee feel that they are more engaged in an organization and less likely to search for another opportunity

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RWJH rewards their employees with RWJ Dollars which can be used in the cafeteria, gift shop or to purchase gift cards.

The senior leaders of RWJH take advantage of Managing up program with hand-written notes that personally recognize employees for acts of kindness and extraordinary service.

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Benefits of the solution Source: allegiance.com

Since implementing advanced engagement technology more than four years ago, they have continued to enjoy increasing patient satisfaction scores. Our excellent service has been recognized through numerous awards, including the Press Ganey Summit Award presented to the hospital’s Cancer Institute.

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Quality Awards

2004 Malcolm Baldrige National Quality Award

2004 Governor’s Award for Performance Excellence-Gold

2004 Consumers' Choice Award

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Malcolm Baldrige National Quality Award

Named after Malcolm Baldrige, 26th Secretary of Commerce

Established in 1987 to enhance competitiveness and performance.

Started with Manufacturing, service companies and small businesses.

Expanded to Non-profit organizations and Healthcare in 1999

80 companies have won the award since 1988 Information courtesy of

http://www.baldrige.nist.gov/

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Performance Criteria

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Baldrige Assessment

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Results Scoring Guidelines

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Baldrige Results

15/30 program, which guarantees that patients coming into the emergency department will see a nurse within 15 minutes and a physician within 30 minutes

Emergency department patient satisfaction is at 90%, exceeding the national benchmark

New Jersey’s fastest growing hospital for the last five years and improved its market share while closest competitor’s share declined

Charity Care Dollars increased from $5 million in 1999 to $23 million in 2003

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Governor’s Award for Performance Excellence-Gold

Presented by Quality New Jersey (QNJ) Highest and Most respected state-based

Quality Award The award is comprised of six sectors

› Healthcare› Education› Service› Manufacturing› Environment› Government

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Consumers' Choice Award

Survey’s for the award conducted by the Consumer’s Choice Institute

Surveys conducted in Major Canadian and U.S. Cities

Winners are determined by Consumers and not by panel of judges.

Its purpose in to publicly identify establishments that have been voted by the consumer as their choice for excellence.

Information courtesy of www.consumerschoiceaward.com

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Questions?????