Patient Satisfaction and Patient Engagement · 2. Patient Satisfaction & Networking 3. Patient Education * According to the NIH, 80% of patients are using the internet, and subsequently

*All documents are property of Curis Consulting. Do not duplicate or distribute without written permission.

Patient Satisfaction and Patient Engagement

Prepared By: Jen Calohan, RN, TQMP, PCMH-CCEPrepared For: CHAD

6.11.19

*All documents are property of CURIS Consulting. Do not duplicate or distribute without written permission.

Objectives• The difference between patient satisfaction and patient

engagement• Strategies to create more meaningful patient satisfaction and

patient engagement programs• Best practices for engaging patients• Opportunities to employ patient engagement strategies specific

to your PCMH transformation


Why Patient Satisfaction and Engagement?

Engagement


Patient Satisfaction vs. Pt. Engagement

Satisfaction• Point in time• Reason• Reactive• External Variables

Engagement• Over a period of time• Purpose• Proactive• External or Internal Barriers


Measuring Pt. Satisfaction vs. Engagement• Pt. Satisfaction:

• Quantitative Surveys assessing point in time• Qualitative feedback• You know… but do you really know why?

• Pt. Engagement:• Commitment• Access• Now you know why


Meaningful Satisfaction and Engagement• Satisfaction

• Focused Satisfaction Surveys• Proactive qualitative feedback• Process Improvement oriented measurement

• Engagement• Comprehensive Care Team purpose• 5 dimensions of access• Patient Perspective


Opportunities for Engagement• Five Dimensions of Access:

1. Availability : Patient Needs and preferences2. Accessibility : Ease of use and usability3. Accommodation : Convenience4. Affordability : Understand opportunity5. Acceptability : Patient Centeredness

ACCESS IS A BARRIER TO ENGAGEMENT


After Hours Survey• Have you tried calling our office after hours to speak to a

nurse or provider?• What did you call about?• If no, did you know you could call after hours to speak to a

provider for an urgent care need?


ED Survey

• Have you been to the ED since your last visit?• Why did you go the ED?• Did you try calling our office first?• What time of the day did you go?


Alternative Access Utilization• Would you?• When would you?• Why would you?• Why not?


Elements of Effective Care Management

• Functional:• Data Integration

• Clinical, Claims, Social Determinants of Health

• Risk Stratification• Care

Coordination• Patient

Engagement• Outcomes/

Performance Metrics

• Organizational:• Culture of Team

Based Care• High Performing

Care Teams• Patient Centered

Care• Trust

• Between Team Members

• Between Patients, Families & Care Teams

CareManagement


Aligning Care Management with Population Health Management • Alignment of care management with population needs

promotes supportive, trusting relationships between providers and patients. 8

• Care Management services can build a stronger relationship between the patient and provider and help extend that relationship to the care team.

• Key services directed toward the needs of particular populations include:

• Patient Engagement• Coordination of Care • Self-Management Support• Outreach


Patient Engagement…What is it?“Patient engagement is used to describe everything from patient portals to social media strategies, from tracking vitals with wearables to patients actively participating in their own health and wellness. Everyone seems to be talking about patient engagement, even though we can't agree on what it is.”

http://www.healthcareitnews.com/news/what-does-patient-engagement-really-mean

http://www.healthcareitnews.com/directory/patient-portals

http://www.healthcareitnews.com/directory/social-media

http://www.healthcareitnews.com/news/what-does-patient-engagement-really-mean


Understanding Patients & Their Support Systems• People are complex…don’t assume you

know….ASK!• Who makes up their support system?• What is important to them?• What do they value?• What do they feel that they need?• What are their goals?• What keeps them from reaching those goals?

(from their perspective)• Do you have a process/mechanism to ask

these questions, gather this information and document it?

• Hint….this is highly important data!!!!


The Role of Technology• A recent survey by the California HealthCare Foundation found that

patients pay more attention and are more engaged in their healthcare when they have easy access to their health information online; this is especially true for patients with lower incomes.11

• 80% of Americans who have access to the information in their electronic health records use it; a full two-thirds of those who don’t yet have electronic access say they want it.12

• 41% of U.S. consumers would be willing to switch doctors to gain online access to their own electronic medical records.13

• Only about 20% of U.S. adults currently have access to their medical records online.14


Meaningful Patient Engagement• Meaningfully engaging patients

requires a multimodal approach, which can be largely supported by technology

• The patient portal approach of today, alone, cannot successfully engage, activate and empower patients toward positive behavior change

• There is a growing need for a broader, more comprehensive engagement strategy – and technology holds the keys to many of the vehicles of change

What technology are you using or could you be using to enhance patient engagement?


A Catalyst for Change• Social Media

“Between improving provider communication and building a healthcare-oriented community among patients, social media holds a lot of promising in improving patient engagement” –Sara Heath 19

1. Improved Communication2. Patient Satisfaction &

Networking3. Patient Education

* According to the NIH, 80% of patients are using the internet, and subsequently social media and blog sites, to get healthcare information19


Patient Engagement & Activation• Patient

engagement contributes to improved health outcomes

• Communicating with and educating patients about what matters to them is the key to patient engagement


Self Management & Support

• According to AHRQ-Self Management Support is defined as: “the help given to people with chronic conditions that enables them to manage their health on a day-to-day basis. Self-management support can help and inspire people to learn more about their conditions and to take an active role in their health care” 2

• Self-management support is an essential component of any PCMH care delivery model, effective patient engagement and any care coordination program in primary care


Self Management• Supporting a patient with Self

Management begins with understanding readiness to change

• Affects what decisions he/she will make toward improving his/her own health

• Readiness to change is determined by:

• Importance• Personal values related to

change• “Why should I change?”

• Confidence• Self Efficacy

• “Can I do it?”• “How wil l I do it?”• “Who wil l help me?”


Changing the ConversationThrough Self Management Support techniques, providers have an opportunity to move from a position of:

“Getting” the patient to changehis/her behavior

To a position of: “Motivating and inspiring the

patient to make changes” “Supporting” the patient through

the stages of change?” “Establishing mutual trust and

respect”


Motivational Interviewing 101• Evidence based conversational approach that is

designed to help people identify their readiness, willingness, and ability to change and to make use of their own change-talk. 3

• Collaborative• Patient Centered• Motivating• Inspiring• Respectful• Affirming• Evocative


Collaboration is Key!• Motivational Interviewing is a

collaborative technique that develops a partnership between the patient/family and the healthcare professional.

• The collaborative environment demonstrates respect for the patient/family’s life experience, perspectives and priorities.

• Collaboration invites and encourages equal participation between the patient/family and the healthcare professional.


Essential Care Management Communication Skills• The success of motivational

interviewing relies heavily on the essential skills referred to as ‘OARS’

•O – Open-ended questions

•A – Affirmations•R – Reflective Listening•S - Summarization


The Process• Motivational Interviewing:

• A non-judgmental tone and attitude helps patients be more open about their issues, barriers, “pros” and “cons”

• Focus on the patient’s current state –(meet them where they are)

• Roll with resistance • Dismantle the assumption that we have failed if

patients don’t make decisions toward desired change at each encounter


Helpful Starters• Tell me about ...

• To what extent ...

• What else...

• Help me understand ...• How did you ...• What, if any ...


Outreach Strategies• Outreach to patients is a critical aspect

of managing patients with chronic conditions and those experiencing transitions of care

• Phone calls to patients transitioning to lower levels of care, (i.e. inpatient hospital setting to home) supports reconnection with primary care and reduces the risk of readmission

• Contact with patients on disease registries/population lists facilitates ongoing care coordination and the delivery of follow-up services


Importance of Outreach for Health Center Patient Populations• Because health centers serve vulnerable and

medically underserved communities/populations, our patients face many barriers to accessing healthcare

• Strong outreach initiatives offer the best opportunity for many patients to connect to care, engage with medical homes, and improve their health

• Outreach connects patients to community resources, supportive care services, prevention education, benefits assistance, and care coordination services


“Four Pillars” ®of Transitional Care

• Understanding of medication changes

• Awareness of signs for which they should seek medical attention

• Unanswered questions regarding their hospitalization

• Appropriate follow-up with primary care and/or specialty providers

9 Coleman’s “Four Pillars”® of effective transitional care, describes 10outreach calls during transitions of care can address patients’:


Patient Engagement and PCMH• Team Based Care:

• Do your patients know the roles of the care team members? (TC09)• Are you prepared for what the patient wants and needs? (TC06)• Have you optimized the role of the patients on your Board? (TC04)

• Knowing and Managing Your Population:• Do you know the clinical needs and concerns of your patients? (KM06)• What are the SDoH that could be contributing barriers? (KM07)• Do you know how patients prefer to be communicating with, what is usable, understandable?

(KM08)• Do you know what outreach will have an ROI? (KM12)• Who are your resources outside of your practice and are they helpful to patients? (KM26, KM27)• Is the care team comprehensive and working together? (KM28)


Patient Engagement and PCMH• Patient Centered Access and Continuity:

• Do you know what your patients want from access and how they define the 5 dimensions of access? (AC01, AC06)

• Do you know barriers by population characteristics? (AC09)

• Do your patients have access to continuous care? (AC12, AC13)

• Care Management and Support:• ALL OF IT! (CM01-CM09)


Patient Engagement and PCMH• Care Coordination and Care Transitions:

• Why do patients go or not go to their “orders” (CC01, CC04)• Are your specialists actually helpful and engaging? (CC08)• Do your patients understand treatment options and cost implications?

(CC13)• Can you clinically intervene to encourage appropriate access? (CC14,

CC16)

• Performance Improvement and Quality Improvement• You cannot improve if you don’t understand patient perspective• How can we collect meaningful pt. feedback? (QI04)• Do your patients have an opportunity to contribute to meaningful

quality measures? (QI 17)


QUESTIONS/COMMENTS??

Documents

Patient Satisfaction and Patient Engagement · 2. Patient Satisfaction & Networking 3. Patient Education * According to the NIH, 80% of patients are using the internet, and subsequently