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Best Practices for Working with Practice Managers on CG-CAHPS and Patient Experience

In September 2012, in the midst of the myriad demands of the 25 physician practices across their network, CHI Memorial made the strategic decision to implement CG-CAHPS, receiving their first results in December 2012. This effort would not have been possible without the support from executive leadership within the Physician Enterprise as well as the commitment of hospital executive leadership who both saw the value CG-CAHPS feedback would provide to improve the patient experience and ultimately improve patient care. 

The Beginnings of a CG-CAHPS Initiative

The first order of business was to seek and secure commitments for the program at all levels, including from Catholic Health Initiatives (CHI), the Executive team of the Physician Enterprise, and Executive leaders at CHI Memorial system, who were crucial to the success of the effort. 

The plan to implement CG-CAHPS surveys was presented to physician leadership at Medical Staff Committee. That group immediately saw the value of early adoption of CG-CAHPS and the value of committing to improvement of the patient experience across the system. As the decision for CG-CAHPS implementation was fully supported, Paul Weaver BSN RN, Director of Service Excellence for the system, was tasked with spearheading the effort to get out in front of the CG-CAHPS curve.

When asked why he thought the system was so willing to make the commitment to this effort, Weaver observed: “When CG-CAHPS was first rolled out and was strictly voluntary, we decided to act. We had taken HCAHPS very seriously when it was first introduced. We became early adopters on the inpatient side and saw our early efforts pay off. What we learned as early adopters gave us an edge on HCAHPS as it became mandatory. Prior to HCAHPS, our healthcare system already had a strong focus on the patient experience, and early adoption of HCAHPS just strengthened that focus and prepared us for the impact Value-Based Purchasing would ultimately have on hospitals. Because of our success with early adoption of HCAHPS, we wanted to get ahead of the curve with CG-CAHPS also.” 

Challenges After an Easy Beginning

The results started off fairly strong, but as is typical with any early implementation, opportunities for improvement were also identified. The physician leadership teams worked diligently to make improvements. Over 18 months, they recognized some declines in results and knew they needed to take some additional approaches to excel to the high level at which they knew they were capable. After all, this is a strong group of excellent physician practices. But as we all know, as nationwide scores increase, the gap narrows in regard to getting high percentile ranks. 

So in the Fall of 2014, they sought the assistance of Paul Weaver and requested staff training in CG-CAHPS and even more importantly, Service Excellence training for communication with patients to improve the patient experience within the practices. As recognized at the beginning of the initiative, garnering the attention and ongoing commitment of a group of busy Practice Managers was crucial to the success of the voluntary CG-CAHPS effort.

Connecting to Practice Managers Was Essential

To this end, agenda time at the Practice Managers’ Meeting was made available for review of the progress of the CG-CAHPS survey effort and for reinforcing the value of maintaining momentum as CG-CAHPS moves toward pay-for-performance. Here are some of the best practices for working with physician practice managers on CG-CAHPS and patient experience that were identified in this effort. Organizations should communicate with them on a regular frequency to:

  • Reinforce the purpose for andimportance of preparing for CG-CAHPS
  • Review what is being done with Quality Boards at the practice level
  • Review of CG-CAHPS results using Top Box %, percentile ranks, and trend lines
  • Keep results in perspective and defuse defensiveness about low scores by using the analogy that CG-CAHPS scores are like lab results (They are not intended to be punitive but used as indictors of where action steps need to be taken to get better.)
  • Acknowledge and celebrate high scores among peers
  • Reinforce that provider communication is key
  • Reinforce system-wide quality commitment and consistency

Next Steps

As always, the effort continues to sustain focus at the practice level of busy providers and practice managers. Another next step is to have a rewards and recognition program in which the practices with the highest patient experience scores receive public recognition and a trophy and plaque to openly display in the practice, visible to staff and patients. The organization has done this for many years on the hospital side for inpatient and outpatient surveys to create internal competition to win the trophy and receive the well-deserved recognition.

These tactical efforts are all a part of a larger strategic plan to continue to strengthen the bond between the hospital and the affiliated physician practices so that the Memorial System will continue to move toward being a truly integrated system of health services that delivers a consistently positive patient experience across all locations and all providers.

This blog post is taken from an article in our complimentary eBook, The New Rules of Patient Experience: Creating Sustainable Improvements Across the Care Continuum, available here.

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