1. #HASummit14 James Merlino, MD Session #4: “Voice of the Patient” Using Data to Transform the Patient Experience Chief Experience Officer, Cleveland Clinic

3. “Patients First….”

4. Main Campus Nurse Communication %ile Source: CMS and Dashboard 1.31.14

5. Nurse Communication Data Time Frame: Discharges between Q2 2012 – Q1 2013

6. Main Campus Doctor Communication %ile Source: CMS and Press Ganey 5.1.14

7. Largest Hospitals in US Doctor Communication

8. Healthcare providers understand what their “customer” – the patients, want? 1)True 2)False Poll Question #1

10. Leaders Survey Top priorities New facilitiesNew facilities Quiet-time to ensure restQuiet-time to ensure rest Private roomsPrivate rooms Food on demandFood on demand Interactive bedside computersInteractive bedside computers Eliminate visiting hour restrictionsEliminate visiting hour restrictions

12. Patient Desires Respect Communication between staff Happy people

13. Patient Emotions StressfulStressful AnxietyAnxiety Fear – Terror !Fear – Terror ! UncertaintyUncertainty ConfusionConfusion …And the Family

14. Scale of Importance on Satisfaction Staff Cared Doctor concern for Comfort Doctor Explained Info to care for self at home Doc kept pt Informed Nurse kept pt Informed Info about Delays Family & friends kept Informed Nurses attn to Needs Doctor Listened Pain Control Doctor Courtesy Respect for Privacy Nurses Listened Courtesy to family & friends Most important Communication & Information Global Sat., Concern, Empathy Wait time before Doctor Nurse Courtesy Nurse concern for Privacy Staff permitted family & friends to be w/patient Cleanliness Helpfulness of person first asking about condition Wait time for Radiology Comfort during blood draw Wait time before treatment area Comfort during Rad Personal Ins Privacy Rad Staff Courtesy Waiting Area Comfort Ease to provide insurance Courtesy taking ins. Wait time of staff notice Less important Nursing / ED Staff, Wait Times Ancillary Care, Comfort, Administrative Staff Behavior and Pain

15. What is the most important factor driving improvement in healthcare delivery? a)Data transparency b)Financial incentives for performance c)Improved leadership / management skills d)Both 1 and 2 e)Both 2 and 3 Poll Question #2

16. Increasing Accountability

19. Compared like Washing Machines

20. Quality – Based Payment Reform Initiatives Inpatient Quality Reporting Requirement (IQR) 2% of APU Value Based Purchasing 2% Readmissions 3% Meaningful Use 1% Hospital Acquired Conditions 1% VBP Hospital Acquired Conditions (DRG Demotions) 201020132012201120172016201520142018

21. Every caregiver in an organization must be held accountable to organizational metrics? 1)True 2)False Poll Question #3

22. The Episode The “360” Manage the 360 Continuum BeforeAfter

23. Pre-admissionactivity Admission DischargeActivities Follow up care Ongoing relationship management Access Calls Visits Billing Ambulatory Inpatient Journey Hospital Stay Events / Procedures

24. Inpatient flow Caregiver Perspective data along the Continuum

25. Enterprise Business Unit Hospital Institute Department Center Floor / Unit Leader Manager Individual data along the Continuum Strategic Tactical Operational data down the vertical

26. Enterprise view

27. Institute view

28. Center view – Physician specific metrics Unit view – Nurse and team specific metrics

29. Trending

30. Score - Scorecard

31. DDI Physicians Doctor communication vs. Hospital rating Good doctor Bad hospital rating Low Communication Low Rating Low Reputation Poor Doctor Communication High Hospital Rating

32. Patient comments – anecdotes and verbatims – alone, can drive improvement! 1)True 2)False Poll Question #4

33. VerbatimsVerbatims “Never sure who my doctor was..”“Never sure who my doctor was..” “Surgeon never saw me – until I was very critical”“Surgeon never saw me – until I was very critical” “Never saw my surgeon – only the fellow”“Never saw my surgeon – only the fellow” “Doctor had attitude”“Doctor had attitude” “Doctor was rushed”“Doctor was rushed” “Too many doctors – I never new who was in charge.”“Too many doctors – I never new who was in charge.” “ ----- group was backing out of the door as my wife was asking questions – very rude.”“ ----- group was backing out of the door as my wife was asking questions – very rude.”

34. Physician Patient Comments N = 540

35. Opportunities for Improvement Doctor Communication Verbatims 72% Communication

36. Purpose is transformationalPurpose is transformational Understand your customerUnderstand your customer TransparencyTransparency Collect data across the continuum and drive it down the organizationCollect data across the continuum and drive it down the organization The “soft” stuff counts!The “soft” stuff counts! Patients First….

37. #HASummit14 Analytic Insights A Questions & Answers

38. #HASummit14 Session Feedback Survey 38 1.On a scale of 1-5, how satisfied were you overall with the Glenn Steele / Geisinger session? 2.What feedback or suggestions do you have for the Glenn Steele / Geisinger session? 3.On a scale of 1-5, how satisfied were you overall with the Jim Merlino / Cleveland Clinic session? 4.What feedback or suggestions do you have for the Jim Merlino / Cleveland Clinic session?