New Solutions

Three Reasons Why CAHPS Survey Questions Aren’t Enough

Posted by Greg Hyman on Jul 29, 2014 9:41:56 AM

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys have done much over the last several years to encourage increased focus on the patient experience by tying patient survey scores to a portion of Medicare reimbursement.

Where many feel CAHPS has fallen short, however, is in potentially creating the impression that a static, standardized national survey is a sufficient tool for assessing the patient experience, let alone serving as a jumping point for improvement.  What more and more healthcare leaders are recognizing is that CAHPS surveys alone simply are not enough.

Scientific research bears this argument out.  A recent article in the journal Health Marketing Quarterly reviewed the validity and usefulness of HCAHPS. The authors concluded that the HCAHPS survey is an excellent beginning, with some problematic elements.

The results of the study closely mirror the findings of similar analyses conducted by Avatar.  In one such analysis, Avatar researchers compared the scores of clients who use an Avatar patient survey in conjunction with HCAHPS against the scores of those who use HCAHPS only.  The researchers found that clients who use an Avatar survey in conjunction with HCAHPS perform significantly better than clients who use HCAHPS only.

So why the discrepancy in scores among users of a robust, customized survey tool and users who limit themselves to the CAHPS survey?  HCAHPS measures only a small portion of the patient experience. Many other service and care factors are important or even central to the patient experience.  As a case in point, a regression analysis performed by Avatar researchers found that HCAHPS predicted only 38.6% of variance in Overall Hospital Rating and 35.8% of Recommend.  As such, HCAHPS is not providing complete information on the patient experience, potentially leaving organizations with missed opportunities to improve performance.

This is one of the reasons why surveys customized at the point of generation to reflect the individual patient experience are so powerful.  Adding items addressing services that an individual patient has received allows organizations to collect more accurate, more comprehensive data on the patient experience, extending the reach and specificity of their performance improvement initiatives.

While existing and emerging CAHPS programs have helped shift healthcare to a culture with increased focus on the patient experience, the demand this focus places on healthcare leaders to identify and improve service gaps underpins the reasons why CAHPS survey questions aren’t enough.  Customized, diagnostic surveys measuring each specific aspect of the individual patient’s experience have proven a powerful tool for driving significant gains in experience scores, and thus are the natural complement to any CAHPS program.

                                   
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Topics: HCAHPS, CAHPS Survey, patient satisfaction surveys, patient experience surveys

Three Ways to Ensure Confidentiality When Conducting Employee Engagement Surveys

Posted by Melissa Herrett on Jul 23, 2014 1:54:49 PM

Often, one of the biggest deterrents for employees when completing an engagement survey is their concern that the survey is not entirely confidential. If employees are worried they could be identified by their responses, they may be less apt to fill out the survey, and/or they may not be as truthful. The information gathered from the survey may therefore be inaccurate, and improvement plans will be less impactful.

In order to gather the most comprehensive data, organizations must be proactive about alleviating employees’ concerns regarding confidentiality.

Here are three tips to help ensure employees’ confidence in the confidentiality of your next employee survey.

  1. Contract with an outside party – Employees will likely feel more comfortable taking the survey if they are submitting their responses to a third party, rather than to management directly.
  2. Include information about confidentiality in the survey instructions – By clearly explaining what measures you are taking to keep responses confidential, employees will have a better understanding of these measures and will be more trusting of your commitment to maintaining confidentiality. Include detailed information in the survey instructions, clearly outlining your methods for keeping responses confidential, thus encouraging employees to state their honest opinions.
  3. Don’t report results under a certain threshold – If a manager only has one or two employees, it will be much easier to identify which employee is responding in a certain way. Therefore, to avoid this issue, report responses for small groups of employees as part of a larger group. At Avatar, for example, we maintain a five-person threshold, where responses from groups with less than five people are not reported directly to managers, but rather folded into a larger group.
By taking these steps to ensure confidentiality, you will show your employees you are dedicated to getting the most accurate responses and ensuring they are at ease answering the questions honestly. Alleviating confidentiality concerns will likely contribute to higher participation rates, thus allowing you to gather the most actionable data to engage your employees.
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Topics: employee engagement survey, employee engagement, Confidentiality,

Patient Satisfaction Survey Questions and Dimensions

Posted by Kelli Killian on Jul 8, 2014 6:09:30 PM

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Patient satisfaction is a priority objective for many healthcare leaders today. With the implementation of Value-Based Purchasing (VBP) and the increased importance placed on patient loyalty, healthcare leaders are focused on finding ways to improve patient satisfaction. One influential way to implement this change is by administering a patient satisfaction survey to gather detailed information.  Patient satisfaction survey questions are posed based on broad dimensions of health care through which they can be measured.  Avatar Solutions utilizes the 5 point Likert scale to measure response to survey items instead of questions that make statements such as “Overall I was satisfied with the care I received.” Survey items that can be measured from “strongly agree” to “strongly disagree” dig deeper than questions alone. Read on to learn some of these dimensions and their common accompanying items that help to measure patient satisfaction.

Physician A high area of interest for healthcare leaders conducting a patient satisfaction survey is the physician dimension. This dimension measures the patients’ satisfaction with their doctor. There are many items of focus under the physician dimension. Common survey items include:

    • The doctor treated me with dignity and respect

    • I was given the opportunity to ask questions

Check-Out Process As an important part of the patient journey, the check-out process is frequently measured on patient satisfaction surveys. Common survey items include:

    • How promptly you were able to check-out

    • Explanation about the use of medications

The check-out process is one of the last points of contact during the patient journey and thus an area that healthcare leaders are concerned with measuring patient satisfaction.

Facility The organization’s overall facility is an important and often overlooked part that helps make up the patient experience. Common survey questions include the following:

    • Comfort and safety while waiting

    • Adequate parking was available

These are just a few of the dimensions and items that can be addressed on a patient satisfaction survey. To learn more about patient satisfaction, check back on our blog next week and join Avatar’s LinkedIn group The Patient Journey to continue the conversation.

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Topics: patient satisfaction survey

What the 4th of July Can Teach About Employee Engagement

Posted by Melissa Herrett on Jul 3, 2014 10:58:42 AM

In honor of the holiday tomorrow, let’s examine what July 4th can teach us about employee engagement.

Independence – On Friday, we celebrate the independence of the nation. Just as our forefathers desired independence, employees also want autonomy. Most engaged employees excel in environments where they are allowed to be independent, without a manager constantly looking over their shoulder. When given the independence and leeway to accomplish tasks in their own way, employees see that their managers trust them to get the work done, and these feelings of being trusted are instrumental to engaging workers.

Celebration – The 4th of July is a day filled with barbeques and fireworks to commemorate the holiday. It’s important to remember that employees want to be celebrated too. Take time to recognize what employees are contributing. Recognition doesn’t have to be monetary or extravagant. A simple “thank you” goes a long way. Sit down with employees to acknowledge the hard work they are doing for your organization on a regular basis. This extra effort will be incredibly effective when it comes to engaging your workers.

Community – over the July 4th holiday weekend, a lot of attention is given to community. Whether you’re going out with friends, hanging with family, or barbequing with neighbors, the holiday is often a time to bond with people important in your life. At work, employees need the opportunity to connect with their coworkers as well. After all, they see these individuals often, even more so than some of their friends and family. Given this frequency, it’s worth the effort to encourage employees to establish rapport and relationships among their peers. Additionally, Avatar has found that coworker satisfaction strongly impacts retention. By encouraging employees to get to know each other in a more personal way, you will contribute to their engagement and retention.

Fun – July 4th is a time to kick back, relax, and have some fun, which is why many people look forward to the holiday. Adding a little fun into the workplace regularly can go a long way in engaging employees. Avatar has found that fun is strongly linked to engagement. Employees appreciate the opportunity to let loose a bit. Not only does it help them unwind, it also helps reduce stress which may lead to burnout.

Beyond independence, celebration, community, and fun,the 4th provides a great opportunity to inspire employees to maintain a work/life balance. Encourage workers to completely disconnect for the holiday and enjoy their time off. Let them go home a little early on July 3rd so they can get a jump start on their weekends. Employees will appreciate your thoughtfulness and will likely come back more engaged and ready to jump into work following the holiday.

Happy Fourth of July! The team at Avatar Solutions wishes you a fun and relaxing holiday!

 

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Topics: employee engagement

Four Home Health CAHPS Decisions Every Agency Should Consider

Posted by Greg Hyman on Jun 24, 2014 6:00:00 AM

In an age when consumer data and reviews are always just one click away, there are no less than one hundred good reasons why every healthcare agency should be surveying their patients, and many companies are indeed doing so.  But when it comes to implementing a highly regulated survey like Home Health CAHPS, many agencies hesitate.  The prospect of additional regulatory requirements to comply with is seldom an attractive prospect to leaders, who may also be unsure how to navigate the aspects of the survey for which there is a choice of approaches or methods.

To help leaders develop a recommendation regarding how to move forward with Home Health CAHPS, here are four exploratory decisions that every agency should make:

Decision #1: When to Implement?  For most organizations, the decision of whether to implement Home Health CAHPS can be approached as a matter of straightforward arithmetic.  CMS has tied a 2% Annual Payment Update for Medicare to participation, and for large agencies, this financial incentive can be significant.  So the question then becomes when to implement.  Agencies that have the resources to put a Home Health CAHPS process in place are advised to do so early, to help align performance in anticipation of future public release of data. Improvement initiatives supported by your survey data this year can generate ROI not only through the Annual Payment Update, but also through improved reputation and patient retention.

Decision #2: In-house or Outsourced?  While some organizations opt to conduct their Home Health CAHPS surveys in-house, most home health agencies will find the financial and ancillary benefits of outsourcing their Home Health CAHPS process far outweigh the initial investment. In addition to saving you time and ensuring compliance with complex regulations, an experienced vendor can provide resources to help your organization improve its scores, as well as make expert recommendations on administration and sampling techniques.

Decision #3: How Much Data?  Home Health CAHPS is an excellent starting point for assessing the patient experience. However, because the information it captures is very high-level, users who wish to understand why they scored a particular way and how to improve will need more insights. Vendor-developed diagnostic survey items designed to provide actionable insights can be included with each Home Health CAHPS survey to support improvement efforts.

Decision #4: What to do with the Data?  Some organizations will content themselves with a Home Health CAHPS process designed solely for and ending with fulfilment of the CMS participation requirements. However, these agencies are missing out on a powerful opportunity.  By using the CAHPS and supplemental survey item data to steer improvements, agencies can drive better financial outcomes and, more perhaps important, honor the feedback of their patients.  Organizations that don’t take these steps may even risk appearing cavalier regarding the feedback their patients have taken the time to share.

Whether the focus is Home Health CAHPS or any other patient survey, agencies are well-served to consider these questions and make an informed initial decision as part of the exploratory process.  The answers to these questions, as well as the underlying rationale, can help not only determine whether and how to implement a survey, but also how to position the initiative when submitting a proposal to executive leadership or a board of directors.

               

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Topics: CAHPS, Patient Survey, Patient Surveys, patient experience, patient experience survey,, Home Health Care CAHPS, hh-cahps, medicare, home healthcare

Employee Engagement Versus Satisfaction: Which Is Best for You?

Posted by Kristina Anderson on Jun 19, 2014 8:30:00 AM

Despite the permeation of employee engagement throughout the industry, there is still confusion about what employee engagement is, how it differs from satisfaction, and which is a better indicator of workplace success.  Measuring employee engagement versus satisfaction can impact the results you see from your employee survey.  While satisfied employees may be happy in the workplace, they aren’t necessarily the best performers, and vice versa for engaged employees. 

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When thinking about the difference between employee engagement and employee satisfaction, it’s important to think about the impact of each on an employee’s job performance.  For example, your organization may choose to improve the employee parking situation, which would make employees happy and satisfied.  However, while they may be happy, is that happiness likely to translate into better performance? 

On the other hand, your organization may choose to add more career development opportunities, helping employees see their potential future within the organization as well as providing effective training to help them in their current positions.  This type of improvement, related to employee engagement, is likely to actually boost performance as it makes employees more excited about the organization and the work itself, and therefore willing to exert extra effort into their work. 

When deciding which type of survey is best for your organization, it’s important to think about what you’re measuring and how it will impact the organization.  If you suspect satisfaction issues are driving employees to resign, an employee satisfaction survey may be a better starting point for your organization.  However, if you’re looking to improve business outcomes, employee engagement may be a better fit.  To learn more about the different types of employee surveys available, check out our previous blog post here

 

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Topics: employee engagement versus satisfaction

How Do I Increase Employee Survey Participation?

Posted by Melissa Herrett on Jun 12, 2014 12:02:18 PM

One of the top questions we often receive when discussing employee engagement surveys with organizations is how to increase employee survey participation. While we have a variety of proven best practices for increasing survey response rates, I would argue that the most important of all is to ensure employees understand that actions are being taken from the survey. Without this understanding, workers will be much less likely to participate in surveys moving forward. Think about it – would you take time to complete a survey or do a project knowing it probably wouldn’t change anything or result in any outcomes?

Here are some tips for publicizing the actions you have taken from past surveys:

  • Send out a company-wide email summarizing results and action plans. Ideally, this email will be branded in a similar fashion to your survey, such that employees instantly understand the connection. This email could take the form of your company newsletter, with an issue dedicated solely to the survey, or simply be an all-employee blast.
  • If you have a company intranet, post the action plans and progress in a special area on the site. You could have a page dedicated to the results and actions. You could also post plans or changes on company bulletin boards where they will be seen by employees throughout the day.  
  • Dedicate a town hall or company meeting to discussion of the results and what changes will be made, as well as providing tentative timelines for action plan completion.
  • Extend your survey branding to any deliverables resulting from the action plans, or any communication regarding the results and plans for improvement. If you develop a new policy, clearly mark it with the survey brand and/or clearly state within the policy that it resulted from the employee survey. Any emails or written communication about new policies or procedures resulting from the survey should also include the survey brand.
  • Confront employee concerns regarding specific changes the organization is unwilling or unable to make. The organization should openly explain why these issues cannot or will not be changed. Employees will appreciate your honesty more than your silence.

Beyond these tips, you should hold managers accountable for what they promise employees. Consider incorporating engagement/improvement metrics into the compensation plan for leaders. By holding managers accountable, you will likely see more action taken from the surveys, which can then be communicated to employees.    

Organizations should also consider conducting a pulse survey to assess whether employees feel progress is being made. A pulse survey will allow you to revitalize your action plans and take more drastic steps if necessary. It will also reiterate to employees that you are listening. When promoting the pulse survey, highlight actions that have already been taken, and stress that the pulse survey is a method for you to refine your plans and take additional action to help improve employee engagement.

By taking each of these steps, employees will see that you actually listen to what they have to say, and are willing to put forth effort to ensure they are happy in their jobs. As a result of these efforts, you will likely realize increased employee survey participation in future surveys.

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Topics: employee survey participation, How to Increase Employee Survey Participation

How to Improve Physician Engagement

Posted by Kelli Killian on Jun 11, 2014 1:17:00 PM

With physician employment on the rise in hospitals and health systems, now more than ever it is important that hospital leadership know how to understand and engage this unique population.

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Measure initial engagement levels

The first step in improving physician engagement is to measure initial engagement levels to see where your organization currently stands by administering a physician engagement survey. Physicians are a niche set of individuals and thus the survey must be tailored to the distinct drivers of physician engagement. More information about what to measure on a physician engagement survey can be found in our past blog post, The First Step to Improve Physician Satisfaction: Measure It. 

Consider your audience during survey launch

While employee engagement surveys can be launched in a number of ways, a physician engagement survey launch should be treated more formally. Physician’s schedules are often filled up with back to back appointments throughout the day and it’s important to get them in an environment where survey administrators can have their full attention. For example, Avatar recommends launching physician surveys during a hosted breakfast or luncheon. In this environment, survey administrators can explain the survey process, available survey modes and answer any questions the physicians may have.  Furthermore, this event provides the opportunity to stress the importance of the survey as a method to maximize communication and the partnership between physicians and the hospital administration.

Action plan

Once survey results are collected, the hospital administration can action plan around weak areas in your results. A common best practice when action planning around physician engagement is showcasing positive patient comments to highlight physician’s hard work in improving their patient’s experience. This positivity helps create a sense of pride and encouragement in physicians’ work. Another effective action plan is establishing a method for physicians to submit their ideas and suggestions to improve patient care. There should always be an open platform for physicians to contribute how to improve the patient experience at your organization

These are just a few ways to improve physician engagement at your organization. To learn more about physician satisfaction check our other blog posts here.

 

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Topics: How to Improve Physician Engagement

How Telecommuting Policies Can Benefit Employers

Posted by Kristina Anderson on Jun 5, 2014 9:00:00 AM

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Telecommuting is starting to become much more accepted in mainstream America, with many employees working remotely anywhere from a single day now and then to full time.  While employees definitely understand the benefits (A shorter commute!  Working in pajamas!), employers may not fully understand the benefits they can see from offering a telecommuting policy.  Allowing employees to work remotely can help your organization in the following ways:

Reducing Overhead When an employee works from home, the employer saves money from not having to provide a physical location for the employee to work. This means less money is spend on rent, heat, electricity, furniture, supplies, janitorial costs, security, and many other things. Even if the employer helps telecommuters cover a portion of expenses such as cell phones, office supplies, and internet costs, the overhead is generally much less than providing an actual physical space with those amenities. Whether it is a couple of employees from each office, or a large percentage of the workforce, these savings truly impact the bottom line.
Attracting Top Talent The element of trust is important in any relationship, including that of the employer and employee. A telecommuting policy sends a positive message to employees: i.e., "We trust you." When an organization fosters an environment of trust, employees will help spread the message of being a part of a great company culture. Top talent will settle for nothing less than the best, and company culture can certainly make a difference in attracting the best job candidates or losing them to the competition.
Increasing Engagement The ability to work from home is a major bonus for many employees. This added value oftentimes makes employees appreciate their position more than they would have otherwise, which leads to commitment to the organization. An increase in personal commitment fosters a bond to the organization, which builds a strong foundation for engagement.
Increasing Retention The cost of replacing an employee goes far beyond recruiting fees. Reducing voluntary turnover could make a huge impact on an organization's budget. One strategy that has proven to be an effective way of reducing turnover for many companies is incorporating a work from home policy. This increase in retention could save organizations a great deal of money over time.
Reducing Carbon Footprint Social responsibility is becoming a more common organizational focus than in past years. Many employees, especially millennials, are drawn to organizations that limit their environmental impact. Telecommuting reduces carbon emissions from transportation, allowing organizations to reduce their carbon footprint and tout their commitment to the green movement.

Considering the aforementioned benefits, it would be wise for employers to consider incorporating a work from home policy, or expanding their current policy. In the past, telecommuting has sometimes been considered a risk for employers. However, as technology advances and business norms change, it could soon be more of a risk not to incorporate telecommuting into talent management.

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Building Employee Engagement to Break the Cycle of Disengagement

Posted by Kristina Anderson on May 29, 2014 12:02:00 PM

Employees are greatly influenced by the people who surround them.

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Carl is a new employee and loves his job. Since he started two weeks ago, he's been praised constantly by his supervisor for his great work ethic and high productivity. However, Carl has noticed his coworkers seem less than thrilled by his stellar performance. After work one day, they approach Carl as a group and tell him something needs to change. Carl's productivity on the job is making the rest of them look bad and changing their supervisor's expectations. Carl backs down and lowers his performance at work from excellent to merely average in order to fit in with the group's expectations. Rather than having a new, highly engaged employee, Carl's company now has another partially engaged employee.

This scenario, while extremely troubling, is more common than most managers would like to think. Even when employees do not take things to the extreme, they still may belittle or joke about highly productive employees to get their point across. Not all employees back down as Carl did, but most get the message: keep the status quo or be disliked. It all comes down to the high school mentality that when an individual "sets the curve" too high, it is unfair for everyone else. This attitude is extremely dangerous in the workplace, as it breeds disengagement. New employees quickly pick up on cultural cues within a workplace, which can spread disengagement like wildfire.

Situations like Carl's can create an ongoing cycle of disengagement. In order to break this cycle, organizations must focus on creating a culture of engagement among the staff. Employees tend to mirror the behaviors and attitudes of those around them. If a partially engagedemployee is placed in a situation where he or she works closely with actively disengaged employees, it is more likely he or she will start to exhibit the traits of disengagement. If, on the other hand, partially engaged employees are paired with actively engaged employees, they are more likely to become engaged themselves. Engaged employees are distinguished in the workplace because they are passionate, prideful, and clear brand champions. By separating out negative staff members, managers can make a huge impact on employee engagement within their organization.

In order to make an even bigger impact on employee engagement, managers should focus on the most impactful key driver of engagement: recognition. Recognizing employees for great behaviors and outcomes is an excellent positive reinforcer. However, it is important to be fair when providing recognition, as any perceived favoritism could discourage employees who are not engaged and strengthen the cycle of disengagement. Being fair does not mean that managers should recognize everyone equally, instead, they should make sure to give employees the recognition they deserve. In Carl's situation, his coworkers may have believed their manager was favoring Carl, which could have added to their dislike of Carl's work ethic as well as increased their personal levels of disengagement. As a best practice to avoid conflict, managers should consider recognizing employees privately for their work to avoid any perceptions of favoritism.

Another issue employees face on their path to engagement is a lack of connection with the organization's goals and values. The employees who cornered Carl clearly thought only of their own personal desires, rather than connecting their productivity to company outcomes. When employees understand how they contribute to an organization's overall mission, they stop worrying about competing with other employees over performance and realize they instead need to focus on making the organization better as a whole.

Managers should take all steps they can to attempt to engage their disengaged employees. However, if employees do not show any signs of change, it may be time to cut them loose. People within our industry as well as some of our clients have referred to disengaged employees as vampires, water cooler malcontents, arsonists, and even terrorists. Disengaged employees are a drain on an organization and lead to bad customer outcomes. When a customer has a bad experience, he or she tends to tell 10 different people, who in turn tell five additional people. All in all, 60 potential customers hear about this bad experience. This chain of negativity is known as the Multiplier Effect, and can be detrimental to an organization.

Managers may not always be aware of conversations like the one Carl experienced or realize their employees have entered into a cycle of disengagement. If management notices employees exhibiting increased behaviors of disengagement, it is important to act quickly to ensure the situation does not become worse. By breaking the cycle of disengagement, managers can see a huge difference in the behaviors of their employees.

To learn more about employee engagement, click here to visit our website, or download our ROE: Return-on-Engagement white paper

 

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Topics: employee engagement

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