February 26, 2021 - CC

QI Spotlight: Using Press Ganey Scores to Improve Patient Experience

The February QI (Quality Improvement) Project was submitted by Joseph Brooks, DO. Dr. Brooks is an Osteopathic Physician based in Davenport, IA.

After Press Ganey reports showed patient likelihood to recommend was below the 75th percentile target, Dr. Brooks used his QI project to increase the scores at his inpatient rehabilitation unit. Starting last fall, Dr. Brooks and his team identified possible causes of the low scores and implemented a patient communication plan to eventually bring the scores to above the 75th percentile.

Thank you for submitting your QI project, Dr. Brooks!

The QI Project Spotlight (formerly the PIP Spotlight) is a periodic feature on the ABPMR News Center to highlight exemplary Quality Improvement projects submitted by your fellow diplomates (or residents) for continuing certification (CC) credit. Diplomates can use the QI Project Spotlight as a tool to plan their own QIs or as a way to connect with other diplomates doing similar work.

What is the problem you are trying to solve?

Patient experience in the inpatient rehab unit had been measured as a quality metric for several years and has been reported at a lower percentile than our target. The target for this year was in the 75th percentile, as ranked by Press Ganey compared to similar rehab hospitals across the U.S. Specifically, a focus on the "likelihood of recommending" was the patient experience outcome measured on Press Ganey that was identified by key stakeholders, including our Board of Directors and leadership of the health system.

What data (objective measurements) do you have that supports this as a problem?

The specific measurements were Press Ganey surveys sent to all patients discharged from inpatient rehab to a home setting.

What is your opportunity statement? State the goal you hope to achieve.

Based on review of previous measurements, our percentile ranking has varied from 5% to 33% on the key metric of patient likelihood to recommend.

What is the underlying cause of the performance/quality problem?

An interdisciplinary task force including physician leadership, nursing leadership, administration leadership, physical therapy, occupational therapy, and speech therapy was organized to brainstorm underlying issues that could impact the patient likelihood of recommending.

There was consensus that patient experience had not been previously discussed with the interdisciplinary team, nor was it a focus of our conversations with our patients. We reviewed with leaders from each therapy discipline and nursing, and found in the fourth quarter of 2020 the likelihood of recommending was in the 27th percentile in July and 34th percentile in August, with a goal of being in the 75th percentile. We met monthly to review.

What change(s) did you implement?

Following the evaluation and identification of the problem that the patient experience by likelihood to recommend as measured by Press Ganey was short of our goal of the 75th percentile, we implemented a team approach to routinely review these scores with all therapy disciplines, nursing staff, physician staff, and administration leadership team. We implemented a team approach to authentically communicate our core value of a good patient experience to each patient on admission daily and at discharge by Physicians, NP, nursing, and therapy staff.

Did you achieve your goal or target from your opportunity statement? What data do you have to support your conclusion?

We did achieve the goal of improving Press Ganey scores to above the 75th percentile.

Prior to our team approach of meetings and interventions, data was collected showing our score in the 27th percentile in July and 34th percentile in August. Following the initiation of our communication interventions in September, we measured the same outcome measures in October, November, and December. The October likelihood to recommend was measured at the 6th percentile. In November, the likelihood to recommend improved to the 95th percentile, and December improved to the 85th percentile.

Will you continue with the changes you have implemented?

We will continue to implement a focus on patient experience by communicating our core value that we want all patients to have a good experience at inpatient rehab. This interdisciplinary approach to communicating our core value has been sustainable for over three months to put our Press Ganey scores for likelihood to recommend above our target of the 75th percentile.