Bane Care Management LLC operates 12 Skilled Nursing Facilities (SNF), three Adult Day Health Centers and two Assisted Living Facilities in Massachusetts. The Bane Care facilities located on the South Shore of Massachusetts use the CoreQ patient experience survey, a set of five measures for skilled nursing care centers and assisted living communities to use to assess satisfaction among patients, residents, and their families. The leadership team and frontline staff including admission, nursing, and social work noted a variance in survey results among the facilities and began to investigate the variance to improve their CoreQ score.
To gather the most up-to-date information, they used Survey Monkey to survey patients as closely to real time as possible and then used that data to adjust in real time to improve the patient experience. To do this properly, they surveyed the patient within the first few days upon admission to the SNF and then again a few days after the patient was discharged. Another way they ensured they were getting the right information was by using questions that would identify the referring facility, to ensure they could use that data to work with their referring hospitals and ACOs. They could identify and address issues from the hospital discharge to SNF admission and what barriers got in the way for the patient. They then met with their referring hospitals and ACOs and used this data to help improve those transition processes and do the same for discharges. They also asked which home care/VNA the patient may be set up with. This provided them with the necessary data to drill down to those specific VNAs and address any transition barriers from SNF discharge to the patient being home with the VNA services.
The Bane Care Management team looked at the overall CoreQ Score for the year 2017 to establish the benchmark of the top 10% performers in the 300+ skilled nursing facility database. The top 10% performers averaged a 91% overall CoreQ Score. The overall CoreQ Score average for all skilled nursing facilities in the database was 84%. All of the Bane Care Management facilities scored at or above the overall average, however, the team wanted to improve their score to be in the top 10% performer tier.
Using the Quality Improvement Initiative Provider Plan/Process Improvement Plan (PIP) Template to identify area(s) for improvement, the Bane Care Management team came up with action plans/interventions, and as a pilot, implemented these interventions at the Bane Care facilities on the South Shore. The identified interventions would help improve the patient experience right from the very beginning of the patient’s admission to the South Shore facilities. They investigated what was working well across their facilities, compiled these practices, and shared them with each facility. In addition to informing patients about what to expect at the onset of admissions, the team also implemented an Admissions Survey and a Discharge Survey to collect and track data about what the patient was experiencing throughout the stay at the SNF, also addressing any comments/concerns from the surveys in real time.
The Bane Care Management team tracked and trended three main questions from each survey:
- Did the SNF personnel explain what to expect during your stay?
- Overall rating of the Nursing staff so far.
- Overall rating of the Rehab Staff so far.
- Did you receive and understand your discharge instructions (medications, care needs, follow up appointments, etc.)?
- Overall rating of care given.
- Likelihood of you recommending this facility to others.
The feedback from the patients’ comments in the Admission Survey was revealing for the Bane Care Management team and led to process improvement in many facilities. While each facility in the pilot thought they had a standard process that involved explaining what the patient should expect during their stay at the SNF, this process was not a consistent practice with all staff. Many patients commented in the Admission Survey that they did not feel the staff consistently explained what to expect during their stay at the facility. Data from the Admission Survey was used as an impetus to create a Frequently Asked Questions (FAQs) sheet to help staff explain and to help the patient/family understand what to expect during their stay at the facility.
After implementing the surveys and incorporating staff and patient suggestions, most of the Bane Care Management facilities participating in the pilot are now scoring in the mid to upper 90%. Feedback from the surveys are shared with each facility, so that all can benefit from the great ideas from staff and patient comments at the other facilities. Although some of the facilities still need to see more improvement to get up to the 90% mark, they are working very hard at striving for that goal and sustaining the outcomes. Since implementing the pilot, the survey process is beginning to become a standard practice among all Bane Care Management facilities.
Do you have any feedback or comments about this article? Tim Carey, Performance Improvement Manager, Bane Care Management LLC, would like to hear from you! Please feel free to reach out to him and share what you’re doing.