July 1, 2011 was a critical milestone for hospitals. It's when the government's value-based purchasing performance period began. How much organizations improved in HCAHPS and Core Measures between July 1 and March 30, 2012 directly impacted reimbursement for fiscal year 2013.
Yes, we've left "pay-for-reporting" behind and entered the "pay-for-performance" era. Understandably, most hospital leaders are focused on how much of their reimbursement is at risk. And while it's true that there are many "calculators" out there that can assess your risk, just knowing the number won't improve the quality of care or the patient experience.
What will allow you to make these positive changes is taking action—the right action—aimed at quickly moving results and sustaining them at higher levels. And, with only nine short months before the performance period ends, it's important to start implementing the right actions right now.
Below are some suggested actions:
- Connect back to values. As terms like HCAHPS composites, Core Measures, performance scoring, and even pay-for-performance become regulars in our vocabulary, connecting all of these words back to providing the best quality care for the patient is vital. It is about always doing the right thing for the patient.
For example, instead of emphasizing hourly rounding as an effective tactic to improve Responsiveness of Staff composite results, connect hourly rounding to ensuring that patients don't have to increase their stay in the hospital due to pressure ulcers.
- Implement AIDET® organization-wide. AIDET—which stands for Acknowledge, Introduce, Duration, Explanation, and Thank You—is a framework for effective, consistent communication. Because good communication impacts every HCAHPS composite, AIDET is one of the most valuable tools an organization can implement. AIDET provides a structure that works in all departments and with all staff—from registration staff to nurses to lab workers to housekeepers.
Recent analysis of AIDET's impact on Studer Group partner results vs. the national average demonstrates its effectiveness.
- Use Leader Rounding on Patients to validate behaviors. Often we hear from organizations that they are doing a certain behavior but aren't seeing results. Our response is: "Are you really doing the behavior, fully focused on the outcomes, or are you just going through the motions? Are you doing them consistently? Are the tactics truly hardwired?" Use Leader Rounding as an opportunity to verify with the patient that a behavior has occurred and was done correctly.
Design questions around strategic focus (e.g., "Has your nurse discussed your targeted discharge date?"). After rounding, leaders should ask themselves:
- What have I learned about the care of my patients?
- What must I do with the information?
Of course, tactics alone are not enough. Without the right foundation in place, organizations may see an initial surge in better results but may not be able to sustain them over time.
Only a culture that's aligned from top to bottom—where leaders, staff members, and physicians are accustomed to working together to provide quality care to the patient—will be able to sustain their improvements and keep making new ones as the bar is raised higher and higher. It's this kind of culture that will help people stay connected to the passion and sense of purpose that drives them to do their best work over and over again.
Please don't miss Part Two of our HCAHPS Webinar, Pay-for-Performance Is Here. Quint Studer shares the impact on reimbursement of the Value-Based Purchasing Final Rule for FY2013. He interviews David Callecod, FACHE, CEO, Lafayette General Medical Center, Lafayette, LA. To access, click here.