MedCAHPS Analysis & Plan_Active

MedCAHPS
ANALYSIS and PLAN

Presented to: Jack Hakim and Tim May with EC Wise and the MEDCAHPS Stakeholders including
CRGMedical, PSO Services Group, InfoTool, RWD and GP Strategies

Prepared by: Bret Rahn.
Concept Version
Tuesday, May 22, 2012

Mitotel Inc. 620 Newport Center Drive, CA 92660 T 949-760-5333 www.mitoterl.com

MedCAHPS Needs Analysis Outline
1. Purpose of MedCAHPS

2. Target Audiences

3. Competition

4. Competitive Advantages

5. CAHPS and HCAHPS Agencies

6. HCAHPS4Less Stakeholders

7. MedCAHPS Opportunity

8. MedCAHPS Solution

9. MedCAHPS Website Demo

5/15/2012 9:24 PM

1. Purpose of MedCAHPS
The purpose of the MedCAHPS is to create a Web Presence to:
1. Sell patient-centered, social media-empowered survey systems by EC Wise.
2. Sell HCAHPS survey call center and direct mail service.
3. Upsell 6 Sigma and Lean Process consulting services for companies like GP Strategies and
Press Ganey.

HCAHPS
The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first
national, standardized, publicly reported survey of patients' perspectives of hospital care. HCAHPS
(pronounced “H-caps”), is a survey instrument and data collection methodology for measuring patients’
perceptions of their hospital experience. While many hospitals have collected information on patient
satisfaction for their own internal use, until HCAHPS there was no national standard for collecting and
publicly reporting information about patient experience of care that allowed valid comparisons to be made
across hospitals locally, regionally and nationally.
Three broad goals have shaped HCAHPS. First, the survey is designed to produce data about patients’
perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are
important to consumers. Second, public reporting of the survey results creates new incentives for
hospitals to improve quality of care. Third, public reporting serves to enhance accountability in health care
by increasing transparency of the quality of hospital care provided in return for the public investment.
Since 2007 most hospitals have been required to submit HCAHPS results in order to receive full
Medicare payment. Starting this year, HCAHPS will play an even larger role in reimbursement. The
Patient Protection and Affordable Care Act establishes a Value-Based Purchasing (VBP) plan beginning
in FY2013 (based on hospitals’ performance in 2012 on measures that are part of the hospital quality
reporting program). This will transition providers from HCAHPS pay-for-reporting to HCAHPS pay-for-
performance.

CAHPS
Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys ask consumers and
patients to report on and evaluate their experiences with health care. These surveys cover topics that are
important to consumers and focus on aspects of quality that consumers are best qualified to assess, such
as the communication skills of providers and ease of access to health care services. CAHPS originally
stood for the Consumer Assessment of Health Plans Study, but as the products have evolved beyond
health plans, the name has evolved as well to capture the full range of surveys. The acronym "CAHPS" is
a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
All CAHPS surveys are in the public domain, which means that anyone can download and use these
surveys to assess experiences with care. Users of CAHPS survey results include patients and
consumers, quality monitors and regulators, provider organizations, health plans, community
collaboratives, and public and private purchasers of health care. These individuals and organizations use
the survey results to inform their decisions and to improve the quality of health care services.
The CAHPS program is funded and overseen by the U.S. Agency for Healthcare Research and Quality
(AHRQ), which works closely with a consortium of public and private research organizations. AHRQ and
its grantees and contractors develop and maintain the CAHPS surveys; they do not administer any of the
surveys to health care consumers.

5/15/2012 9:24 PM

2. Target Audiences
The following audience segments represent Mitotel’s understanding as the target for the MedCAHPS
Online Solution. All aspects of this project will be aimed at these specific groups.

1 – HCAHPS Survey Consumers
• Organizations
o Hospitals
o Survey Vendors
o Value-Adding Resellers
o Patient Safety Organizations
o Six Sigma and Lean Process Intervention Providers
• Individuals and Decision Makers by Position
o CEOs
o Executive Leaders
o Executive VPs
o Quality Improvement Professionals
o Nursing Managers
o Project Managers
o Purchasing Managers
o Person directly responsible for leading HCAHPS improvement efforts
• Characteristics
o Gender: Male and Female
o Average Age:
21-35 years: 00%
36-45 years: 00%
46-55 years: 00%
55 years and older: 00%
o Income:
$40,000-$80,000: 00%
$80,001-$120,000: 00%
-$120,000 and above: 00%
o Education
Non-Graduate: 00%
Graduate: 00%
Masters: 00%
Ph.D: 00%

5/15/2012 9:24 PM

3. Competition
The following companies represent Mitotel’s understanding of the key competition for MedCAHPS that
will be used for competitive positioning and messaging.

1 - HCAHPS Approved Survey Vendors
The organizations listed below have met HCAHPS participation requirements and are approved to
administer the HCAHPS Survey. Highlighted companies are analyzed in the next section.

1 Alexandria Marketing Research Group, Inc. 23 LSUS Institute for HS and Public Policy
2 Altarum Institute* 24 Management and Technology Consultants*
3 Arbor Associates, Inc. 25 Minnesota Rural Health Cooperative
4 Avatar International LLC 26 NRC+Picker
5 Beacon Technologies, Ltd. 27 OutSource Services, Inc.*
6 CAMC Institute 28 Press Ganey Associates
7 Center for the Study of Services 29 Professional Research Consultants, Inc.
8 Communications for Research, Inc. 30 Quality Data Management, Inc.
9 Conifer Patient Communications, Inc* 31 Regenstrief Institute Inc.
10 CRG Medical InfoTool 32 Research & Marketing Strategies, Inc.
11 CTQ Solutions, LLC 33 Rural Comprehensive Care Network
12 Data Recognition Corporation 34 Rural Wisconsin Health Cooperative
13 DataStat, Inc * 35 Simple Precision, Inc. (formerly Data Based
I i ht I )
14 Field Research Corporation 36 Sterling Research Group*
15 Fields Research, Inc. 37 Strategic Health, Inc.
16 Gallup 38 Synovate*
17 Gilmore Research Group 39 The Dallas Marketing Group Inc.
18 Health Management & Informatics Group * 40 The Dieringer Research Group, Inc.
19 HealthStream Research 42 The Jackson Group
20 Informed Decisions, Inc.* 42 TNS*
21 J. D. Power and Associates 43 WestGroup Research
22 JL Morgan & Associates, Inc.

Organizations denoted with an asterisk (*) are conditionally approved to administer the HCAHPS Survey, pending
acceptance of their Quality Assurance Plan and their participation in a Dry Run and/or successful submission of one
quarter of hospital HCAHPS data to the data warehouse via My QualityNet.
Source: http://www.hcahpsonline.org/app_vendor.aspx

5/15/2012 9:24 PM

2 – Other HCAHPS Value-Adding Providers
The organizations listed below are value-adding HCAHPS participants. Highlighted companies are
analyzed in the next section.

1 ActiveStrategy. 23 HIPOE
2 Amcom Software 24 LeaderPoint Consulting
3 AHA Solutions 25 Lean Human Capital
4 Atlantic Heath Solutions 26 Medelia
5 Baptist Leadership Group 27 NAPH
6 Baird Group 28 Phytel
7 Best Upon Request 29 Planetree
8 Beryl Institute 30 Siemens
9 CHANET 31 Sunnyside
106 CipherHealth 32 Skill Clinics
11 Compirion 33 Skylight Healthcare Systems
12 Crothall 34 Sodexo
13 Drive Ideas 35 SoranoHealth
14 Empath 36 StruderGroup
15 Enahanced 37 TVR
16 FaithSearch Partners, Inc. 38 The Beryl Institute
17 GetWell Network. 39 The CAHPS
18 GiveMore 40 The LeapFrogGroup
19 HCAHPS Consulting 41 Versus
20 HealthcareSource 42 Vocollect
21 Healthcare Team Training 43 Xantos
22 HealthGrade

5/22/2012 12:09 PM

3 – Competitors
Press Ganey – www.pressganey.com
• Tagline: Outcomes Driven. Performance Strong.
• HCAHPS Solution Score: 10/10
• HCAHPS on Home Page: Barely
• HCAHPS Solution(s)
o Value-Based Purchasing Optimizer
o Value-Based Purchasing Calculator
o Patient Experience Optimizer
o PatientFlow Optimizer
o PatientFlow Calculator
o Focus Group Optimizer
o Goal & Barrier Optimizer
o Opportunity Assessment Optimizer
o Employee Partner Optimizer
o Secret Shopper Optimizer
• Social Media
o • Blog: Press Ganey Improving Health Care Blog
http://pressganey.com/improvingHealthCare/improvingHCBlog.aspx
o • Facebook: Press Ganey Associates, Inc.
http://www.facebook.com/pressganey
285 Like This
o • Twitter: Press Ganey
http://fr.twitter.com/PressGaney

o YouTube Channel
o RSS Feeds
http://pressganey.com/rss.aspx
7 Feeds
• Advertising:
o Press Releases
o Google Ads
• Search Engine:
o 10th on 1st Page of Google Search

5/15/2012 9:24 PM

Press Ganey – www.pressganey.com

5/15/2012 9:24 PM

PRESS GANEY PERFORMANCE CONSULTING SUITESM

Value-Based Purchasing OptimizerSM

Prepare to Optimize Your Reimbursement

Position Your Organization for Success
As health care reform takes hold and reimbursement is linked to clinical quality and patient perception,
hospital leaders must have an understanding of where their organization stands according to the current
value-based purchasing model and be able to estimate the effects that different improvement initiatives may
have on their bottom line in the future.
Press Ganey’s Value-Based Purchasing Optimizer solution includes the dynamic value-based purchasing
calculator and provides customized consulting to help put your hospital on the path to success. The value-
based purchasing calculator provides an estimate of how your reimbursement may be affected and models
how incremental improvements at the measure level may affect your scores and overall reimbursement. The
consulting services included in this solution are tailored to your organization’s needs and will ensure that key
staff members are equipped to put the information to work for the benefit of your hospital.
When you engage the Press Ganey Consulting Group you can expect the following:
Broader understanding of value-based purchasing and its effect on your reimbursement.

Alignment of performance improvement objectives with organizational objectives.

Prioritized opportunities that will positively affect the bottom line.

Understanding of the resource investment required to affect improvement at the measure level.

Improved quality measures and HCAHPS performance.

Increased cooperation between the board of directors and hospital operations.

Improvements that will drive value for health care.

A Press Ganey consultant will analyze operational and clinical information, conduct interviews to gain
deeper insight and utilize data-collection tools to develop a detailed report outlining recommendations and
prioritizing objectives. The result? Your organization will have a clear, data-driven path to improvement.

The Press Ganey Consulting Process: A Proven Pathway to Success
Our approach to consulting, the A2RISE Process™, is based on six steps that are the foundation of our
service. This approach provides a consistent framework to ensure that we search for the true root causes
of issues, rather than making assumptions based on the symptoms.
Although this process is the same for each client, the solutions and recommendations are tailored to
each organization’s distinctive challenges and opportunities. This approach provides clear expectations
of our work, consistent quality, a positive experience and a focus on improvement that you can trust.
We pride ourselves on creating sustainable solutions, so you can rest assured that the positive
changes we make within your organization will endure
beyond our partnership.

Benefits of the A2RISE Process:
 Accurate determination of root cause.
 Realistic solutions.
 Clear expectations.
 Trust and confidence.
 Consistent quality.
 Focus on improvement.
 Long-lasting effects.
 Custom solutions.
© 2010 Press Ganey Associates, Inc.

404 Columbia Place South Bend, IN 46601 phone 800.232.8032 fax 574.232.3485 pressganey.com


Focus Group OptimizerSM

Keep a Finger on the Pulse of Your Organization
The Key to Improving Awareness and Insight
Do you know how your colleagues and employees feel and think about their workplace environment? Are you
aware of their ideas for innovation, their dreams, their goals and concerns? Would you like to find out?

Press Ganey’s Focus Group Optimizer program can help you uncover the answers to these questions and
more. Press Ganey consultants – former clinical professionals and hospital administrators with years of health
care experience – will conduct focus groups with key stakeholders in your organization to identify barriers to
success, root causes of issues and opportunities for improvement. Focus group participants can include
patients, employees, physicians, board members, management, community members or stakeholders of
competitors – in short, any audience you wish to know better.

When you hire the experts at Press Ganey to conduct the Focus Group Optimizer program, you can expect
results such as:
 Better comprehension of barriers to success.
 An in-depth understanding of the current state of your organization.
 Increased engagement of the stakeholder group.
 Increased innovation and creativity in approaches to improvement plans.
 Increased understanding of the root causes of quality, customer service, employee satisfaction and
engagement issues.

2
Our approach to consulting, the A RISE Process™, is based on six steps that are the foundation of our service.
This approach provides a consistent framework to ensure that we search for the true root causes of issues,
rather than making assumptions based on the symptoms.

Although this process is the same for each client, the solutions and recommendations are tailored to each
organization’s distinctive challenges and opportunities. This approach provides clear expectations of our work,
consistent quality, a positive experience and a focus on improvement that you can trust. We pride ourselves on
creating sustainable solutions, so you can rest assured that the positive changes we make within your
organization will endure beyond our partnership.
2
Benefits of the A RISE Process:



Goal & Barrier OptimizerSM

Identify and Eliminate Barriers to Success

The Clear Path to Improvement
If you’re serious about achieving your long-term strategic goals, it’s time to think about how to overcome the
barriers that stand in your way. It’s time to bring in the consulting experts at Press Ganey.
The Press Ganey Consulting Group’s Goal & Barrier Optimizer examines challenges across a wide range of
key performance drivers, including:
Leadership capability.

Organizational strategy and planning.

Service excellence.

Employee and physician relationships.

Clinical outcomes.

Patient safety.

Process efficiency, throughput and flow.

A Press Ganey consultant will review key information, conduct interviews and focus groups as appropriate
and deliver a detailed report to organizational leadership outlining recommendations on how to overcome
barriers to success. The result? Your organization will have a clear, data-driven path to improvement.
When you hire the experts at Press Ganey to conduct the Goal & Barrier Optimizer, you can expect results
such as:
Achievement of organizational goals.

Higher patient satisfaction and improved community image.

Identification of the root causes of problems.

Identification of barriers to success.


service. This approach provides a consistent framework to ensure that we search for the true root causes of
issues, rather than making assumptions based on the symptoms.
organization’s distinctive challenges and opportunities. This approach provides clear expectations of our
work, consistent quality, a positive experience and a focus on improvement that you can trust. We pride
ourselves on creating sustainable solutions, so you can
rest assured that the positive changes we make within your
organization will endure beyond our partnership.




Opportunity Assessment OptimizerSM

Improve Your Clinical, Operational and Financial Performance
Choose the Right Priorities for Your Organization
Hospitals today have more options in terms of information systems, core measure vendors, business
intelligence tools and consulting. However, these options often make the landscape confusing. The decisions
regarding what options are right for the organization can be daunting. This solution seeks to provide the
organization with a third-party assessment of the tools and techniques currently employed in the organization,
and where there may be gaps that, when filled, will optimize performance, provide a more in-depth view of
operations, and provide a better and more global picture of where to focus improvement efforts and dollars.

When Press Ganey consultants perform an opportunity assessment for you, you can expect the following:
 A better understanding of where gaps in performance exist with regard to clinical, operational and
financial metrics.
 Clear prioritization of improvement strategies along clinical, operational and financial metrics that will
provide the highest and best returns.

2
Our approach to consulting, the A RISE Process™, is based on six steps that are the foundation of our

ourselves on creating sustainable solutions, so you can rest assured that the positive changes we make
within your organization will endure beyond our partnership.

2
Benefits of the A RISE Process:
 Accurate determination of root
cause.



Employee Partner OptimizerSM – Advanced

Strengthening Relationships, Improving Outcomes

Develop Powerful Partnerships to Boost Organizational Performance
By creating strong relationships with your employees, you can transform your workplace culture in ways
that can profoundly affect your bottom line. Press Ganey’s Employee Partner Optimizer – Advanced solution
arms organizations with the insight and interventional methods necessary to develop powerful partnerships
with their employees.
Are you ready to build powerful relationships with your employees? Talk to the experts at Press Ganey. Our
consultants – seasoned health care professionals with a depth of clinical and administration-level experience
– will train your hospital’s leaders and managers in the development of collaborative action plans that
improve employee relationships through changes in culture, processes and people. The result? Happier,
engaged employees; a more efficient workplace; improved quality of care; and a healthier bottom line.
When you hire the experts at Press Ganey to implement the Employee Partner Optimizer – Advanced
solution, you can expect results such as:
Reduced turnover, increased retention.

Improved productivity and performance quality.

Better outcomes and increased patient and workplace safety.

Enhanced patient experience and community image.

Improved HCAHPS performance.

Higher employee referrals and reduced time per hire.

Reduced supply cost and supply loss.

Increased innovation.


service. This approach provides a consistent framework to ensure that we search for the true root causes
of issues, rather than making assumptions based on the symptoms.




PRESS GANEY PERFORMANCE CONSULTING SUITE SM

Employee Partner OptimizerSM – Trainer

Become the Catalyst for Organizational Success
Lead Your Transformation – Build Strong Employee Partnerships
In order to successfully facilitate change at your organization, you need to be able to clearly identify the key
opportunities that exist, as well as rally the troops and implement successful action plans – together.

Press Ganey’s Employee Partner Optimizer – Trainer program helps you own your organization’s
improvement process, as well as develop and grow internal improvement ambassadors to lead the change in
your organization. With guided expertise, our consultants will show you exactly how to become self-directed
in your ongoing employee partnership efforts.

When you participate in the Employee Partner Optimizer – Trainer program, you can expect results such as:
 Improved employee-hospital relationships.
 Empowered internal ambassadors who can coach their staff through the entire improvement process.
 Employees who assume full responsibility and accountability for your organization’s success.
 Improved patient, physician and staff satisfaction.

Your Roadmap to Employee Partnership Excellence
With the Employee Partner Optimizer-Trainer program, you select individuals from your organization to attend
a two-day, off-site training session to build the skills they need to cultivate improvement. The Press Ganey
Employee Partner training benefits are many. During the two-day off-site training sessions, you will receive:
 A Partnership Roadmap™ for all attendees. The roadmap provides powerful, proven and practical
direction for improving employee partnerships. It offers clear guidance through the partnership-
building discussion, action planning and ongoing implementation of initiatives.
 An electronic version of the Partnership Roadmap to share with other managers at your facility.
Typically, five hard copies are provided and a PDF is sent for internal distribution. Additional hard
copies may be purchased.
 Certificates for each Employee Partnership Trainer.
 Time with your Press Ganey Account Manager on a limited basis (i.e., a brief first phone call/set-up
call; a one-hour conference call to review or walk through an example data file; or your initial data file
draft and up to three one-hour conference calls throughout the project to answer general questions).
 Employee Partnership Survey and Report.
 Limited virtual guidance, available for Trainers only, to answer questions and discuss challenges.
(Number of hours is determined during contracting process).
 Defined number of attendees for the training.
 Limited Press Ganey Online/Online Action Planning training for primary contact only.

We Give You the Action Steps for Vast Improvement
Clearly Defined Goals and Direction
After attending the Employee Partner Optimizer – Trainer sessions, you will be able to:
 Be the spokesperson for Employee Partnership within your facility.
 Understand the Employee Partnership philosophy and the Five Partnership Principles, and be able to
communicate and disseminate this knowledge to your team.
 Identify the key opportunities within each principle necessary to facilitate change at your organization.
 Facilitate senior leadership sessions.
 Develop and implement successful action plans.
 Apply learned best practices to your facility.
 Create goals with specific metrics for your facility to ignite improvement.
 Successfully implement the Collaborative Action Planning Process™ (CAPP).

Additional Considerations
 Travel costs to attend training are not included.
 Must attend training either 30 days before or within 90 days after the arrival of your Employee
Partnership report.
 Number of trainers recommended within an organization depends on number of managers. A ratio
of one trainer per 100 managers is standard.
 Certification for training group is conducted using sample data, although clients may bring their
report if it is available. Note: We will not review individual reports, rather we will use them for
training purposes.
 If more than 25 members of an organization wish to attend, Press Ganey will conduct a personal,
on-site training session.



Secret Shopper OptimizerSM

Solve the Mystery of Improved Customer Service
Experience Your Organization from a Patient’s Point of View
Seeing your organization from a different perspective can help uncover opportunities for improvement.
However, because you are so embedded in the culture of your organization, it is impossible for you to truly
experience your organization from a patient’s point of view. That’s where the secret shoppers at Press Ganey
come in.

Through Press Ganey’s Secret Shopper Optimizer, Press Ganey consultants – all of whom are health care
experts with experience building and sustaining world-class customer service – serve as secret shoppers,
experiencing your health care organization through a wide range of touch points. From setting up an
appointment over the phone to walk-arounds testing accessibility to general culture assessment and facility
appearance, the secret shoppers will document their experiences in an executive summary report that will
address your organization’s strengths, weaknesses and opportunities for improvement.

Secret shopper patients can be used in a variety of health care settings including:
 Inpatient hospital setting.
 Outpatient tests and treatment areas.
 Emergency and surgical services.
 Medical practices and clinics.
 Ancillary facilities.

When you hire the experts at Press Ganey to be secret shoppers in your organization, you can expect results
such as:
 Increased revenue from higher service volume and value-based purchasing.
 Increased patient satisfaction results.
 Improved patient/staff/physician interaction.
 Improvement of consistency in performance.
 Increased positive word-of-mouth.
 Increased referrals and return patients.
 Improved staff accountability for customer service.
 Greater employee understanding of service reality vs. intention.

2
Our approach to consulting, the A RISE Process™, is based on six steps that are the foundation of our


2
Benefits of the A RISE Process



PatientFlow Optimizer SM

Frequently Asked Questions
ƒƒWould my hospital benefit from Press Ganey’s Patient Flow Optimizer solution, and if so, how?
ƒƒIsn’t adding capacity (physical and staff) in areas of unmet demand the right way to address
overcrowding in the ED and other units, long wait times and patient boarding?
ƒƒWhat are some of the available approaches to improving patient flow? How is Press Ganey’s
PatientFlow Optimizer approach different?
ƒƒHow does Press Ganey’s approach compare with Lean Management and Six Sigma?
ƒƒHow can changing the OR schedule ease ED overcrowding and patient boarding?
ƒƒWhat is artificial variability and how does it cause patient flow problems?
ƒƒWhat is OR smoothing?
ƒƒWhy is OR smoothing important?
ƒƒCan my hospital cost-effectively match demand and capacity without addressing artificial variability?
ƒƒWhat does it take to successfully implement patient flow improvements?
ƒƒWhat role does the client’s staff play in a typical PatientFlow Optimizer project?
ƒƒWhat are the data needs for a successful implementation project?
ƒƒHow does Press Ganey ensure that the improvements are sustained in the long run?

Would my hospital benefit from Press Ganey’s Patient Flow Optimizer solution, and if so, how?
Do you have patients boarding in your ED due to lack of ICU and medical/surgical beds? Does your ED go
on divert periodically? Do you have overtime challenges in your ORs? Do emergent and urgent cases bump
scheduled OR cases on a regular basis? Do you perform substantial add-on cases after daily OR prime
time? Do you often place patients in non-preferred inpatient units?

If you answered yes to some or all of these questions, your organization can benefit substantially from
working with us. You will see operational, financial and quality of care improvements within weeks of
implementation of the first phase of work. To quantify your potential benefits, check out our calculator.

Isn’t adding capacity (physical and staff) in areas of unmet demand the right way to address
overcrowding in the ED and other units, long wait times and patient boarding?
Adding capacity to select services, without streamlining overall patient flow through your hospital, could
exacerbate wait times for patients ready to move to the next stage of care (ED to OR, ED to inpatient, OR
to ICU, etc.). If, after streamlining flow, there is still unmet demand, you may in fact need to add capacity.
When, where and how much capacity to add should be determined using data analytics in the context of a
hospital’s unique characteristics. Check out our approach to determining capacity need.



What are some of the available approaches to improving patient flow? How is Press Ganey’s
PatientFlow Optimizer approach different?
Several tools and services are available to help hospitals with their patient flow challenges. One example
is electronic patient and asset tracking. The main process methodologies in the market are Six Sigma
and Lean Management. All of these options can drive improvements in specific ways. As you consider
alternatives, be sure to ask the following questions:

ƒƒ the approach based in science or best practice at other hospitals? Approaches with a scientific
Is
basis are universally applicable. If the approach is based on other hospitals’ experiences, how can you
confirm if it will work in the unique environment of your organization?
ƒƒ the methodology based on system-wide thinking or applied to a specific department? If applied to a
Is
limited area, will improvement in one area lead to problems in other areas?
ƒƒ the approach provide you with lasting improvements that your staff can sustain going forward?
Will

Press Ganey’s PatientFlow Optimizer offering is unique in that it is:

ƒƒ full implementation, not just a set of analyses and reports.
A
ƒƒComprehensive across key inter-related services, i.e., not silo based.
ƒƒRobustly based in Operations Management science as applied to health care.
ƒƒTailored to address unique aspects of individual hospitals.
ƒƒApplied deliberately using pilot testing.

How does Press Ganey’s approach compare with Lean Management and Six Sigma?
Lean Management and Six Sigma are process management and quality improvement methodologies that
originated in the manufacturing industry. Since Lean Management and Six Sigma focus on optimizing
individual processes, sub-optimization may occur in other parts of an organization. For example, if you
improve the processes and patient flow through the Cath Lab, it could lead to pressures on your CCU
and telemetry units. Press Ganey’s approach recognizes the inter-relatedness of health care operations.
We believe that the benefits of applying process improvement methodologies like Lean Management
and Six Sigma can be greatly enhanced by addressing artificial variability first, which is at the core of our
implementation solution.

How can changing the OR schedule ease ED overcrowding and patient boarding?
It has been scientifically proven that periods of ED diversions and overcrowding are more often caused by
surges in scheduled surgeries than by problems with ED volume or internal processes. Surprisingly, the
main root of ED overcrowding and boarding is the unavailability of inpatient beds that have been filled by
scheduled surgical admissions, usually in the middle and later half of a typical week.

What is artificial variability and how does it cause patient flow problems?
In any system, there are two kinds of variability. Natural variability, as the name suggests, is driven by
natural variation, for example, across various clinical providers’ skill levels. Artificial variability, on the other
hand, is typically introduced extrinsically by management practices like scheduling. The result is substantial
fluctuation in patient volume through a typical day, week or month. Since a part of patient demand varies in a
truly random fashion (e.g., most of the inflow through the ED), scheduling-driven fluctuations result in further
amplifying the variation. In the end, artificial variability in a hospital affects its ability to provide patients the
right level of care, at the right place, at the right time.



What is OR smoothing?
OR smoothing is the process of eliminating artificial variability in surgical volume. A common misconception
is that OR smoothing can be accomplished by equalizing the number of scheduled OR cases done on each
day of the week. While doing so might be an improvement over a hospital’s current state, it will not fully
realize the benefits of smoothing when done correctly. The specific aspects of smoothing need to be tailored
to each hospital’s surgery practice (OR schedule, individual teaching responsibilities, clinic schedules, etc.),
service mix, ICU and step-down capacity, and program sizes, in order to achieve a sustainable solution.

Why is OR smoothing important?
No hospital can efficiently and effectively manage variability in demand that is both unpredictable and non-
random. Variability in scheduled OR volume is a function of scheduling practices and staff preferences,
which do not follow any statistical patterns. Such variability is best managed by elimination, hence the need
for OR smoothing.

Can my hospital cost-effectively match demand and capacity without addressing artificial variability?
The only time that matching capacity (physical and staffing) to demand is an appropriate solution is when
demand variation is entirely random in nature, which is typically not the case in hospitals. Artificial swings
amplify peaks and valleys in daily volume.

Typically, hospitals cannot afford to always staff for peak demand – this leads to waste during all the times
when demand is less than peak. The alternate approach of staffing for average demand leads to stress on
providers, as well as concerns about quality of care, when demand exceeds the average (about half the
time). Finally, flexing capacity to match demand variation, apart from being operationally challenging, is
inefficient due to the artificially exaggerated demand peaks. The only appropriate solution is to eliminate
artificial peaks, and then build/staff to manage natural variations in demand.

What does it take to successfully implement patient flow improvements?
From a consulting standpoint: Technical expertise in Operations Management, especially as it applies to
the unique aspects of health care; clinical and hospital management experience; ability to generate buy-
in from key constituents; extensive health care data analytics expertise; expertise in managing complex
implementation projects; and previous implementation successes.

From a hospital standpoint: Support from the executive suite; political will to try significant changes; and
agreement to develop and monitor certain measurements on an ongoing basis.

Take a look at the unique expertise in patient flow offered by Christina Dempsey, Press Ganey’s senior vice
president of clinical and operational consulting.

What role does the client’s staff play in a typical PatientFlow Optimizer project?
Our goal is to drive improvements in quality of care, patient safety, patient satisfaction and staff satisfaction.
It is not possible for us to effect these improvements without working very closely with your staff. We provide
wide-ranging expertise to help your providers and staff to develop and implement new practices specific to
your organization. In many cases, our client’s staff helps to gather additional metrics needed to implement
and sustain patient flow improvements.



What are the data needs for a successful implementation project?
Typically, we start with a review of whatever data and reporting currently exists, mainly for the ED, OR and
inpatient units. The data we look for are a variety of time stamps (e.g., arrival time, patient in-room time,
discharge time) and patient classifications (emergent, urgent, ICU, telemetry, etc.). In some cases, it is
important to look at other major services like the Cath Lab, Radiology and specialty units such as heart
hospitals.

How does Press Ganey ensure that the improvements are sustained in the long run?
We work very closely with client administrative and clinical staffs throughout a typical project. Client staff
play a key role in developing and implementing new processes. The result is that there is a strong internal
ownership of the process and changes. Secondly, we are able to show strong positive results by the end of
the first phase (about six months), which results in buy-in from surgeons as well as other key constituents.
Finally, we believe in training client staff so that they can continue to build on the successes achieved in the
course of the project.




PatientFlow Optimizer SM

Determining Capacity Need

Make Every Interaction With Your Patients Count
We work closely with our hospital clients to identify patient flow issues and to implement changes to
effectively resolve those issues. Our typical engagement with a hospital involves three phases:

ƒƒPhase I – Patient flow assessment and reengineering of scheduled vs. unscheduled operating room
flow.
ƒƒPhase II – Smoothing of daily operating room flow and resulting flow to preferred units.
ƒƒPhase III – Determination of specific bed and staffing needs for major hospital units.

The overall engagement takes between 15 and 24 months, with each phase ranging from five to eight
months in duration. The structure and benefits of each of these phases is described in the following sections.

Phase I – Patient Flow Assessment/ Scheduled vs. Unscheduled OR Flow
Phase I starts with an overall patient flow assessment. In order to perform that assessment, we request a
variety of historical data from the hospital’s existing information systems such as ADT and OR information
systems. We also conduct an extensive on-site visit. During that visit, we meet with the appropriate clinical
and non-clinical staff involved with the major units being assessed to discuss patient flow issues. Upon the
completion of the patient flow assessment, we conduct a half-day on-site presentation and discussion where
we review our findings, present our recommendations and discuss next steps. As part of that meeting, we
share our written assessment report that will contain the detail and analysis behind our presentation and
recommendations.

Phase I concludes with the implementation of scheduled vs. unscheduled OR flow changes identified
through the patient flow assessment. These changes will encompass identifying and implementing the
appropriate number of unscheduled operating rooms by day and by hour. We will work with the hospital on
implementing these changes for a one- to three-month period while closely monitoring the results. We make
the commitment that these changes will not reduce the surgery volume of any surgeon by even a single case
and will not have any adverse effect on patient care, or we will cease the implementation immediately. Quite
to the contrary, the benefits that we expect the hospital will realize through Phase I are:

ƒƒShorter waiting times for surgery for unscheduled patients.
ƒƒReduced bumped elective surgeries.
ƒƒLower nursing overtime.
ƒƒHigher OR prime time utilization.
ƒƒGreater surgical throughput (increase in overall surgical volume).
ƒƒImprovements in patient safety.

These benefits will be achieved without adding additional staff or expanding current facilities and will begin
to accrue before the completion of Phase I. The benefits go well beyond the pure financial to encompass
improved physician, nursing and patient satisfaction.



Phase II – Smoothing Daily OR Flow and Flow to Preferred Units
During Phase II, we identify whether additional separation of disparate surgical patient flows is advisable
(e.g., inpatient vs. outpatient surgery, complex vs. short cases) and how artificial variability in scheduled
surgeries by day of week and hour of day can be substantially reduced. This phase also includes smoothing
the outflow from surgery to the preferred units designated for surgical patients leaving recovery.

The benefits that we expect the hospital will realize through Phase II are:

ƒƒReduced waiting times for placement in an inpatient bed for both surgical and medical patients.
ƒƒIncrease in percentage of patients placed in the preferred unit based on their condition.
ƒƒAdditional increases in surgical throughput beyond what is achieved in Phase I.
ƒƒFurther improvement in OR prime time utilization beyond what is achieved in Phase I.
ƒƒAdditional decreases in nursing overtime beyond what is achieved in Phase I.
ƒƒImprovements in patient safety and reduced mortality.

These benefits will also be realized without adding additional staff or expanding current facilities. The
benefits of Phase II occur on top of the benefits of Phase I and are maximized when Phase I changes
are optimally implemented. As with Phase I, this phase further enhances physician, nursing and patient
satisfaction.

Phase III – Determination of Specific Bed/Staffing Needs By Unit
Phase III includes analyzing the specific number of beds needed in routine and ICU units and the resulting
staffing necessary to achieve a desired level of service. This phase involves developing complex simulation
models regarding actual and projected patient flows and is only productive after the successful reduction of
artificial variability through Phase I and Phase II of the project.

The benefits that we expect the hospital will realize through Phase III are:

ƒƒProper allocation of bed capacity to maximize the availability of the right bed for medical and surgical
patients, thereby reducing waiting times, ED boarding, patient misplacement and the likelihood of
medical errors.
ƒƒProper allocation of bed capacity and nursing resources, thereby decreasing nursing stress and
improving the quality of patient care.
ƒƒProper allocation of bed capacity to reduce inpatient length of stay, thereby reducing the number of
disallowed hospital days and increasing patient throughput.
ƒƒImprovements in patient safety and reduced mortality.

Our experience indicates that the capital cost of an extra (unneeded) bed to meet artificial swings in patient
demand is approximately $1 million and its annual cost exceeds $250,000.



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See the most recent news about Press Ganey or search the Press Release Archives for a specific story.

PRESS GANEY ONLY COMPANY TO INTEGRATE MOST RECENT HCAHPS, CORE MEASURES DATA TO
PROVIDE NEAR REAL-TIME PICTURE OF VBP SCORE
January 19, 2012

The Press Ganey Value-Based Purchasing Calculator has been updated to integrate hospitals’ most recent nine months of complete HCAHPS and core measures performance
data from Press Ganey databases, enabling hospitals to have a near real-time estimate of their value-based purchasing (VBP) score. The calculator is a solution which helps
hospitals understand how much they have at risk, as well as how to target the areas for improvement that are most likely to optimize VBP incentive payments.

“With the VBP performance period underway, it is critical for hospitals to have real-time performance information on the measures that may contribute to a decrease in Medicare
payment,” said Robert Draughon, Press Ganey’s CEO. “Press Ganey is the only company that can provide clients with timely, accurate HCAHPS and core measures data, giving
them what they need to properly prioritize their improvement opportunities, improve their VBP scores and optimize their Medicare DRG payments.”

Press Ganey’s Value-Based Purchasing Calculator is updated monthly with clients’ most recent, complete data from Press Ganey’s proprietary databases – data that are a full year
more recent than publicly available data. This means that hospitals that work with Press Ganey to meet HCAHPS or core measures reporting requirements can now calculate their
VBP scores based on 2011 data.

The latest release of the Value-Based Purchasing Calculator also features the ability to toggle between current Press Ganey data and public data to see progress, as well as the
option to define custom performance periods to model specific performance scenarios.

The Centers for Medicare and Medicaid Services’ value-based purchasing program will impact Medicare payments for general, acute-care hospitals beginning with Oct. 1, 2012
discharges. The baseline assessment year for all hospitals subject to VBP is FY2012, which began October 1, 2011. For further information on Press Ganey’s Value-Based
Purchasing Calculator solution and VBP-related resources, visit http://www.pressganey.com/VBP.

Press Ganey Associates, Inc.
Recognized as a leader in performance improvement for more than 25 years, Press Ganey partners with more than 10,000 health care organizations worldwide to create and
sustain high-performing organizations, and, ultimately, improve the overall health care experience. The company offers a comprehensive portfolio of solutions to help clients operate
efficiently, improve quality, increase market share and optimize reimbursement. Press Ganey works with clients from across the continuum of care – hospitals, medical practices,
home health agencies and other providers – including 50% of all U.S. hospitals. For more information, visit www.pressganey.com.

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Home > Research & Resources > Government Initiatives > Value-based Purchasing

Value-based Purchasing Resources
The 2010 Patient Protection and Affordable Care Act contains numerous provisions to bring most providers of care into value-based purchasing under Medicare.
Here, we provide resources, including background articles and analyses of the law, to help you gain broader understanding and deeper insight into the program
and how it will affect your organization.

On Jan. 7, 2011, the Centers for Medicare and Medicaid Services (CMS) proposed regulations to implement the Hospital Inpatient Value-based Purchasing
Program (VBP), which bases a portion of Medicare payment on hospitals' performance on a range of quality of care and patient satisfaction measures. This
program will impact payments for general, acute-care hospitals beginning with Oct. 1, 2012 discharges.
Download Press Ganey's analysis (5/26/11).
Press Ganey's Value-Based Purchasing Calculator can help you optimize your value-based purchasing reimbursement.
Read "Integrating for Accountable Care: Under Reform, More Providers Look to New Models for Delivering Better Value to Patients," from the
November/December 2010 issue of Press Ganey Partners.

Read "The Grand Experiment: How Health Reform will Change the Health Care Delivery System Forever," from the May/June 2010 issue of Press Ganey
Partners .
Read our summary of the Key Provisions of the 2010 Health Reform Law.

WHAT YOU NEED TO KNOW - VBP RULE UPDATES, METHODOLOGY, HCAHPS AND CORE MEASURE
TRENDS
Attend our regular updates on value-based purchasing to keep up with the changing rules, learn the methodology and scoring details, as well as hear about how
trends in individual measures are impacting performance benchmarks and thresholds. We offer both on-demand and live events focused on value-based purchasing

To learn more about the Press Ganey solution for value-based purchasing, or to talk with one of our experts, please telephone us at 800.232.8032 or contact us.

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1 of 2 1/24/2012 10:12 AM

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Home > Our Solutions > For Hospitals > Clinical Performance Suite > Value-Based Purchasing Calculator

Value-Based Purchasing Calculator
The days of earning your full Medicare Annual Payment Update by simply submitting complete and accurate data are drawing to a close. Under the Centers for
Medicare and Medicaid’s (CMS) value-based purchasing (VBP) plan, your facility’s performance on clinical quality and patient satisfaction measures will determine
1% your base DRG payment for federal fiscal year (FFY) 2013. With the performance period underway, and final rules for FFY 2014 that get more complicated
and more challenging, it’s vital to understand and improve your hospital’s position. Learn how your hospital stacks up to identify top priorities and key strategies to
improve your score.

BRING CLARITY TO YOUR MOST IMPORTANT VALUE-BASED PURCHASING QUESTIONS
Value-based purchasing calculation methodology is both complex and fluid. Due to the complexity of the calculations and the evolving nature of the model, most
hospitals find it impossible to answer key questions such as:

If value-based purchasing were in effect today, how much of our Medicare reimbursement would our hospital be losing annually?
How can my facility earn the greatest number of VBP points?
How should I prioritize my hospital’s various opportunities for improvement?

The Press Ganey Value-Based Purchasing Calculator brings clarity to these questions and allows you to take an ROI approach to target areas for improvement.
Prepare today to optimize your value-based purchasing reimbursement.

GET THE MOST CURRENT DATA AVAILABLE – EVERY MONTH
The Press Ganey Value-Based Purchasing Calculator integrates hospitals’ most recent nine months of complete HCAHPS and core measures performance data
from Press Ganey databases, delivering a near real-time estimate of your VBP score. The VBP Calculator is updated monthly with clients’ most recent, complete
data from Press Ganey’s proprietary databases. Since the data are a full year more recent than publicly available data, hospitals that work with Press Ganey to
meet HCAHPS or core measures reporting requirements can now calculate their VBP scores based on 2011 data. In addition, the calculator offers the ability to
toggle between current Press Ganey data and public data to see progress, as well as the option to define custom performance periods to model specific
performance scenarios.

USER-FRIENDLY RESOURCE HELPS PRIORITIZE YOUR IMPROVEMENT OPPORTUNITIES
The Value-Based Purchasing Calculator is a user-friendly, web-based tool that takes your facility’s clinical quality measures and HCAHPS performance and
provides you with an estimate of your facility’s VBP exposure – all the way down to the measure level. Additionally, this flexible tool enables users to quickly model
different performance scenarios so you can pinpoint the areas of opportunity that would provide the greatest return on your quality improvement efforts.

Whether you are well versed in value-based purchasing but need a reliable tool to help prioritize improvement opportunities for the biggest VBP impact, or you are
brand new to the discussion and trying to get a base understanding of your facility’s exposure, the Value-Based Purchasing Calculator is an essential component
for your hospital’s improvement tool kit.

1 of 2 1/24/2012 10:13 AM

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See the most recent news about Press Ganey or search the Press Release Archives for a specific story.

NEW TOOL HELPS HOSPITALS IMPROVE PATIENT EXPERIENCE, BOTTOM LINES: PRESS GANEY
UNVEILS COMPREHENSIVE, INTERACTIVE PATIENT EXPERIENCE OPTIMIZERSM
May 18, 2011

A new tool, unveiled this week by Press Ganey, can help hospitals create a patient-centered environment to reduce patient defections, improve HCAHPS scores, increase brand
equity, and grow revenue and market share.

Creating a better experience for patients is more crucial now than ever due to the integration of public reporting and value-based purchasing. The patient experience is increasingly
cited by hospital C-suite executives as a priority, and last year, HealthLeaders Media reported a national study in which close to 80% of health care executives indicated that the
patient experience is a business imperative. The Patient Protection and Affordable Care Act and the creation of accountable care organizations will only increase the importance of
the patient experience in the years ahead as the value-based purchasing program is implemented and performance is tied to federal dollars.

"We know that improving the patient experience is always top of mind for hospital administrators – especially now that it's more closely tied to organizations' bottom lines," said
Richard B. Siegrist Jr., CEO of Press Ganey. "We also know that integration is key to success in both areas, which is why we've created a tool that combines a multimedia solution
with experts who have hands-on experience at implementing and sustaining service excellence improvement initiatives."

The Patient Experience Optimizer is a comprehensive, strategic improvement program that is ideal for hospitals that want to improve the patient experience throughout the
organization in a systemic way. The new tool integrates two components – an evidence-based multimedia platform and interventional consulting by Press Ganey experts – to help
understand patient expectations, identify unmet expectations and design solutions to address gaps.

This new tool will also help to assess current strengths and weaknesses, analyze the barriers that have prevented improvement in the past, and implement sustainable actions that
will result in exceptional patient experiences.

"What really makes this tool unique is that it will help organizations understand how expectations shape patients' evaluations of their health care experiences," added Siegrist.
"They can then take the next, most important steps in the process and design systems and practices to address patient expectations."

For more information on the Patient Experience Optimizer, visit www.pressganey.com.

Recognized as a leader in performance improvement for 25 years, Press Ganey partners with more than 10,000 health care organizations to create and sustain high performing
organizations, and, ultimately, improve the overall health care experience. The company offers a comprehensive portfolio of solutions to help clients operate efficiently, improve
quality, increase market share and optimize reimbursement. Press Ganey works with clients from across the continuum of care – hospitals, medical practices, home health agencies
and other providers – including 50% of all U.S. hospitals. For more information, visit www.pressganey.com.

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Home > Our Solutions > Consulting > Performance Consulting Suite > Patient Experience Optimizer

Patient Experience OptimizerSM
Groundbreaking Multimedia Platform for World-class Success
The Patient Experience Optimizer is a strategic improvement program that provides the multimedia tools and insight health care organizations need to create a
patient-centered environment where employees and physicians are empowered and motivated to deliver a world-class experience to every patient.

This unique platform integrates evidence-based solutions with the guidance of Press Ganey consulting experts who have hands-on experience implementing and
sustaining service excellence improvement initiatives. As a result, your organization can realize improved patient satisfaction and brand equity, reduced
out-migration, and increased market share and revenue.

Learn more about Patient Experience Optimizer:

Watch this informative video to see and appreciate the features of this multimedia platform.
Download and print the Patient Experience Optimizer solution sheet (PDF) to better understand the three key areas that affect
patient experience.
Read the press release to understand the role this solution plays in a VBP environment.

Enter your information below to join our mailing list or to have a Press Ganey representative contact you to discuss the Patient
Experience Optimizer.

First Name: Last Name:
Title: Facility:
Email: Phone:
State:
Country:
Join our mailing list.
I would be interested in a related webinar.
Have a Press Ganey representative contact me.

1 of 2 1/24/2012 10:18 AM

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Home > Our Solutions > Consulting > Performance Consulting Suite > PatientFlow Optimizer

PatientFlow OptimizerSM
Patient flow bottlenecks have a profound impact on a hospital's quality of care and financial performance. PatientFlow Optimizer combines operational consulting
with the expert insights, hands-on experience and proprietary tools to help your hospital achieve sustainable improvements.

COMMON PROBLEMS CAUSED BY PATIENT FLOW BOTTLENECKS
ED overcrowding, diversions and boarding.
Lack of available ICU and Med/Surg beds, patient misplacement.
Bumped or delayed elective surgical cases, backups in the PACU.
Excessive ED and OR waiting times.
Overburdened nurses, high overtime, excessive nurse vacancy rate.
Upset doctors, nurses, patients.

PatientFlow FAQ : It isn’t always necessary to add capacity to address overcrowding. Learn about artificial variability, OR smoothing and more.

Determining Capacity Need: Find out how Press Ganey can assess your scheduled and unscheduled OR traffic, smooth daily OR flow and determine specific
bed/staffing needs by unit.

EXPERTISE, PROPRIETARY TOOLS AND EXPERIENCE
Our patient flow consultants have decades of hands-on operational and clinical experience. They work closely with hospital and physician leadership alike to build
alignment – from the initial analysis all the way through to your organizations' operational and cultural change.

Through a combination of operations management tools such as queuing theory and simulation modeling, and the soft science of change management, we help
your hospital optimize existing resources and achieve real results:

Separating different patient flows that are competing for the same resources to optimize availability and usage.
Smoothing artificial variability in patient flow in order to reduce peaks and valleys (to/from ED, OR, ICU, tele and routine units, cardiac cath) and improve
ROI.
Determining the optimal allocation of resources to meet current and future demand.
Fully engaging physicians and nurses in patient flow improvements for improved quality, safety and efficiency.

WHAT YOU CAN EXPECT FROM PATIENTFLOW OPTIMIZER
Patient Waiting Times

Waiting time for emergent/urgent surgeries down 25% to 50%.
Compliance rate with waiting time guidelines up to 90%+.
Bumped surgeries virtually eliminated.

Patient Placement and Boarding

Patient placement in clinically preferred routine/ICU unit up by 20%+.
ED and PACU boarding substantially reduced.
Ambulance diversions significantly reduced.

Volume, Revenue and Cost

Surgical throughput up 20% to 40%.
ED throughput up 5%+.
Percent of case hours done during prime time up by 20%+ (reduced overtime).
Reduced patient length of stay.

Quality and Satisfaction

Fewer patient flow related medical errors.
Enhanced patient, nurse, physician and staff satisfaction.

YOUR POTENTIAL BENEFITS
Estimate the potential benefits that PatientFlow Optimizer can bring to your organization.

1 of 2 1/24/2012 10:19 AM

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Patient Flow Calculator
SM
Hospitals that implement PatientFlow Optimizer typically experience a number of benefits including reduced wait times and shorter length of stay, improved
throughput, fewer medical errors, and enhanced physician, nurse and patient satisfaction.To receive an estimate of some of the potential benefits that PatientFlow
Optimizer can bring to your organization, please provide as much of the following data as possible. If exact values are not available, you may provide an estimate;
or if data is not available, leave the field blank. All contact fields are required.

First Name: Last Name:
Email: Title:
Facility: Phone:

Total number of ORs Total ORs being used currently.

Number of these ORs used exclusively for add-on Include ORs that are used exclusively for add-on cases; if all ORs are used for both scheduled and add-ons
(unscheduled) cases then leave this field blank.

Annual number of surgeries Use most recent year.

Average duration of surgical case In minutes; measured as patient in to patient out.

Average OR turnover (room cleaning) time In minutes; measured as patient out to next patient in.

Number of prime time hours e.g., M-F 7 a.m. to 3 p.m. = 8 hrs

% of cases done during prime time Include all cases, scheduled and unscheduled.

% cases done after prime time Include all cases, scheduled and unscheduled.

Described as a percentage. Look at actual patient in to patient out of the OR plus turnover time divided by
Average OR utilization rate during prime time hours the number of prime time hours.

Average OR nurse salary plus benefits (per hour) Benefits should be calculated as 30% of wages.

Average contribution margin per surgical case Do not include overhead costs.

Annual number of ED visits Total number of ED visits.

ED LWBS rate Percentage of patients who leave before medical screening examination.

Inpatient discharges Annual number of inpatient discharges.

Average contribution margin per ED visit Do not include overhead costs.

Average contribution margin per inpatient discharge Do not include overhead costs.

1 of 2 1/24/2012 10:20 AM

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2011 Press Releases
GOOD PATIENT CARE EQUALS GOOD BUSINESS – NEW REPORT SHOWS HIGHER-PERFORMING HOSPITALS EARN MORE PROFITS

Press Ganey’s 2011 Pulse Report Provides Broad Look at Key Trends in Health Care

Hospitals with high performance scores in patient care are more profitable, according to the 2011 Pulse Report from Press Ganey, which serves hospitals that represent 66% of
U.S. hospital admissions. Analyzing public data on hospital profitability and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores, the
report found that the top 25% of U.S. hospitals with the highest scores on the HCAHPS question about performance were, on average, the most profitable and had the highest
clinical scores. Taken together, the data suggest that excellence in patient experiences, clinical outcomes and financial profitability often occur together.

“Taking great care of patients is the best business model for hospitals,” said Robert Draughon, CEO of Press Ganey. “Hospitals that are making performance on patient satisfaction
and publicly reported clinical core measures a priority are proving to be the most successful.”

Excellence in patient experiences, clinical outcomes and financial profitability often occur together, the report concludes, likely because “quality” is often structural or systematic.
When an organization focuses on quality, it tends to do so in all areas.

The report also found that since the advent of public reporting of clinical and patient satisfaction data, hospital performance across the board has increased. Compliance rates with
evidence-based standards of care have increased for most of the common causes of hospitalization, including heart attacks, heart failure, pneumonia and surgical care.

“With CMS’ value-based purchasing (VBP) program – the first national pay-for-performance program – beginning its performance period on July 1 this year, hospitals are more
focused than ever on understanding and improving their performance,” Draughon said.” As the largest HCAHPS and third- largest core measures vendor, we are helping hospitals
develop and prioritize initiatives that will optimize performance and lead to higher quality outcomes.”

For example, from the time voluntary public reporting began in 2006 to when the Affordable Care Act was signed into law in 2010, the composite performance score for hospital
performance on the heart failure measure set saw a significant increase. Overall, hospital ratings on the HCAHPS survey increased from 64% to just over 67% over the same time
period, also indicating improved performance.

“The good news is that the mandates for public reporting of quality of care data continue to have a positive effect on quality improvements,” Draughon said.

Press Ganey’s report provides data and insights on a number of other key areas in health care, including the following topics and highlights:

Emergency department (ED) – Patients seen in the ED from 7 a.m. to 3 p.m. report much higher satisfaction ratings than those that arrive at any other time.
Inpatient – Patients are more satisfied now than they were four years ago (a 2.25% increase in satisfaction scores for inpatients).
Outpatient – Women are generally more satisfied than men with their outpatient experiences, especially those 35-49.
Physicians – Doctors specializing in pathology, radiology, pediatrics and family medicine are the most satisfied (among 18 specialties evaluated).
Health care employees – The closer employees are to patients, the lower their workplace satisfaction and engagement, likely due to the higher stresses and responsibilities
of patient care.
Medical practice – Medical oncology, cardiovascular disease and interventional cardiology are the top medical practice specialties for patient satisfaction (among 25
specialties evaluated).
Home care – Nurses create the greatest amount of satisfaction among home care patients.

“Press Ganey provides a 360-degree view into the perspectives of those who will drive change at health care organizations – patients, physicians and employees,” Draughon said.
“This report includes a fraction of some of the important data and insights that can help improve the health care system.”

The entire Press Ganey 2011 Pulse Report provides additional details, information and methodology. It is available at www.pressganey.com/2011pulsereport.

Recognized as a leader in performance improvement for 25 years, Press Ganey partners with more than 10,000 health care organizations worldwide to create and sustain high
performing organizations, and, ultimately, improve the overall health care experience. The company offers a comprehensive portfolio of solutions to help clients operate efficiently,
improve quality, increase market share and optimize reimbursement. Press Ganey works with clients from across the continuum of care – hospitals, medical practices, home care
agencies and other providers – including 50% of all U.S. hospitals. For more information, visit www.pressganey.com.

View all 2011 Press Releases

1 of 2 1/24/2012 10:24 AM

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2011 Press Releases
NATION’S BEST HEALTH CARE ORGANIZATIONS FOR PATIENT SATISFACTION, CORE MEASURES HONORED BY PRESS GANEY

Press Ganey Associates, Inc. has announced its elite class of 2011 award-winning health care organizations, including recipients of the first-ever Summit and Top Improver awards
™
for clinical achievement and the new Patient Voice Award for Academic Medical Centers.

Press Ganey, the health care industry's leading performance improvement firm, is trusted by more than 10,000 health care organizations worldwide to create and sustain high
performing organizations and to help improve clinical, operational and patient satisfaction outcomes. In addition to Patient Voice, Summit and Top Improver award recipients, the
company is also honoring winners of the following awards this week at the 2011 Press Ganey National Client Conference in Dallas, Texas.

Partner of Choice® Award
Best Place to Practice® Award
™
Distinctive Workplace Award
®
Success Story Award

"We're excited to recognize more than 160 clients for their outstanding achievements over the past year," said Press Ganey CEO Robert Draughon. "These health care
organizations serve as shining examples of the positive outcomes that result from focusing on patient satisfaction and core measures performance to improve quality of care."

This year for the first time, in addition to achievement in patient satisfaction, Press Ganey recognized clinical core measures performance in the Summit and Top Improver
categories. Ninety-eight organizations were honored with a Summit Award® for achieving and sustaining the highest level of excellence; 11 for core measures performance and 87
for patient satisfaction. Thirty-one facilities were named Top Improvers for demonstrating continuous improvement over two years; 13 for core measures initiatives and 18 for patient
satisfaction.

A new award was also introduced this year – the Patient Voice Award. This award recognizes academic medical centers that have achieved excellence in patient satisfaction as
demonstrated by HCAHPS performance compared to other academic medical centers in the Press Ganey database. There were three Patient Voice recipients.

In addition, three Partner of Choice Award winners were recognized for organization-wide excellence in satisfaction among patients, physicians and employees; six Best Place to
Practice winners were recognized for excellence in physician partnership; and 11 facilities were honored with Distinctive Workplace awards for outstanding employee partnership.
Nine Success Story awards were given to facilities that demonstrated leadership, implemented organizational change and improved patient satisfaction or clinical measures
performance.

Winners include health care providers from across the country in both metropolitan and rural areas. A complete list of 2011 Press Ganey award recipients can be found on the
Press Ganey web site.

Nearly 2,000 health care leaders from across the country have gathered in Texas at the Press Ganey conference to discuss, learn and share best practices on some of the key
issues related to health care quality improvement. Attendees also have an opportunity to hear from leaders of the award-winning organizations and take back practical improvement
tips to their own organizations.

Recognized as a leader in performance improvement for 25 years, Press Ganey partners with more than 10,000 health care organizations worldwide to create and sustain high
performing organizations, and, ultimately, improve the overall health care experience. The company offers a comprehensive portfolio of solutions to help clients operate efficiently,
improve quality, increase market share and optimize reimbursement. Press Ganey works with clients from across the continuum of care – hospitals, medical practices, home care
agencies and other providers – including 50% of all U.S. hospitals. For more information, visit www.pressganey.com.

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Teaching patient-centered care a must for physicians,
patients
November 29, 2011 — 5:40pm ET | By Karen M. Cheung
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Although much of the focus of competencies revolves around clinical abilities of
Subscribe physicians, there are other competencies to consider with other stakeholders in
Email healthcare.
Print
Contact Author "Patients need competencies too," Dr. Eric Holmboe, chief medical officer of the
Reprint
American Board of Internal Medicine (ABIM), said Tuesday at the ECRI Institute's
18th Annual Conference at the FDA in Silver Spring, Md.
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physician Sign up for our FREE newsletter for more news like this sent to your inbox!
communication
patient-centered care
"All too often, we don't include patients," he said. What's more, "systems also
Fierce exclusive
core competencies needs competencies," Holmboe added. Physicians should help patients to
manage their own care, and the system should help them improve their health
literacy and empower them to advocate for themselves.

Teaching patient-centered care
In certifying physicians, the ABIM looks at the six Accreditation Council for Graduate Medical
Education/American Board of Medical Specialties core competencies to evaluate the skills of those
clinicians: patient care, medical knowledge, practice-based learning, systems-based practice,
professionalism, and interpersonal skills and communication. Where does patient-centered care fit in?
Holmboe explained that patient-centeredness plays a role throughout all six competencies.

With that in mind, teaching patient-centeredness to future generations of doctors plays an increasingly
important role in healthcare.

"We have to re-think the way we train medical professionals," Holmboe said.

As American College of Surgeons Executive Director Dr. David Hoyt noted, today's physician leaders,
notably the ones teaching young physicians, didn't have that patient-centered, dedicated curriculum
and mounting measures. "We are learning this together," Hoyt said.

Measuring patient-centered care
How does an organization evaluate patient-centered care? Many organizations use the industry
standards of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
survey, Press Ganey, or other similar patient surveys.

However, Holmboe cautioned that there is a difference between patient satisfaction and patient
experience.

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"Surveys should target patient experience and outcomes, not just satisfaction," he said.

Studies have shown experience correlates to quality performance, although there is little correlation
between satisfaction and outcomes, according to Holmboe. For example, patients who report their
providers' communication as good have better outcomes. Patients who experienced higher ratings of
performance (access to care, waiting time, general communication, communication about illness, care
coordination, and office staff interaction) showed to have better blood pressure control, indicating a
link between communication and care outcomes.

Key to medical education and health reform is practice redesign that is conducive to patient-centered
care, said Dr. Malcolm Cox, chief academic affiliations officer of the Veterans Health Administration.
"Patients have a right to personalized, patient-centered care that is safe, effective, and efficient," he
said.

Related Articles:
Patient-centered care shortens length of stay by 30%
Training helps docs improve explanations, not general communication
Patients, provider rate physician professionalism with bias
Physicians pick up situation-specific communication skills

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The National PACE Association (Program for All Inclusive Care for the Elderly) is such a program. It practices
this very type of care for seniors. Putting the patient in the center and providing an array of services touching
their medical, social and housing needs.

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