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CMS Adds HCAHPS Five-Star Ratings to Website, April 2015

Posted on Mon, Mar 23, 2015
CMS Adds HCAHPS Five-Star Ratings to Website, April 2015

HCAHPS Five-Star Ratings are intended to make it easier for consumers to use the star system to make decisions concerning their choice of healthcare providers.
Centers for Medicare & Medicaid Services (CMS) administers patient experience surveys with the goal of improving healthcare in the U.S.  These surveys represent a change in the way CMS pays for services.  Rather than paying for the number of services provided, CMS is moving in the direction of paying for high-quality service.  CMS’s desire to transform the patient experience will involve the utilization of penalties for poor performance in order to ensure healthcare providers will modify existing behaviors to improve patient experience as reflected within the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience surveys.
HCAHPS star ratings are intended to provide a quick summary of each HCAHPS patient experience survey result in a format that is easy to interpret by the consumer.  CMS plans to update HCAHPS star ratings quarterly.  The HCAHPS star ratings are based on the same data that is used to create the HCAHPS measure publicly reported.
The HCAHPS star ratings shall be based upon averages of survey responses regarding communication with nurses/doctors; responsiveness of hospital staff; pain management; communication about medicines; discharge information; and care transition, as well as cleanliness and quietness of the hospital environment and the overall hospital rating, and whether the patient would recommend the hospital.
All hospitals that participate in the HCAHPS survey are eligible to receive HCAHPS star ratings.  Hospitals must have at least 100 completed surveys in a 12-month reporting period to be eligible for HCAHPS star ratings.  Therefore, the ratings may be based on as few as nine completed surveys per month.
It is critical that the healthcare providers are aware of the categories surveyed, continuously analyze quality improvement data and utilize its quality improvement system to improve the patient experience to avoid the negative public perception of poor care.  The negative star rating will place not only the hospital, but its nurses, doctors and trusted vendors at risk, when hospital management attempts to remedy its poor showing by assessing blame on those responsible for the poor rating.
Prash Pavagadhi
CEO, Qualitick 
March, 2015.

Prash Pavagadhi is a leader in the field of management and marketing both nationally and internationally.  He is the President and CEO of Qualitick, an organization dedicated to bringing innovative data capture, analytics, and quality improvement solutions to the market.  He has worked in diverse markets in both North America and Europe, working with Fortune 500 organizations like Xerox, Corp (UK). and Eaton Corp.  His insightful business and marketing strategies help organizations across numerous industries improve quality initiatives and performance.  The author is also active in the community in Tampa (FL), including a Past President of the Indo-U.S. Chamber of Commerce and also served  on the Board of Directors at the Museum of Science & Industry.  Prash also authored, ‘The Knowledge-Power Paradigm,’ a book which explores the business strategic impact of information as a critical competitive advantage for organizations in this century.

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Research Measures Perceptions of Physician Compassion

Posted on Thu, Mar 05, 2015
Research Measures Perceptions of Physician Compassion

Patients perceive higher level of compassion among physicians who provide a more optimistic message

Patients prefer physicians who convey a more optimistic message, and perceive in them a higher level of compassion, according to a study published online Feb. 26 in JAMA Oncology.

Kimberson Tanco, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues compared patients' perceptions of physician compassion after watching video vignettes of two physicians conveying a more optimistic and less optimistic message. One hundred patients with advanced cancer were randomly allocated to observe two standardized videos depicting a physician discussing treatment information with a patient with advanced cancer. Both physicians made five empathetic statements and displayed identical posture.

The researchers found that patients reported significantly better physician compassion scores after watching the more optimistic video versus the less optimistic video (P < 0.001). There was a sequence effect, with the second video favored in both compassion scores and physician preference (both P < 0.001). Higher perception of compassion correlated with greater trust in the medical profession; the physician was ranked as trustworthy by 63 patients observing the more optimistic message versus 39 observing the less optimistic message (P = 0.03).

"More research is needed in structuring less optimistic message content to support health care professionals in delivering less optimistic news," the authors write.

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Patient Engagement Can Cut Costs, Improve Outcomes

Posted on Sun, Feb 08, 2015
Patient Engagement Can Cut Costs, Improve Outcomes

Initiatives can decrease hospital visits, cut morbidity and mortality, up treatment adherence

MONDAY, Feb. 2, 2015 (HealthDay News) -- Patient engagement initiatives can decrease costs without sacrificing quality care, according to an article published Jan. 22 in Medical Economics.

According to the article, physicians are expected to reduce costs and accomplish more at each patient visit; be responsible for a tremendous medical repertoire; and meet meaningful use objectives, pay-for-performance measures, quality incentive measures, and medical home elements, all in the context of a shortage of primary care physicians.

The article emphasizes the value of patient engagement, similar to customer-empowerment initiatives employed in other industries. Patient self-management represents an important element of the chronic care model, designed to guide higher-quality chronic illness management in primary care. Patient engagement initiatives have led to decreases in hospital visits, reduced morbidity and mortality, and improvements in treatment adherence and quality of life associated with chronic diseases. Scheduling appointments; managing correspondence, refills, and prior authorizations; and facilitating communication with the medical team are areas for patient engagement. Many patients embrace this responsibility and perceive this as better-quality care.

"Although barriers will exist for individual patients to adopt this system and its associated technologies, we must focus on developing an infrastructure that supports and encourages active patient participation in their health care," according to the article.

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Copyright © 2015 HealthDay. All rights reserved.


Managing Wait Times to Improve Patient E.D. Experience

Posted on Tue, Feb 03, 2015

The results are in: Punxsutawney Phil saw his shadow, which, some believe, means that we'll have to wait six more weeks for spring.

As healthcare professionals, we know that waiting, especially in the emergency room setting, can lead to dissatisfied patients.

Let's rewind and take a look at one of our most popular presentations on the psychology of waiting, by EmCare Executive Vice President, Dr. Kirk Jensen as he offers practical tips to improve your patients' ED experience.


Dr. Kirk Jensen is an Executive Vice President with EmCare. He is also the Chief Medical Officer of BestPractices and serves as a Medical Director for Studer Group. He has spent more than 20 years in emergency medicine management and clinical care and is a respected expert in patient safety, performance improvement and patient flow. Jensen has held numerous leadership positions with The Institute for Healthcare Improvement and was named Speaker of the Year by the American College of Emergency Physicians. He has been involved in coaching and/or consulting with more than 200 hospitals nationwide and has developed some of the most innovative and creative solutions in emergency medicine. Jensen holds degrees from the University of Illinois (Champaign), the University of Illinois (Chicago) and the University of Tennessee (Knoxville). He completed his residency in emergency medicine at the University of Chicago.


Rx: Laughter?

Posted on Tue, Jan 27, 2015
Rx: Laughter?

A few weeks ago, I was in a meeting, when during the lunch break, I was so tickled that I ended up laughing for the rest of the day. There was nothing earth-shatteringly funny happening; I was simply enjoying the fact that I was sitting in a room with a group of people that I enjoy. And, well into the next day, I found myself smiling about the incident and I realized that the apples of my cheeks were still somewhat sore from smiling.

This experience led me to research laughter and how it affects our health. 

There's actually a wealth of information that suggests there is great value in incorporating some aspect of humor and laughter in the care plans of our patients, even in emergency medicine. French surgeon, Henri de Mondeville, famously wrote, "Let the surgeon take care to regulate the whole regimen of the patient's life for joy and happiness, allowing his relatives and special friends to cheer him, and by having someone tell him jokes."

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Here are some of the benefits of laughter:

  1. Laughter dissolves tension, stress, anxiety, irritation, anger, grief, and depression. Like crying, laughter lowers inhibitions, allowing the release of pent-up emotions. There is no doubt that after an episode of intense laughter, you will experience a sense of well-being. We have all heard the phrase “he who laughs, lasts.” So true!
  2. Medical researchers have found that laughter boosts the immune system.
  3. Laughter reduces pain by releasing endorphins that are more potent than equivalent amounts of morphine.
  4. Humor helps integrate both hemispheres of our brain, for the left hemisphere is used to decipher the verbal content of a joke while the right hemisphere interprets whether it is funny or not.
  5. Laughter  can help you be more productive, engaging and help you be more of a team player
  6. Everyone loves someone who can make them laugh. People want to surround themselves with those who have a good sense of humor and can tell a joke or two.
  7. Humor brings the balance we need to get through the turbulence of life comfortably.
  8. According to Dr James Walsh, laughter is even equivalent to a small amount of exercise. You can feel the muscles of the diaphragm, abdominals, face (remember when I mentioned having sore cheeks?), leg and back get a good workout.
  9. A sense of humor can help you accept the inevitable, rise to any challenge, handle the unexpected with ease, and come out of any difficulty smiling.
  10. Lower blood pressure.
  11. Increase vascular blood flow and oxygenation of the blood.
  12. Reduce certain stress hormones such as cortisol and adrenaline.
  13. Defend against respiratory infections–even reducing the frequency of colds–by immunoglobulin in saliva.
  14. Increase memory and learning; in a study at Johns Hopkins University Medical School, humor during instruction led to increased test scores
  15. Improve alertness, creativity, and memory

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One of the other things about laughter is that it is incredibly contagious.  Like a yawn that's passed on from one to another, you can’t help but smile or join in when someone around you is laughing. I am convinced that if we can share some laughter, even in stressful situations, we can have a positive impact on overall health -- not only our own but those around us.

Ginger joined EmCare in 2013 as a Divisional Director of Clinical Services for the South Division with the strong belief that she could continue to make positive changes within healthcare by helping others focus on quality, excellence and the overall patient experience. Ginger Wirth regards her role as Director of Clinical Services as the ideal opportunity to partner with nursing, physician and facility leaders to make positive changes to the entire patient care experience. Her 20+ year nursing career has been dedicated to quality and excellence, promoting overall positive outcomes and safety for patients.


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