Title: An Innovative Approach with the use of Information Technology to Assess & Address the Patient
Experience at UC Davis Dermatology
Submitted by: Stephen A. Mathis, MBA, MS
Practice Manager
UC Davis Dermatology
3301 C Street, Suite 1400
Sacramento, CA 95816
(916) 734-6859
[email protected]
Name of project leader: Stephen A. Mathis, MBA, MS
Name of team member(s): Barbara Burrall, MD
Project Description:
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys ask
consumers and patients to report on and evaluate their experiences with health care.
The goals of the CAHPS program are twofold:
•Develop standardized patient surveys that can be used to compare results across sponsors and
over time.
• Generate tools and resources that sponsors can use to produce understandable and usable
comparative information for both consumers and health care providers.
Relevance of HCAHPS® Scores and Potential Impact on Reimbursement
• Starting Oct. 1, HCAHPS® scores will begin to influence how much hospitals are compensated
under the Patient Protection and Affordable Care Act. Safety Net Hospitals (SNHs) are at a risk
of receiving even less compensation based on the scores they receive. Safety Net Hospitals
(SNHs) are facilities that “care for vulnerable and typically poor populations.
UCDHS recently transitioned to Press Ganey and CG-CAHPS questions to survey our patients.
Press Ganey offers a variety of survey methodologies to obtain patient feedback. The patients
are randomly chosen from the number of visits and the practice manager and staff will receive
the feedback within a 3 month period of the actual date of visit. The feedback can be used to
focus on improvement efforts by understanding opportunities by specialty, provider, and
patient demographics.
To supplement Press Ganey’s patient satisfaction feedback, we piloted a point-of-service survey
kiosk offered by Opinionmeter® for immediate feedback during patient discharge. The patient
has the opportunity to provide immediate feedback via the Opinionmeter® kiosk located
adjacent to the discharge desk. All surveys are anonymous and voluntary. Patients are also
offered the opportunity to meet with the manager regarding the visit to identify staff that
provided excellent service and to render suggestions for improving the visit.
A) Technology utilized in the project
An I-Pad with Retinal Display was purchased along with the software from Opinionmeter® and
the survey kiosk stand. The total investment for the project was $1,695. The flexibility of the
software allowed the practice manager to develop the questions that were pertinent for the
Dermatology practice. Development of the survey took less than 2 hours and was easily
uploaded to the I-Pad. No internet connection is needed; however, additional features occur with
the internet connection such as pager alerts to the practice manager should a patient rate a
question as strongly disagree (unfavorable) or strongly agree (very favorable). The strongly
disagree notifications were opportunities for the manager to address a patient concern prior to the
individual leaving the UC Davis Dermatology clinic. The strongly favorable response allowed
the manager to obtain immediate feedback to possibly recognize a provider or staff member for
exceptional service. Reports can be run at any time to provide immediate feedback to providers
and staff regarding patient satisfaction. The Dermatology residency program was able to develop
a research project entitled “Patient Satisfaction and Provider Self-Assessment of Patient
Satisfaction at an Academic Outpatient Dermatology Clinic” based upon the survey results. The
results emphasized that patient satisfaction was in alignment with perceptions from both groups.
B) Timeframe of implementation
From 31 May -29 July 2013, 562 surveys were completed during patient discharge. The
Opinionmeter® offers reporting features that can deliver Summary Reports, Cross Tabulation,
Cross Tabulation Graph, Summary Graph, Trend Analysis, Compare Locations, Service Scores,
and Respondent Levels. The kiosk survey continues to be in use but has now been used to
address interests in the Dermatology cosmetic offerings. The data obtained helps to drive
marketing efforts and has addressed patient satisfaction efforts per provider and staff.
C) Relevant URLs
Information about Opinionmeter® can be obtained through http://opinionmeter.com/
Information about UC Davis Dermatology can be obtained through
http://www.ucdmc.ucdavis.edu/dermatology/
D) Objective customer satisfaction data
A total of 562 surveys were obtained during this initial pilot period. An overall result obtained
per question addressed is listed below.
Question 1: Why did you choose UC Davis Dermatology for your health needs?
Results: 29% Insurance Plan requires, 22% My Dermatologist is great, 19% UCD quality
reputation, 17% Happy with service received, 9% Other, 4% Close to work/home
Question 2: When making an appointment, was the scheduler courteous and professional to you
over the phone or in person? Results: 98% Yes, 1% No, 1% Unsure
Question 3: Was your receptionist courteous and professional during the check-in process today?
Results: 99.8% Yes, 0.2% No
Question 4: How long did you wait from time of check-in until you were seen by a provider?
Results: 83% 0-15 minutes, 12% 16-30 minutes, 4% 31-45 minutes, 1% over 45 minutes
Question 5: Was your Medical Assistant or Licensed Vocational Nurse courteous and
professional today? Results: 99.8% Yes, 0.2% No
Question 6: What provider did you see today? Results: Used for cross tabulation of results
Question 7: What resident doctor did you see today? Results: Branching question N/A unless
indicated in Question 6.
Question 8: Did you doctor listen to you and acknowledge your concerns?
Results: 99% Yes, 1% Somewhat, 0% No
Question 9: Did your doctor fully explain your medical condition and treatment?
Results: 98% Yes, 2% Somewhat, 0% No
Question 10: Please indicate your overall satisfaction with your doctor for today’s visit:
Results: 72% Extremely satisfied, 24% Very satisfied, 3.5% Satisfied, 0.5% Dissatisfied
Question 11: You indicated that you were dissatisfied with your doctor today. Please indicate
most relevant reason. Results: (1) response: Doctor did not address my concerns fully and (1)
response: Doctor was late
Question 12: Was your surgery schedule and/ or check-out receptionist courteous and
professional today? Results: 98.4% Yes, 1.6% No
Question 13: Would you recommend UC Davis Dermatology to friends/relatives?
Results: 82.6% Definitely Yes, 17.2% Yes, 0.2% No
Question 14: Would you like to identify a staff member(s) that provided excellent service? Do
you have any suggestions on how we can improve? Results: 9% Yes, 91% No
E) Health Care: How does it improve the quality of patient care at UC?
The ability to obtain immediate patient feedback versus waiting 3 months is a tremendous benefit
for the department providers and staff. When shortcomings are identified, we have the ability to
fix the issue and improve the patient experience. The survey kiosk takes a patient between 1-2
minutes to answer via the touch screen. During this time period, the discharge receptionist is able
to print the patient’s After Visit Summary and make any follow up appointments as needed. The
discharge receptionist is then able to reinforce the message that we strive for excellence and how
valuable their feedback is to the department. The discharge receptionist also thanks the patient
for choosing UC Davis Dermatology. Patients have a choice when it comes to healthcare and we
strive for them to choose our department not because their insurance dictates it but because they
feel respected, valued, and appreciated.
F) Be innovative – present a unique, new, or different solution to a problem
We are the first department to pilot the survey kiosk within the UC Davis Health Care System.
We have received positive feedback from patients that the kiosk survey was easy and that they
prefer it over the lengthy phone interviews and extensive Press Ganey surveys. The opportunity
to improve patient satisfaction before they leave the site is monumental. The opportunity for
patient retention versus service recovery has been a tremendous benefit within the department.
We are able to proactively address issues and concerns which results in greater patient
satisfaction and transparency of commitment to excellence in service.
G) Improve operational efficiency and usability/accessibility
Operational efficiency has improved because we have been able to identify providers that have a
larger percent of patients that indicated that they waited to be seen greater than ideal time of 0-15
minutes. Measures have been put in place to determine if delays in check-in, nursing vitals, and
physician delays are the root cause of the patient assessment. The opportunity to address these
issues has resulted in improvements in the patient flow through the clinic and has brought greater
attention to the need to be cognizant of the patient’s time and how it may affect overall
satisfaction scores.
H) Be sharable and readily implementable elsewhere within the University
The patient survey kiosk pilot program results have been presented during the UCDHS Clinical
Leaders Meeting, Practice Managers Meeting and the Ambulatory Care Work Group Meeting.
The program cost of less than $1700 total was well worth the investment. The kiosk survey
program has multiple uses and is readily implementable and sharable within the UC University
systems.
I) Be interoperable and integrated within UC, as well as nationally and internationally
The survey kiosk program is interoperable and can be integrated within UC as well as nationally
and internationally. The results can be shared with other UC Dermatology and non-Dermatology
outpatient clinics. The ability for other practice managers within the UC system to review results
on how well their counterparts at other UC sites did would be of great benefit. The goal would be
to create an UC intranet site that offers a shared Best Practices for similar managers to review
and possibly implement. The ability to reach out to counterparts at other UC sites would be of
tremendous benefit. Unfortunately this site does not exist at this time. Spending hours
reinventing the wheel is not feasible if another shared option is available.
J) Demonstrate collaboration
The survey kiosk program has been shared with all UC Davis Health System practice managers.
The survey kiosk has been adapted so not to interfere with current efforts to improve Press
Ganey survey statistics. The survey kiosk can be readily revised and new surveys can be rolled
out within hours to address needs of the clinic. Interest in the pilot program has been generated
from numerous department managers and chairs.
K) Demonstrate assessable success criteria
Patients, providers, and staff have expressed their appreciation for the survey kiosk. In a
relatively short period of time, 562 surveys were completed. The survey kiosk is available during
patient discharge. The length of the survey takes no more than 1-2 minutes. Results can be
uploaded within minutes if needed. The ability to address patient concerns in real time has been
extremely beneficial with the use of innovative information technology within UC Davis
Dermatology.
Photo of 1st Patient using UC Davis Dermatology survey kiosk (use of photo acquired)
Response card comment from patient in UC Davis Dermatology