Title of Outcome Improvement Measure: IT-11.4 Improve patient satisfaction and/or quality of life scores in target population with identified disparity.

RHP Performing Provider / TEXAS TECH HS CTR FAMILY MED / 084597603

Unique RHP outcome identification number: 84597603.3.3

Outcome Measure Description:

We propose to utilize the RAND VSQ-9 Patient Satisfaction Survey (attachment A) to measure patient satisfaction. The survey population will be limited to patients who self-identify as Hispanic. The Performing Provider has experience with Press Ganey survey instruments within the past decade. Overall response rates were very low, in the single digit range. We believe there are a series of structural issues that drove this poor response. Our population is heavily enriched in low income patients. Challenges related to incorrect and changing addresses, and the comprehension level required to complete more complex survey tools such as CG-CAHPS limits response rates. Also, our Region shares an international border with Juarez, Mexico. We believe that many patients in our population choose not to respond to such a survey, not fully understanding the importance of their response, and not recognizing that their participation has no impact on their residence in the region. For these reasons we believe a short survey, administered at the point of service, represents the best option to obtain meaningful data across a wide patient representation. The RAND survey has been validated for accuracy and validity (1) and contains questions which focus on high level patient satisfaction domains and will provide actionable information to improve our regional care delivery. We acknowledge that this survey will not provide results which are directly comparable to CG-CAHPS on a national level. They will, however, provide valid, actionable data on which to assess the impact of this project in Region 15.

Process Milestones:

DY2

  • P-1 Program Planning – provider and staff education, development of tracking and reporting tools, design access plan

DY3

  • P-2 Collect baseline data on the number of unique patients with diabetes, self-identified as Hispanic race or ethnicity, who receive a diabetic eye exam as defined in OD-1, IT-1.11. This data will be collected from EMR, Registry, and scheduling systems

Improvement Milestones:

DY4

  • IT-11.4: The percent of patients reporting a score of 80 or higher will increase by 10% from the baseline in DY3 OR be 70% or greater

DY5

  • IT-11.4: The percent of patients reporting a score of 80 or higher will increase by 10% from the rate in DY3 OR be 75% or greater

These data will be collected from EMR, scheduling system software and the survey instrument.

Rationale: P-1 and P-2 were chosen because at this point we do not collect patient satisfaction data in any form across our enterprise. These reflect the steps necessary to inform our care team of the importance of this issue, and to develop the infrastructure to capture this data.

Patient satisfaction is an essential component of holistic care and particularly important in a population who may feel disenfranchised. IT-11.4 directly measures this metric in a minority population.

Value: The Performing Provider considered a series of factors in establishing a valuation for each project. These included the amount of human resources required to meet the milestones of the project, through new hires as well as the assignment of existing support personnel such as Information Technology, EMR and administrative support. We considered what non personnel resources would be required, such as equipment specialized for a certain specialty, and what, if any, additional space would be required to house the initiative. We considered timing issues related to when we had to add resources compared to when a corresponding milestone could be achieved. We also considered the amounts of potential professional fee revenues the project may generate, and offset these against resource demands.

We made a risk assessment for each project, considering the complexity, the scope, the extent to which any single point failure in the milestones would jeopardize downstream success, the degree of inter-dependence on other projects within the waiver program as well as institutional initiatives outside the waiver, and the amount of time required to manage the project. We made an assessment of potential general community benefit.

Finally, we considered organizational priorities, and to what extent the Performing Provider was able to justify partial support of these efforts as meeting existing institutional requirements or objectives.

1. Accessed September 29, 2012.

Attachment A