Organizational success starts with goal alignment. It is essential for leadership teams to come together and discuss the company's vision and strategy, and identify the specific objectives they want to achieve. These objectives must be specific, strategic, and based on a shared vision that the entire organization can get behind. When it comes to improving the patient experience, healthcare organizations can take advantage of established principles and approaches to quality improvement (QI).
This includes using the concept of microsystems to focus the IQ process at the center of patient experience responsibility, providing an overview of the quality improvement process, analyzing known models of quality improvement, and presenting tools and techniques that organizations can use to address various aspects of the patient experience. Prioritizing communication, commitment, and participation from all stakeholders affected by the QI process is key. It is also important to start implementing improvements with small-scale demonstrations, which are easier to manage than large scale changes. Small-scale demonstrations or small change tests also make it possible to refine new processes, demonstrate their impact on practices and results, and generate greater support from stakeholders.
A useful way for health plans and medical groups to approach the improvement process is to think of the organization as a system, or more specifically, as a set of interrelated microsystems. The term microsystems refers to the multiple small units of caregivers, administrators and other personnel that produce health care products. Examples of microsystems include a team of primary care providers, a group of laboratory technicians, or call center staff. To develop and refine such systems, healthcare organizations begin by defining the smallest measurable group of activities.
Feedback on measurement and performance should be part of the microsystem's principles for learning and improving. If a quality improvement intervention is successful for one microsystem, it can be scaled to other microsystems or to the organization in general. However, to achieve successful scalability, organizations must adopt a dissemination framework that works within their structure and culture. The Plan-Do-Study-Act (PDSA) cycle is an iterative process that involves all staff in evaluating problems and in suggesting and testing possible solutions. This bottom-up approach increases the likelihood that staff will accept changes, a key requirement for a successful IQ.
When implementing changes, organizations should always be prepared to address problems and challenges as they arise. When you are ready to apply the PDSA cycle to improve performance in the CAHPS ratings, you will need to decide your objectives, strategies and actions and then move forward with its implementation and monitor the progress of its improvement. You can repeat this cycle several times, first implementing one or more small-scale interventions and then expanding them to larger actions based on lessons from previous cycles. The team's first task is to set an objective or goal for improvement work. By setting this objective, you will be able to better communicate your objectives clearly to all sectors of your organization that may need to support or help implement the intervention. The goal should reflect the specific aspects of performance related to the CAHPS that the team is targeting.
It must also be measurable and feasible. One of the limitations of an annual CAHPS survey as a measurement tool is the time elapsed between the implementation of the changes, the impact on people's experiences and the evaluation of that impact. For that reason, the team needs to define both final goals and incremental objectives that can be used to measure short-term progress. After defining your final objectives, ask What is the gap between our current state and our goals? Make a list of those gaps and use them to set incremental SMART goals (specific, measurable, achievable, realistic and time-limited). When you are ready to apply these goals in practice, remember that quality improvement is an ongoing process - you will make frequent corrections as you learn from each step.
