Utilizing the 3Ms in Improving Patients’ Experiences – And CMS Overall Star Rating.
The 3Ms of Improvement great leaders utilize are:
1. Measure 2. Manage to the measure 3. Make it easier
Measuring patient experience is not new in healthcare. However, measuring the right things at the right time are still a struggle for many. Healthcare is complex. One measure of complexity is the count of measures. For acute care hospitals, there are 13 questions just to measure the patient experience. And, there are actually many more questions that make up these 13 that CMS uses to score your hospital in both the Value-Based Purchasing reimbursement multiplier and the new Overall Star Rating. Which of these many questions are most important in improving scores the public see?
What is your CMS Overall Star Rating and your CAHPS Star Rating? Are you happy with where you stand relative to your local competition? National competition?
I ran the correlation between the new CMS Overall Star Rating and the patient experience star rating for 3,000 organizations. Answer: High, let me say, “huge” correlation. And, just using the HCAHPS Star Rating explains over 35% of the CMS Overall Star Rating. Write to me if you want the stats including P value, R Squared, and test of residuals.
Ask whoever tells you which questions to focus on for the statistics that validate such opinions. Too often I have frustrated clients say that they can’t improve their scores despite “doing the rounding thing.” They tried bedside reporting, or looked at the results every day. Utilizing the 3Ms of improvement is about measuring frequently, but I find that many organizations are reacting to common cause variation based on when your pricey 3rd party administrator received the survey – not when your team actually provided care.
Measuring experiences by when a survey is received is like choosing a donut based on when the donut arrived in your office rather than when it was made.
Managing to the measure is the second M, and a differentiator. Measuring alone got healthcare nowhere in global ratings. CMS and accreditation organizations have measured healthcare since CMS was created. Managing to the measure is doing something about the measure. And, managing also means re-measuring and continuously improving. We took an organization from the 40th percentile to the 85th percentile by measuring experiences correlated back to when we gave care and doing the 3rd M.
Managing to the measure in the donut story is to change the measure to the date of manufacture. And, then managing to the measure by identifying the root causes that the donut is showing up days after being made.
Make it easier for providers and staff to improve patient experiences. This improves scores. At every client, our analysis techniques filter the 20 plus questions down to a few. This simplification is statistically based and makes the improvement work easier. Then, we engage the frontline staff measuring in real-time. Measuring in real-time allows rapid improvements. Prioritizing more complex issues, we manage to the measure by training staff in Six Sigma, Lean, and Change Leadership and eventually celebrate their success.
Lastly, we make it easier for executives, providers and staff to see how they are doing by sharing daily charts. And, we eliminate process defects and wastes that add no value to patients, such as many of the rounds which were pushed onto overloaded managers and rounds that actually disturbed patients, and took caregivers away from giving care – what patients really value.
Summary: Make it easier to get the donut fresh to your office within hours of baking.
More importantly, make it easier for your team to: 1. measure what is important frequently. 2. Manage to the measure in real time, or at least frequently enough to prevent problems, and 3. Train and engage your team in continuously improving processes to make it easier. Utilizing the 3Ms is proven to score well with your patients.