As a complement to our existing HeartCode training, HealthStream now offers the comprehensive portfolio of online courses from the American Heart Association (AHA), the universally trusted and recognized world leader in emergency cardiovascular care resources. Whether your employees are updating their professional skills or being introduced to emergency cardiovascular response training for the first time, HealthStream provides AHA courseware to help you effectively achieve your training objectives.
Many online courses from AHA use a blended learning approach. Students learn cognitive skills through web‐based, self‐paced modules then practice and test the skills they have learned with an American Heart Association Instructor or Heartsaver® Skills Evaluator.
Benefits for Hospitals and Learners:
- Improve patient outcomes, by advancing prevention efforts and education
- Save time by completing certifications faster than classroom-based courses, as well as eliminating the wait for scheduled class times
- Reduce costs by freeing up limited instructor and classroom resources, decreasing or eliminating textbook expenses, and eliminating replacement staff to cover class time
- Interactive, self-paced courses vetted by AHA scientists and educators
- Courses are regularly updated and improved, using the latest AHA Guidelines for ECC and CPR
Courses include:
Acute Stroke Online, which provides training on the symptoms, diagnosis and management of ischemic and hemorrhagic stroke and complications of stroke.
Stroke Prehospital Care Online -- an effective, time‐dependent treatment for acute stroke necessitates the education of all healthcare providers, as well as the general public, about prompt treatment for stroke.
Heartsaver® First Aid Online Part 1 is an online, self‐directed program that teaches learners critical skills and knowledge needed to respond to and manage an emergency in the first few minutes until emergency medical services (EMS) takes over.
Heartsaver® CPR AED Online Part 1 is an online, self‐directed program that teaches learners critical skills and knowledge needed to respond to and manage a sudden cardiac arrest or choking emergency in the first few minutes until emergency medical services (EMS) takes over.
Heartsaver® First Aid CPR AED Online Part 1 is an online, self‐directed program. The program teaches critical skills and knowledge needed to respond to and manage a first aid or sudden cardiac arrest emergency in the first few minutes until emergency medical services (EMS) takes over.
Heartsaver® Bloodborne Pathogens Online is a self‐directed course designed to meet Occupational Safety and Health Administration (OSHA) requirements for bloodborne pathogens training when paired with site‐specific instruction.
BLS for Healthcare Providers Online Part 1 provides a flexible alternative to classroom training. Through case‐based scenarios, interactive activities and videos, this course teaches the concepts of both single‐rescuer and team basic life support. This course is for healthcare professionals who need to know how to perform CPR, as well as other lifesaving skills, in a wide variety of in‐hospital and out‐of‐hospital settings.
Structured and Supported Debriefing is an online tool designed to teach AHA Instructors, particularly those conducting advanced life support courses, how to facilitate an effective debriefing of their learners within 10 minutes after a skills practice session. This course is for AHA advanced life support (ACLS and PALS) Instructors and is also appropriate for BLS Instructors.
By Gwen Faust, RN, MS, Consultant (HCAHPS & Other Surveys), HealthStream
As the first HCAHPS performance period (discharges July 1, 2011 through March 31, 2012) draws to a close and Value Based Purchasing is becoming a reality, hospital leaders across America are looking at their patient experience data (HCAHPS) with a deeper interest and greater scrutiny. With this higher level of concern, clients are looking to their vendors for timely reporting of data and want the ability to view data easily and often. How often to view HCAHPS data is the subject of this blog. I asked my HealthStream colleagues for their recommendations.
CMS GUIDELINES FOR HCAHPS SAMPLING AND SURVEYING MAY HAVE AN IMPACT ON HOW OFTEN NEW DATA IS AVAILABLE
CMS mandates that calls begin within 42 days post discharge. After receipt of client files, HealthStream validates and processes all sample files. HCAHPS studies are then placed on a rotating call schedule. This rotation is necessary to make sure each record is called at different times of the day, on different days of the week, and in different weeks in order to be compliant with CMS rules. Each time HealthStream administers your HCAHPS study, we will attempt to call all available patient records for the study. Any patient records not reached during a session will be set for callbacks the next time the project is scheduled to be worked.
Under CMS rules, only the patient may be interviewed. HealthStream interviewers must follow the CMS script word for word when contacting patients. This approach protects patients’ confidentiality and ensures the questions are asked the same way each time, thereby minimizing the variability in results. For hospitals that elect to include pediatric patients (results are not reported to CMS), surveys are conducted with the parent or guardian of the patient.
HOW OFTEN SHOULD I LOOK AT OUR HCAHPS DATA?
Cyndi Tierney, HealthStream Consultant, advises “Patient satisfaction data (i.e., your HCAHPS results) fall within the realm of social sciences. Using social science guidelines, an N size of 30 generally represents the smallest data sample by which to gauge progress or take action. In a study of HCAHPS data, HealthStream reviewed results across clients, as well as a more granular study of a larger healthcare system’s HCAHPS outcomes. As predicted, we found the greatest stability in viewing data by quarter and by year, where the n size was large enough to stabilize the results. Monthly results showed more variation in scores, while daily reporting, based on a few number of responses, reflected large swings and less confidence that the result accurately reflected the total population. One or two exceptionally happy or unhappy patients will skew the results, creating a false sense of urgency or complacency, depending on the survey.
We recommend using quarterly and annual data for reporting purposes, monthly data for quick pulse checks and course alignment, and weekly review on comments, to provide timely feedback to staff, physicians and leadership. This gives you optimum use of qualitative and quantitative data in ways that reliably reflect your larger patient population.”
Another HealthStream Consultant, Bo Hansen...”generally tells clients that being in the data weekly is fine if they incorporate data for the past month, or better yet for the past quarter. I have been explaining the HealthStream analysis of volatility in the daily and weekly results versus the long term trend.
I have found that asking staff to respond to a small increase in weekly data representing ONE or a few clients who are very unhappy about “the courtesy of the staff” for example, will take their focus away from the long term trend that shows that the low scoring, high correlating item over time is keeping the patient informed about delays. Checking and responding to data weekly dilutes the message from the manager to staff and makes staff confused about where their concentration should be and the reason for it.”
Bob Ogden, HealthStream Senior Consultant recommends “that clients check data monthly or every two weeks. Check verbatim comments/Voice Of The Patient (VOTP) 2-3 times per week. Twelve months of data should be used to identify opportunities and to set goals.”
John Merritt, HealthStream Regional Representative shared that “in working with hospitals, I often am asked about how often to look at the data. As with many things, the answer is always, “It depends!” One of the strengths of our online tool, Insights Online, is the ability to run reports on a daily basis. Because of this, many clients schedule frequent reports, such as weekly or monthly. While admirable, if they do not have at least 30 respondents during this time frame, then the data could be unstable. A lot of people tend to confuse statistical significance with statistical stability. The reason that a sample size of 30 is the “magical” number is due to this being a large enough sample for the Central Limit Theorem to take effect. In simple terms, the Central Limit Theorem is when data normalizes. Perhaps better stated, this is when the sample takes on the same distribution as the overall population. If the overall population looks like a normal bell curve, then once you reach a sample size of 30, then the sample will look like a normal bell curve.”
Merritt adds, “therefore, hospitals have two choices when it comes to how often to look at their data: (1.) Increase their sample size, or (2.) Use a rolling total. If the data is being used for pay-for-performance, then increasing the sample size is the appropriate answer. When increasing the sample size is not a viable option, I typically recommend using a rolling total. Many hospitals will set their sampling plan on a quarterly basis, so if they want to look at data monthly, then I recommend doing a three-month look back. Each month, they would drop the oldest month and add the current month. In theory, a hospital could look at data less frequently, but with VBP and public reporting, they may not want to wait. Our clients haveaccess to timely data, especially because we utilize a telephone methodology. Therefore, I feel it is our obligation to help them best use this timely data.”
Finally, I spoke with representatives of Baptist Leadership Group (BLG) and Studer Group regarding this topic and both take stances similar to our HealthStream Consultants and Regional Representatives about how often to examine HCAHPS data. “BLG recommends leaders review HCAHPS with their staff every month, staff and the leader agree on 3 behavior changes and leader follows up for accountability. We recommend looking at that [particular] month's performance relative to current quarter or fiscal year.” Studer Group recommends looking at data frequently as a peek into what is happening and as a tool for identifying coaching opportunities. They recommend that reported data be trended over longer period of time.
USE DATA TO SET AND STAY THE COURSE
In conclusion:
- Trended data over 12 months or so should be used to set goals and for determining improvement strategies necessary to affect those goals both at the organizational and unit levels. HealthStream consultants and analysts can assist your organization with setting goals.
- Use Voice Of the Patient (VOTP) for coaching and recognition of individuals
- Hold staff accountable for the improvement strategies....verify that these are being done consistently by rounding on patients, huddling, and observing staff
By Hayden McKaskle, Consultant (HCAHPs and other Surveys), HealthStream
Following my recent blog titled “Healthcare is, after all, a people business,” a client gave me a terrific article to read. “Five Reasons Why Physicians Hate Hospital Administrators” was a recent column by John W. Mitchell. It can be found in the LinkedIn group HealthCare C-Suite. This is recommended reading for anyone interested in better physician relations and improving physician engagement.
A summary of Mr. Mitchell’s article is as follows:
Five Reasons Why Physicians Hate Hospital Administrators
1. Lack of follow-up.
2. Ask us. Don't tell us.
3. We never see you.
4. You care more about money than medicine.
5. You never make a decision.
I believe there is truth in those five for most people and not just administrators. It did make me think about the backside of that title—that is, what do physicians love about their CEO?
In the latter part of 2011, I performed a Physician Satisfaction (HealthStream Physician Insights) report review for a rural community hospital. This facility typically scores very high in physician satisfaction. Although these results are due to a number of people, the CEO is a big part of the reason, and she has served there for over 10 years.
The Secret to Physician Satisfaction and Physician Engagement
There may have been a few minor suggestions for improvement that I offered her; but in the end, this session became an opportunity to explore best practices at this hospital, and she became the teacher. When I asked her what physicians want from a CEO, she was quick to respond. “They want an answer,” she said. “It is really that simple. When they come to me with a request, they don’t want an excuse. They just want a straight up, yes or no answer. If it is no, I tell them why; but I never give them an excuse. That physician might not always like the answer, but they will respect me over the long haul.”
Physicians want answers and follow-through on promises
Since that review session, I have quoted her numerous times in physician satisfaction report reviews with other hospitals. You can always tell the CEOs that already operate by that rule; their results almost invariably show the fruits of that approach. More often than not, hospitals with top physician satisfaction scores have an effective CEO who has been in place for a few years or more.
What do physicians want (or love) from their CEO? They want a straight answer from someone who will be around long enough to follow through on promises. There may be a bit of prescriptive medicine in there for all of us.
Are you thinking about your hospital’s need to begin incorporating medical simulation training?
Would your organization benefit from allowing staff to train for the demands of emergency situations in a safe environment?
Are you overwhelmed by everything involved, even knowing how much it could benefit patients and your clinicians?
You are invited to join us for a free introductory webinar about medical simulation-based learning and assessment. Our goal is to help you understand what’s involved in creating a medical simulation training environment, and how easy it could be to improve outcomes and benefit patients.
Please join us for:
An Introduction to Simulation: What’s It All About; Getting Started
May 17, 2012 12:00 PM - 1:00 PM (CDT)
In this session, the presenter will explore the various applications of healthcare simulation in the industry today. From hospital-based education to university/school-based education, there are many applications for simulation-based training. This presentation will be applicable for those thinking of starting a simulation-based program or wanting to learn more about it.
Presenter:
Tom Dongilli, Director of Operations, WISER Institute
Tom Dongilli is Director of Operations for the WISER Institute. Prior to this position, he was the senior clinical simulation specialist for Laerdal Medical Corp. In that position, Tom would train simulation customers on the set up and maintenance of their simulators, curriculum development, and simulation center design and organization. In 1999 Tom helped design and open the Thomas Jefferson University Center for Medical simulation, where he served as the Chief Instructor. His primary responsibilities were to work with staff from different departments and help them create simulation courses based on their curriculum needs. Tom was also employed by MEDSIM Inc., a simulation company, where he worked with simulation center customers helping them start and improve their programs. To date, Tom has run thousands of simulation based training sessions. He contributes expert knowledge and experience in the practical design, implementation, maintenance and monitoring of simulation based medical learning systems.
About Wiser Institute:
The Peter M. Winter Institute for Simulation, Education, and Research (WISER), a collaboration between UPMC and the University of Pittsburgh, is the world’s leading healthcare simulation center affiliated with an academic medical center.
The WISER mission is to improve patient safety and increase the effectiveness of healthcare education for all care providers. This mission is accomplished through education, research, advanced instructional technology, and the development and assessment of innovative simulation programs.
Register for the Webinar.
Learn More About Simulation.
By Bo Hansen, Research Consultant (HCAHPS and Other Surveys), HealthStream
Research shows that only customers who rave about you are loyal!
Loyal advocates are passionate about your brand of business or service. They have a powerful bond with your organization based on emotional loyalty—the strongest, and incidentally, the most profitable kind of loyalty there is.
There are degrees and types of satisfaction that impact advocacy and the financial bottom line. For purposes of this blog, we will look at two types of advocacy:
Rational Advocacy… is NOT enough.
Rational advocacy is not enough. These customers are not dissatisfied about anything, but they are just not raving about your service. Customers who are reached on a rational level may be patients whose expectations are being met, for whom tasks are getting done (i.e., medications are given at the right times, IVs are checked, and staff is rounding making sure that patients and vitals are stable and treatments are carried out as ordered). But guess what? These patients ultimately behave much like non-advocates when compared to the patients who are reached on an emotional level! It turns out that you are at risk for losing rational advocates to your competitors. A large percent of these patients may give top box scores of “always” in response to any of the HCAHPS measures, such as the questions about how often nurses treated them with courtesy and respect or listened carefully or how often nurses explained things in a way they could understand. However, in spite of a high percent of top box scores, these rational advocates are not as likely to give the highest score possible in response to the loyalty question that asks how likely they are to recommend the hospital to friends and family as the patients are who have an emotional attachment to the organization.
Emotional Advocacy is the Key.
Customers you reach on an emotional level are passionate about you! Creating an emotional
bond means that you provide patients with a heartfelt connection. Not only are tasks being completed to meet the patients’ expectations, but staff connects with patients at an emotional level. For example, when nurses round, they come to the bedside, address the patients by name, hold their hand, make eye contact, and ask questions that demonstrate that they have thoughtfully reviewed the patient’s chart and history. They listen exceptionally well and understand that the patients who are demanding, cranky, and angry are really just frightened. They initiate conversations that address patient fears about their health, their family, their future capabilities, and possible limitations. They seek ways to truly make a difference when patients need it the most. It could mean bringing a birthday cake to a pediatric patient, it could mean a hug, a cup of coffee, or a back rub. Emotional loyalty happens when every customer-facing employee creates an emotional bond or connection with a patient and/or family member by instilling faith and hope, being empathetic, using creative problem solving, and treating patients with dignity and respect.
It is important for an organization to understand that both types of patient advocates may score their patient experience with a high percent of top box scores for all patient care aspects, but only the emotional advocate is likely to give top box scores to the loyalty question. Their decision to advocate for you is based on the emotional experience rather than on an intellectual decision.
Learn More About HealthStream's HCAHPS/Patient Insights Survey.
Learn About Using HealthStream's Training to Improve Your HCAHPS Scores.
By Donna Sue Snyder, Sr. Director of Human Resources, HealthStream
Imagine my excitement when I began my employment with HealthStream and learned we were able to implement the HealthStream Performance Center for use within the company. Over my many years in Human Resource Management, I have seen numerous demonstrations and have implemented and converted HR Information Systems, and none has impressed me as much as the HealthStream Performance Center.
The Performance Center Stores Data
The Performance Center product is a powerful tool for the employee evaluation process. It also can be used as a data library in which the users can address Career Pathing for current employees, succession planning for the overall company, and periodic storage of data during the entire evaluation period to enhance an evaluator’s ability to provide a fair and accurate assessment.
Employee Self Evaluations and Goal-Setting
During the evaluation process, employees can conduct a self evaluation and set goals for the following year. This information helps managers identify areas of interest for their employees, allowing them to develop a strategy for mentoring and coaching employees in the desired direction. The company then benefits from an engaged employee, and the manager knows where to focus time and attention.
Succession Planning and Leader Development Benefits
The Performance Center is a great tool for succession planning, which certainly should be on the minds of every manager. The product assists in identification of future leaders, and managers can mentor and coach future successors, providing the company with continuity for success. The leaders who are prepared within the organization already know the company, and are well known, loyal, and dedicated employees. Therefore, there is no wait to search for a candidate when needs arise.
The employees and managers of HealthStream are currently using the Performance Center for the first time for our employee evaluation process. I anticipate that HealthStream’s leaders will find that over the next year this new system will prove to be a critical asset to the managers and to the employees of the company. I look forward to providing continued updates on the progress and the success of our first time of use. Stay tuned for more exciting news as we use this newly launched product with our healthcare customers. We anticipate great satisfaction, quick and simple implementation, secure and reliable information, and, ultimately, improved talent management.
Learn More About HealthStream’s Performance Center.
The Nashville Business Journal recently announced the finalists and winners of its 2012 Best in Business Awards. HealthStream was named the winner for the category of businesses with 101-500 employees.
Finalists were picked by a panel of judges, who considered financial data like profitability and other metrics. Winners in five categories were announced at an awards luncheon April 19 at the Renaissance Nashville Hotel. Winners and finalists were also profiled in the April 20th edition of the Nashville Business Journal.
Link to a video featuring HealthStream President and CEO Robert A. Frist, Jr.
By Todd Sorenson, Consultant (HCAHPS & Other Surveys), HealthStream
Clients often ask me --
"Now that we have collected feedback from our medical staff, what do we do next?"
or
"How do we best share and use medical staff results that are obtained using HealthStream's Physician Insights survey?"
My typical response would include the following points:
- Develop a communication plan that is redundant, using multiple means of communication
- Communicate the basics of an action plan when sharing the results
- Continue the roll-out throughout the year, by helping the medical staff to understand where they are in the action planning
- Provide department directors with feedback for their work areas and encourage action planning to improve experiences for physicians and patients alike
I was recently at a hospital that took a slightly different approach to the last point shown above. The survey results showed that this facility had some issues in a number of departments in terms of how the medical staff viewed the responsiveness of the staff, communication with physicians, consistency of care and service, and teamwork in terms of how doctors, nurses, and other staff work together. As opposed to working on strategies within their own departments, a plan was developed for managers to work together to develop strategies that could be incorporated hospital-wide.
Action Planning With Hospital Leaders and Managers 
An onsite meeting was set up with top leaders and department managers attending. After presenting the survey results with a focus on key drivers of medical staff satisfaction, I talked about best practices that other hospitals are using to improve their physician, as well as patient satisfaction scores. After that, several of the department directors who received the highest physician ratings were asked to talk about their best practices—things that they have implemented that likely accounted for their high ratings. This served as a starter to get the directors thinking about opportunities for improvement that they may not have thought about before.
At this point, an exercise was conducted whereby the department directors put in groups of five or six and tasked to come up with two strategies for the “key driver” survey item they were assigned. For each strategy, the group was asked to consider objectives, responsibilities, and how to audit the directives for accountability. Each group selected a spokesperson to present their ideas to the group. This led to some additional strategies and to some fine-tuning of the ideas that were presented.
Next Steps for Increasing Physician Satisfaction
Using the strategies that were developed by leadership and department managers, the next step was to form a physician satisfaction team that would prioritize the strategies and fully determine action steps to implement the strategies. I encouraged the hospital to form the physician satisfaction team using staff from a number of departments who frequently interact with physicians and to include physicians on the satisfaction team. In addition to prioritizing strategies, the physician satisfaction team will be responsible for communicating improvements to physicians using a number of strategies, including rounding on physicians, email updates, a communication board in the physician lounge, and bulletins in the medical staff newsletter. Senior leaders plan to have regular meetings with medical staff officers to hear about any new issues and to keep the medical staff informed on the progress of initiatives that have been implemented.
Conclusion: Begin Making Change Happen
As opposed to managers working in the "silos" of their own departments to facilitate improvement, I really like the approach summarized above. The actions taken are based on the discoveries obtained from sound research, with action plans focusing on the key drivers of physician satisfaction and engagement. Working in teams is a great way to come up with the best strategies that can be implemented hospital-wide. This type of session has provided the physician satisfaction team with well-thought out strategies to begin making real change that the medical staff wants.
Learn more about HealthStream’s Physician Insights survey.
SimCenter in the News
HealthStream's joint venture with Laerdal Medical, SimCenter, has been featured significantly in recent media. The following feature stories focus on the SimView™ and SimManager™ launches, along with product news. Notable mentions below include news from MarketWatch, medGadget, InformationWeek, Green Technology World, Chief Learning Officer, Investor’s Business Daily, and Today in PT Magazine.
Highlights Below:
MarketWatch, 31 January 2012
“HealthStream and Laerdal Medical Launch SimManager(TM), a Comprehensive, Easy-to-Use Application for Managing Healthcare Simulation Education Programs”
medGadget, 31 January 2012
“HealthStream and Laerdal Unveil New Clinical Simulator Management Tools”
Information Week, 3 February 2012
“Mannequins Recruited To Teach Medicine”
Green Technology World, 3 February 2012
“HealthStream and Laerdal launch SaaS application for simulation-based training”
Chief Learning Officer Magazine, 1 February 2012
“HealthStream and Laerdal Medical Launch Application for Managing Education Programs”
Investor’s Business Daily, 15 March 2012
“HealthStream Takes Medical Training Into The Cloud”
HealthStream and Laerdal have combined our experience and knowledge to make simulation easier. With SimCenter, we are removing many barriers to adopting and integrating simulation into current curricula. It combines curriculum delivery, learning management, debriefing, and competency assessment in a single, fully-integrated platform. SimCenter, which can be purchased as separate components or a single solution, improves orientation of new hires and continuing education for experienced employees, while creating a more efficient process for evaluating staff competencies. By using validated content from industry leaders and delivering it in a usable, manageable format, simulation is truly made easier. SimCenter is a tool that can be used to complement current educational programs and support educational objectives.
Learn More about SimCenter and Medical Simulation Training Here.
Earlier this week, HealthStream Training Partner and ICD-10 Expert Precyse issued a press release advising clients and prospects that the proposed HHS delay is an opportunity for healthcare organizations to further prepare for the coding transition.
Full text of the press release is below:
Precyse Advises Providers to Continue ICD-10 Preparations in Spite of CMS Delay
Delay provides opportunity to refocus, prepare, train and get it right.
April 9, 2012–Health and Human Services (HHS) Secretary Kathleen G. Sebelius today announced a proposed rule that would delay the compliance date for the International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10) from Oct. 1, 2013, to Oct. 1, 2014.
When HHS originally announced its intent to delay ICD-10 on Feb. 16, 2012, Precyse carefully reviewed the implications of the announcement and the need to advise its more than 1,000 clients who relied on its management, staffing and technology solutions and professional advice in health information management matters. Precyse advised its clients to stay the course and continue their ICD-10 preparations, and continues to advance that position.
"We're telling our current and prospective clients that now is not the time to procrastinate. This delay provides them the opportunity to refocus their efforts and get it right," said Chris Powell, president of Precyse. "Precyse believes this delay will allow providers the time they need to improve their clinical documentation processes and build a strong foundation for process improvement. In addition, the delay allows payers to prepare for the change and enables providers to focus on technology implementations and more thorough testing with their vendors."
Clinical Documentation Improvement (CDI) Program:
Precyse believes that now is an excellent time for providers to increase their clinical documentation training programs for physicians and other caregivers. Provider Action Item: Target high volume specialties in your organization that will be most impacted by ICD-10 and train those physician specialists in proper documentation while training the coding team on accurate coding; then, move to the next specialty for training.
Process Improvement Program:
The proposed delay also offers the provider an opportunity to assess the flow of their information across their organization and develop a plan to address gaps through process improvement and technology. Provider Action Item: Develop workflow platforms and applications that allow healthcare providers to do their jobs more efficiently and effectively.
Training and Development:
Take this time to not only invest in the training of coders but also intensify the training for those who will use the data. Provider Action Item: Perform side-by-side ICD-9 and ICD-10 coding analysis, assess the documentation and coding gaps of coders and other caregivers and target training based on these findings.
"Precyse is an innovation company that listens carefully to our clients and prospects; every day we challenge ourselves to come back to our clients with solutions that solve their business problems while improving patient care and outcomes," Powell continued. "We don't believe that an ICD-10 implementation delay changes our goals. We pledge to our clients and future prospects that we will never stop innovating and improving even in the midst of very challenging times."
Learn about HealthStream's ICD-10 Training Suite from Precyse.