RPG on Driving Satisfaction - AOPO Director's Workshop 2014
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A presentation given at the 2014 AOPO Director's Workshop. All images are attributed in the slide notes and used under Creative Commons License.
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RPG on Driving Satisfaction - AOPO Director's Workshop 2014
- 1. Driving Satisfaction What satisfaction research can tell OPOs about building positive partnerships with doctors, nurses and administrators. Presented by Sean Jordan, The Research & Planning Group
- 2. We conduct opinion research. We combine qualitative and quantitative methods. We specialize in healthcare and OPO research. We focus on transforming data into actionable insights. 2
- 3. We’ve worked with 15 OPOs to date. 14 participated in the study we’ll share today.
- 4. The hospital partners study provides two types of comparative measurements: lateral (across the industry to other OPOs) longitudinal (over time with the same OPO) The ultimate goal is continuous improvement. 4
- 5. The study examines four perceptual areas: Service Satisfaction Representative conduct and service touchpoints Education Effectiveness now and opportunities for down the road Communication Both during and after cases Overall Assessment Similar to a SWOT analysis 5
- 6. We use in-depth telephone interviews because they get great results. Human interviewers get better data. We see better participation due to the convenient process. Conversational interviews yield deeper insights. We can set representative quotas for participation. 6
- 7. It’s important that we talk to the right people. We restrict our sample to partners who have worked with an OPO at least three times within the last two years on a donation case. We also offer physicians an honorarium. 7
- 8. We slice the sample into pieces to understand what’s driving satisfaction. Our process works well because we collect both qualitative and quantitative data. Because of this, we can come back with recommendations for action… often with specific supporting data! 8
- 9. The Threshold for Excellence Mean score of 9.00 on a 10-point scale 80% or more express high satisfaction 9
- 10. Hospital Staff Physicians *CORE and IDN participated in 2011 and shared their data for comparison. 10
- 11. Overall Assessment Strengths of OPO Service Variables Weaknesses of OPO Opportunities for OPO Quality of Services Involvement Perceived Problems for OPO Support Shown to Families Overall Satisfaction Response Time Communication Professionalism Respect Communication During Process Shown Communication Following Process Education Follow-up Information Understanding of Donation Way Concerns Were Handled Process Within Hospital Effectiveness of Education 11
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- 16. Top Performing OPOs Satisfaction Champions Overall Satisfaction Collaboration Champions Follow-Up Champions 16
- 17. With our combined data set, we can gain deeper insight into the drivers of overall satisfaction. We know all of the variables we measure play some role in influencing how hospital partners feel… …but which are the most predictive? 17
- 18. Service Variables Model (A Hospital Physicians) Variable Importance Involvement (Collaboration) High Response Time High Professionalism/ Respect Medium Support Shown to Families Low Goodness of Fit 58% 18
- 19. Communication Variables Model (A Hospital Physicians) Variable Importance Communication during donation process High Effectiveness of education Low Goodness of Fit 35% 19
- 20. Combined Model (A Hospital Physicians) Variable Importance Involvement (Collaboration) High Response Time High Professionalism/ Respect Medium Communication during donation process Medium Goodness of Fit 63% 20
- 21. The qualitative data reveal a different perspective. A path, albeit a long and winding one. 21
- 22. Start of the Journey: Collaboration Ensure that hospital partners are not being marginalized in any way. Move on when: Collaborative tools are in place, have been pilot tested effectively and appear to be meeting the needs of hospital 22
- 23. Challenge Ahead: Consistency of Communication Develop accountability indicators to ensure case communication is consistent. Move on when: Accountability measures show that communication during the donation process is being handled consistently to specified standards. 23
- 24. No Turning Back: Feedback and Follow-Up Develop stronger systems for providing feedback (immediately after cases) and follow-up information (long-term outcomes) to hospital partners. Move on when: Accountability measures show that communication following the donation process is being handled consistently to specified standards. 24
- 25. Into Parts Unknown: Educational Offerings Develop new ways to provide education to hospital partners about donation criteria and the donation process. Education requires constant refinement. Keep your methods fresh and you information current and you’ll keep your partners engaged. 25
- 26. Collaboration drives success. Consistent communication helps to navigate difficult terrain. Education is a goal for the end of the journey, but it is not a destination; it’s a mission. 26
- 27. Roadmap to Success What we have learned from hearing 15 OPOs respond to the hospital partners study Presented by David Rich, The Research & Planning Group
- 28. Things have changed since 1998. Physicians see OPOs as a benefit now rather than a threat. Physicians are on your side. Physicians need to be included as key players in the entire donation process. Physicians need to be communicated with constantly throughout the donation process. 28
- 29. First Turn Make communication with physicians a top priority throughout the process. 29
- 30. Second Turn Provide a daily report to involved physicians on the status of the donor and email whenever there is a change in the donor’s condition. 30
- 31. Third Turn After a case, follow up immediately with a full report on what occurred during the case. 31
- 32. Fourth Turn After transplant surgery, follow up as soon as there is information about the outcome, regardless of the success of the outcome. 32
- 33. Fifth Turn Conduct a complete debriefing session analyzing and discussing what occurred from start to finish. 33
- 34. Sixth Turn Do not dismiss what hospital partners have had to tell us in the research. 34
- 35. Final Turn Executive OPO leadership must develop stronger relationships with attending physicians, all active physician partners, and key residents. 35
- 36. Roadmap to Success What we have learned from hearing 15 OPOs respond to the hospital partners study Presented by David Rich, The Research & Planning Group
- 37. A Parting Resource • • • • Industry interviews Our white papers Data from studies And more! Find out more at http://opo.researchplan.com! 37
Editor's Notes
- Photo credit: Photo Dean (http://www.flickr.com/photos/21202433@N08/7809090840/sizes/l/)
- The Research & Planning Group is an independent marketing and opinion research firm that specializes in conducting a wide range of studies for the healthcare industry. The Research & Planning Group is an independent marketing and opinion research firm that specializes in conducting a wide range of studies for the healthcare industry. We have been conducting studies for OPOs since 1998, and over the last six years, we have conducted the hospital partners study we’ll be talking about today for 15 different OPOs across the country.
- Photo credit: Eric Fischer (http://www.flickr.com/photos/walkingsf/6366242033/in/photostream/) Used under CCL.
- The Hospital Partners StudyThe purpose of the hospital partners study is to provide participating OPOs with an understanding of how they can improve the relationships they have with the physicians, nurses and administrators who work with them on organ and tissue cases.The study is designed to provide both a quantitative and a qualitative assessment that can be compared:laterally (across the industry to other OPOs)and longitudinally (comparing each repetition to the baseline and the trend to measure each OPO’s individual performance over time).
- The Objectives We AddressThe hospital partners study has four distinct areas of focus:Service SatisfactionCommunication (during and after cases)EducationOverall Assessment (similar to a SWOT analysis) Photo credit: Jeffery Beall http://www.flickr.com/photos/denverjeffrey/5133538450/sizes/l/
- The Research Method We EmployRPG conducts the hospital partners study using a in-depth telephone interviews.They deliver a number of advantages over other methods, including:A pre-set response rate in the form of quotasHuman interviewers who can ensure responses are deep and meaningfulConversational interviews that allow hospital partners to fully express themselves.Flexibility for busy hospital partners who want to participate when it’s convenient for themPhoto credit: Philippe Put (http://www.flickr.com/photos/34547181@N00/4203901107/sizes/l/)
- The Sampling Plan we SetThe population for the study is defined as all hospital partners who have worked with an OPO at least three times in the last two years on a donation case.Each OPO provides RPG with a list of these partners and sets a quota for how many hospital partners will be included in the study.To incent participation, physicians are offered an honorarium of between $150-200, depending upon the region, payable to themselves, the sponsoring OPO or a charity of their choice.Photo credit: CamilTulcan (http://www.flickr.com/photos/camil_t/1428505675/sizes/o/)
- The Results We DeliverOur analysis is centered around the idea of splitting hospital partners into cohort groups and trying to understand how these groupings impact satisfaction and their perceptions of the sponsoring OPO.We look at different “slices” of each sample to see where differences might exist, and because we have both qualitative and quantitative data, these “slices” aren’t restricted to traditional demographic breakouts.For example, one slice we often compare is Highly Satisfied hospital partners versus those who indicate that the OPO Needs Improvement. Comparing the data collected from these two groups helps us to better understand what is really driving satisfaction.Photo credit: Thomas Leth-Olsen (http://www.flickr.com/photos/thomasletholsen/9486028855/sizes/l/)
- The Threshold for ExcellenceOPOs who meet the following two criteria on a 10-point scaled question exceed what we refer to as the threshold for excellence:A mean score of 9.00 or above80% or more partners expressing high satisfactionWhen an OPO fails to meet the threshold for excellence for one or more variables, we prioritize which areas require the most attention and help the OPO to develop a strategy for improvement.Once an OPO has reached this point, there is little that can be done to improve upon satisfaction for a variable and the strategy shifts to maintaining this high level of performance.
- Photo credit: HoriaVarlan (http://www.flickr.com/photos/horiavarlan/4266657453/sizes/l/)
- Highly-satisfied hospital partners tend to feel very strongly-aligned with the life-saving mission of their OPO and also tend to be highly satisfied with most of the service satisfaction touch points this study measures. They tend to be more positive about their partner OPOs in most areas, but tend to have many of the same concerns as their less satisfied counterparts when it comes to the need for consistent, collaborative communication and protocols and a greater amount of in-hospital education to help prepare them for the donation process.Few physicians question the manner of front-line OPO representatives even if they might question the medical expertise, communication capability or service quality provided by these representatives. Hospital staff tend to express higher levels of satisfaction overall than physician partners, but this is not always the case. In some organizations, these groups are well-aligned, while in others, they express two very different types of experience in dealing with the OPO.Whereas physicians tend to speak about organ donation case experience, hospital staff are more likely to be tissue-centric in their thinking. Having both of these dimensions helps the research team to determine if concerns are systemic or due to consistency, also helps the research team to explain to each OPO how to feel about the data as a whole. As one of the participating organizations said during a research presentation covering both types of hospital partners, “if we were only talking about hospital staff, we’d be celebrating right now; if we were only talking about physicians, we’d be embarrassed.”The most common suggestions for improving overall satisfaction include:Improving communication both during and after the donation process, particularly with regards to follow-up.Building stronger relationships with hospital partners and more collaborative communication during cases.Focusing on improving the consistency and speed of response times for cases, or being better at communicating when to expect OPOs arriving onsite to respond to cases.Being less aggressive about the donation process with the donor families or more sensitive to the families (and, by extension, the hospital partners themselves).Helping hospital partners to do a better job of understanding donation criteria and protocols through good in-hospital education.Photo credit: Wally Gobetz (http://www.flickr.com/photos/wallyg/298431859/sizes/o/)
- The Shape of the DataThe data distributions suggest quite clearly that there is a need for OPOs to place their focus on improving communication and education if they want to improve overall satisfaction.But it’s also important that we understand the relative importance of each variable. For that, we can turn to a process called multiple regression analysis.Photo Credit: Liz (http://www.flickr.com/photos/kingstongal/4764245780/sizes/l/)
- Photo Credit: Carubahttp://www.flickr.com/photos/denial_land/6100081772/sizes/l/
- Collaboration – Ensure that hospital partners are being included in all aspects of the donation process and not marginalized in any way.Suggested actionsHuddling with hospital partners to help them understand their role in the process.“Morning report” emails to affected hospital partners when a case is going on.Sending Hospital Coordinators in pairs to split logistics and communication into two tasks. Put the best communicators in charge of roping in hospital partners. Move on when: Collaborative tools are in place, have been pilot tested effectively and appear to be meeting the needs of hospital partners.Photo Credit: Mike Stanic (http://www.flickr.com/photos/splatt/2506823789/sizes/l/)
- Consistency of Communication– Develop accountability indicators to ensure that communication protocols are being applied consistently during cases.Suggested actionsTrack use of tools like huddling to ensure consistency of use.Measure both internally (OPO staff) and externally (quick survey with hospital partners).Use measurements to improve training and development, not for punitive action.Move on when: Accountability measures show that communication during the donation process is being handled consistently to specified standards.Photo Credit: Jayson (http://www.flickr.com/photos/musicalgenius/8147728054/sizes/l/)
- Feedback and Follow-Up– Develop stronger systems for providing feedback (immediately after cases) and follow-up information (long-term outcomes) to hospital partners.Suggested actionsAutomate systems as much as possible.Create opportunities for information to be available on demand.Conduct debriefing with hospital partners following cases or email a case report to those involved.When information is available on case outcome, however scant it is, share it.When information cannot be provided on case outcome, have a system for ensuring follow-up occurs once the information becomes available.Move on when: Accountability measures show that communication during the donation process is being handled consistently to specified standards.Photo Credit: Active Steve http://www.flickr.com/photos/activesteve/5041133079/sizes/l/
- Educational Offerings– Develop new opportunities and systems to provide education to hospital partners about donation criteria and the donation process.Suggested actionsThink 21st century – replace old styles of education with new ones. Use on demand education instead of traditional events.Use both high-tech (apps, streaming videos, websites) and low-tech (info cards, one sheets) methods to provide information.Focus on the stories, not the statistics.Work more closely with medical schools to ensure med school students learn about the donation side of cases (rather than merely transplantation).Education requires constant refinement. What works today may not work five years from today, and partners will not benefit if you are providing the same training over and over. Keep your methods fresh and you information current and you’ll keep your partners engaged. Photo credit: Ati Sun (http://www.flickr.com/photos/ati_sun/5577379180/sizes/l/)
- We don’t need to drill down very far in the data to understand that collaborative communication is the key to improving satisfaction. The OPOs who are the best collaborative communicators also tend to be the best at providing services that meet with a high level of overall satisfaction.You will be most effective if you reach for the low-hanging fruit first. The structure we have presented will help you to do that, but if you see an opportunity that’s within reach, don’t be afraid to pursue it.Remember that satisfaction is a moving target. The purpose of opinion research is to help you move from a reactive position to a proactive position. When you are reactive, you will be limited in your focus and your capabilities. But when you are proactive, you have time to plan, to develop, to refine and to experiment – all of which will provide you with huge advantages down the road.
- Photo credit: TW Collins (http://www.flickr.com/photos/twcollins/535340101/sizes/o/)
- Physicians see you as a benefit now rather than a threat. They used to look at OPOs as stealing their patient and they felt a great loss and sense of failure as a doctor if they couldn’t save their patient. Physicians are on your side. Even though they may not always act like it, they are on your side. That wasn’t always the case, but for the past six years, that is the case and the trend is growing stronger.Physicians need to be included as key players in the entire donation process. We’ve had ICU doctors tell us that after a positive interaction with an OPO staff person, they are able to spot cases that they would have otherwise overlooked. Without the active involvement of the physician, there is no donation.Physicians need to be communicated with constantly throughout the process of the donation. Regardless of how they are behaving, you can trust that the bottom line is that they want to know what is going on and how they helped to make the case a success.Photo Credit: Robert (http://www.flickr.com/photos/disoculated/4575355256/sizes/l/)
- Photo Credit: Jerry Wong (http://www.flickr.com/photos/wongjunhao/2248733792/sizes/l/)Make communication with physicians a top priority throughout the process. It begins with the Huddle at the beginning. Make the Huddle a mandatory, never to be forgotten part of the routine, regular protocol for each donation case. Even if the physician doesn’t appear to be interested or doesn’t have the time, it is essential that your team make every effort to invite and let the Physician know who is involved, what is expected of the Physician, and that he/she will be constantly informed. Set up the expectation for communication.
- Photo Credit: SuratLozowick (http://www.flickr.com/photos/suratlozowick/4478224846/sizes/l/)Provide a daily report via email or in person to the physician on the status of the donor and email whenever there is a change in the donor’s condition. Remember, deep down most every physician really cares and wants to be in the know. Even if they push you away, they still want to know. Daily reports will be greatly appreciated by all your hospital partners. It shows that you care about THEM and that they have an important part in the process.
- Photo Credit: Miguel Jimenez (http://www.flickr.com/photos/migs212/2345537300/sizes/l/)After a case, follow up immediately with a full report on what occurred during the case. Do everything you can to brief everyone involved, and especially every physician involved—be transparent about conveying the news, whether it is positive or not.
- Photo Credit: Jim Sher (http://www.flickr.com/photos/blyzz/2804724227/sizes/l/)After transplant surgery, follow up as soon as there is information about the outcome, regardless of the success of the outcome. Give them as much information as you are allowed about the recipients and organs. This information is of vital interest to all hospital partners and especially physicians.
- Photo Credit: Ian Britton (http://www.flickr.com/photos/freefoto/2195201178/sizes/o/)Conduct a full debriefing session analyzing and discussing what occurred from start to finish. This should include the physician or be reported to the Physician if she or he cannot be present. Include the physician in this process and she or he will feel a part of your team. It’s a great opportunity to bond and educate.
- Photo Credit: Emilio Labrador (http://www.flickr.com/photos/3059349393/3801728573/sizes/l/)Read and re-read carefully and do not dismiss what the Physicians have had to tell us in the research. Embrace it, act on it, and benefit from it. The statistical information is valuable as a measurement, the heartfelt words of the physicians will give your staff the focus and direction to be successful.
- Photo Credit: Dan Thorburn (http://www.flickr.com/photos/danthorburn/7243163128/sizes/l/)Executive OPO leadership must develop relationships with Attending Physicians, all active Physician partners, and key Residents.Physicians need to know that someone in leadership knows them and is accessible to them. Senior management does not need to micro-manage the donation process, just meet and let the physicians know that they have a connection with top brass at the OPO. Physicians may never make a call, but knowing they can and knowing whom to call is important to them.
- Photo credit: TW Collins (http://www.flickr.com/photos/twcollins/535340101/sizes/o/)