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June 6, 2022

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TeamHealth’s APEX Patient Experience Framework: Elevating Multi-Facility Scores in Texas

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TeamHealth is achieving remarkable success through targeted deployment of its patient experience program, APEX, resulting in elevated scores within several hospitals in a large community-based health system.

The Challenge

A Texas-based multi-facility system including eight leading regional hospitals, and comprising one of the largest health systems in the state, was dealing with a perplexing issue among its approximately 10,600 physicians and associates across more than 160 sites of care.

This health system previously had won national performance excellence awards, with several of its hospitals ranked highly for patient care by the American Heart Association, American Stroke Association and U.S. News and World Report. Yet, new physician leadership spotted a facility-wide downward trend for care experience and care team engagement within the system’s scorecard.

Throughout 2021, pandemic-related emergencies continued to stretch the delivery system and facilities that provide healthcare services. The consistent strain led to prolonged wait times and impairments in patient flow and access to care. As a result, downward trends in national patient experience performance metrics were observed.

While system leaders had a branded program that previously addressed these issues, leaders felt a fresh approach was needed.

System Leaders Turn to TeamHealth

They engaged TeamHealth, already a trusted partner in vital areas such as Emergency Department and Hospital Medicine, to develop and implement a new educational process to teach and inspire their clinicians and facility medical directors. To accomplish this goal, the leadership of six of the metropolitan health system hospitals and TeamHealth joined together in May 2021 to address patient experience improvement.

After a thorough assessment of the situation, TeamHealth leaders traveled to Texas, introducing and teaching customized elements of its new patient experience program, APEX. Using the TeamHealth APEX program, more than 200 clinicians and hospital staff were taught evidence-based communication practices to better address patient and family needs.

The Benefits of APEX

The foundation of APEX, an integrated hospital-wide program for improving patient experience, comes from TeamHealth’s commitment to patient safety, clinical quality and data-driven excellence. Studies across the U.S. demonstrate that one of the benefits of APEX is that patients feel better about the care they’re receiving from clinicians, thus enhancing patient loyalty.

Clinicians, in turn, become energized by the results they see as they move toward a more empathetic approach to patient interactions. TeamHealth’s years of refining APEX show the patient perspective best evaluates how all of the disciplines of healthcare can come together to form a quality-focused, patient-centric experience.

Toolkits and Templates

In its work with the Texas clinicians, TeamHealth introduced a scalable, turnkey program through the APEX toolkit, centered on optimizing the patient experience, through:

  • Didactic learning sessions
  • One-on-one coaching
  • Individual accountability.

Templates and tools include initial self-assessment and startup checklists, topic-specific videos in which behavior modeling is shown, competency grids, communication templates or scripts, shadow rounding documents, ways to form team charters to approach specific issues, and other related materials.

Throughout the Texas sessions, TeamHealth’s top leaders also related personal experiences and demonstrated best practices from other outstanding hospitals and health system partners across the country. Along the way, they personally introduced high-level communication techniques, solid coaching tips, and new ways to approach role playing and interactive sessions.

The new collaborative sessions were a hit with the facility leaders in attendance, leading to a more positive atmosphere across departments and improved quality with a “snowball effect.” Patient scorecard metrics which once had been “in the red” now were “green across the board.” In several instances, healthy competition arose among clinicians when individual scores were posted at the facilities.

Despite COVID-19, Patient Experience Scores Improve

As time went by, COVID volume surges generated recurrent operational challenges across Central Texas. Despite this pressure, Hospital and Emergency Medicine patient experience scores at the six hospitals participating in the APEX strategy increased or remained stable throughout 2021.

In the third and fourth quarters of 2021, evaluations were held at all six hospitals for four performance metrics: two Emergency Department and two Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).The inpatient HCAHPS performance measures were (1) Recommend the Hospital and (2) Rate the Hospital 0-10.

The Emergency Department performance measures were (1) Overall Rating of Emergency Department Care and (2) Likelihood of Recommending the Emergency Department. Each hospital’s performance scores were also compared to the national Inpatient and Emergency Department benchmark database created by Press Ganey Associates. Press Ganey is the vendor used by the health system for patient satisfaction surveying.

The HCAHPS measures of Recommend the Hospital and Rate the Hospital 0-10 reflected sustained improvement at all six hospitals. In addition, top box performance on both questions exceeded scores in the Press Ganey national benchmark database at all six hospitals.

Conclusions: Performance Outcomes Surpass National Trends

Performance outcomes in the four HCAHPS and Emergency Department measures were noteworthy accomplishments at all six hospitals. Despite the arduous conditions and stress endured within these hospitals during multiple periods of COVID-19 surge, they surpassed national patient experience measurement trends.

Performance on the rate and recommend metrics is a reflection of patient loyalty and promotion of the facility within the community. Comparing pre-and-post intervention aggregate scores, patient experience performance among these six facilities showed an improvement in subsequent quarters.

Online consumer reviews and Google star ratings at a high-volume, inner-city Emergency Department participating in the APEX program increased from 2.4 to 3.2 within the first few weeks following rollout.

“It’s Why We Got Into Medicine”

A chief hospital leader mused that one of APEX’s most meaningful effects resulted in the way it addresses the risks of clinician burnout, saying “this is a great way to improve clinician retention and wellness. It gives everyone a pause to remember why they came into this field, why we even got into medicine.” In fact, the resulting significant improvements prompted rousing celebrations and congratulatory emails among the participating facility teams.