Hiring for the Patient Experience

1. Hiring for the Patient Experience Theresa Mazzaro, RN, CHCR Workforce Planning Consultant, Nursing PeaceHealth System

2. After this session, attendees should be able to: • Distinguish how healthcare recruitment hires top quality staff to effect the “Patient Experience" • Discuss current tactics that healthcare organizations utilize to increase patient loyalty through hiring practices • See how healthcare recruitment employs patient satisfaction surveys and targets HCAHPS surveys in a behavioral-based interview format • Discover how to engage current staff in the selection process, creating accountability and success for the team 

3. PeaceHealth System • Headquarters in Vancouver, WA • 1551 beds in 3 states: Alaska, Washington, and Oregon • Top 100 Hospitals in the Nation • 302,325 Emergency Department visits/year • 44,024 surgeries/year • 17,194 Employees • Charity Care Costs: $139,925,120 • Hospitals range from 10 bed “Critical Access” to 450 bed Level II Trauma Centers

4. Our Journey • Our Goal: • Creating the best patient experience by hiring the right caregivers at PeaceHealth • Understanding the impact Recruitment has on patient experience

5. HCAHPS and Patient Experience: • Hospital Consumer Assessment of Healthcare Providers and Systems • Valued-Based Purchasing: Money that used to be ours… • 27 questions: • Responsiveness of Staff • Nursing Staff Communication • Communication from Staff about medicines • Physician Staff Communication • Discharge instructions from Staff • IS THERE OPPORTUNITY FOR HEALTHCARE RECRUITER TO MAKE A DIFFERENCE HERE???

6. BONUSES AND PENALTIES FOR HOSPITALS • Hospitals can gain up to 1.25% in payments from CMS or lose up to 3.25% in payments.

7. Old Practice: • Recruiter sends application to manager if met minimum qualifications (without talking to them) • If the Manager interviews…asking candidate questions such as: • “Have you ever had a conflict with a co-worker” • “What would you do if you had a conflict with co-worker?” • If manager likes candidate, position is offered pending references (calls to HR that netted nothing)

8. RESULTS:

10. Results: • No accountability established upon hire • Patient Satisfaction • What’s that? • AIDET • That’s not really what you expect me to say, is it? • Excellence • Who has time to do these “extra” things? • Quality of Care • I saved their life! What more do they want? • Quality of patient care matters – but it does not always equal an excellent patient experience

11. If You Hire the Right People, Patient Loyalty will Increase

12. Change: • No more “pulse hiring” • The interviews… • Initial Interview • Manager Interview • Peer Interview • Behavioral based interviewing • Integrating Patient Experience Survey & HCAHPS Survey into interview • References

14. Best Practices: • Initial Interview and Triage point: • References or “No thank-you?” • Skill Survey • 360 degree online reference tool • Completed reports to manager prior to application receipt • Can assist with identifying areas for further inquiry during the interview or narrow down the candidate pool. • Decreases the recruitment team’s time • Valuable feedback for hiring manager • HCAHPS specific cluster (right behaviors)

15. Interview Tell me about… Describe a time when… Give an example of… “Could improve upon prioritization and time management” Question to ask: Tell me about a time you had difficulty prioritizing during a shift? Behavioral Questions Skill Survey Questions

16. Interview: Behavior Based Interview Questions that support HCAHPS: Communication: “Describe how you relieve a patient’s anxiety when they are first admitted to the hospital” Respect: “Give me a specific example of how you have demonstrated treating a patient with respect in your previous role” Empathy: “Tell me about a time when you were with someone who was really upset. How did you handle the situation”

17. Interview: • Using the Patient Experience Survey/Standards: • What is your definition of the patient experience? • On our unit, we round on our patients every hour. Do you see any barriers to that? • Tell me about a time you had to explain a new medication to a patient/family member? • Using key words and phrases: • When you close the curtain in a patient’s room – do you say anything? What do you say?

18. For the candidate: • Job Description/Caregiver Profile • PeaceHealth Promise • Copy of patient loyalty survey for specific area • Fact sheet/information

19. Peer Interviewing

20. Peer Interviewing Why peer interviews? It makes for a good beginning; every team member who interviewed the new hire already knows they can get along with him/her. The employees who conduct the interviews take a personal interest and ownership in new hires’ success. It builds Individual Accountability; we hire, train, and orient new co-workers, as well as role model the organization’s standards of behavior.

21. Best Practice: • High-performing team members on peer interview team • Recruiter: train and facilitate peer team interview. • Consistency of questions • Behavioral-based • Peer group using their PES tactics practiced on unit – turn it into an interview question: • We use a white board in our patient’s room for communicating important information…

22. Results: • Decrease in 3-6 month organizational turnover for Behavioral and Policy Issues • 2009: 19 terminations • 2010: 9 terminations • Decrease in RN turnover • 2009: 11.87% • 2010: 7.63% • SAVINGS from 2006-2010: “$2.5 million savings in recruitment and training expense.”

23. Emergency Team Earns National Patient Care Award11/18/2010 The Department was recognized for moving its patient experience scores from the 30th percentile in national rankings to the 87th percentile earlier this year. It means well over three quarters of the patients in the Emergency Department rank their care as excellent on a five point scale.

25. Questions? • Theresa Mazzaro, RN, CHCR • tmazzaro@peacehealth.org