The Minitab Assistant Menu made it easy for the team to choose the correct analysis for identifying specific patient groups with low survey scores. With the ANOVA above, the team saw statistically significant differences among the mean responses by age group, which allowed them to target this audience in their improvement efforts.
The Riverview team began this project with a preset assumption that differences in the education level or the primary language of the respondent might offer insight into the low scores, but their analyses of these variables revealed no statistical significance. However, analysis of other variables uncovered statistically significant differences within respondent age groups and the hospital unit visited. "Analyzing the data in Minitab helped us to identify specific patient groups who were typically scoring lower, and then direct process improvement efforts to those patient populations," says Spranger. "We were able to take a large problem and drill it down to a very specific patient population."
The Riverview Lean Six Sigma team was able to narrow the project scope and use the insights they gathered to improve patient satisfaction for groups identified as scoring the lowest. "Historically, health organizations try to increase patient satisfaction through staff training and other large-scale solutions," says Spranger. "Now, with a data-driven approach, we are able to better target improvements." The improvements for this project targeted low-scoring patient groups from specific age ranges, as well as patients who stayed in specific hospital units.
The team also used the improvement effort to solve key problems identified in the current process for handling patient discharges, which included timing of education, ensuring the involvement of a family caregiver, and clarifying outcomes with the patient. They redesigned the discharge education process into three phases to address previous issues with timing, collaborated with primary care physician clinics to ensure consistency, created a process to ensure that a primary family caregiver was identified to engage in care management after discharge, and clarified terminology in discharge documentation that was considered vague.
After implementing these improvement strategies, the team compared the current proportion of "yes" responses to responses before the project began. They achieved an impressive gain in the proportion of "yes" responses and met their goal to surpass the 91 percent benchmark for average positive monthly responses. Currently, Spranger and his team are leveraging the other lessons they learned throughout this project and are forming additional improvement teams to analyze and improve other HCAHPS dimensions. "Our ultimate goal is to improve the experience for our patients," Spranger says. "Through efforts like these, the Lean Six Sigma team at Riverview continues to fulfill our mission."