How to easily raise your HCAHPS scores

Patient satisfaction has been garnering an increasing amount of attention, since healthcare began its shift to a value-based, more patient-centric system. In an effort to measure “value” as opposed to volume, the Centers for Medicare and Medicaid Service (CMS) have begun implementing the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys to track the level of satisfaction among recently discharged patients. Patients rate their hospital stay in 27 categories, which range from communication with doctors and nurses to pain management to facility cleanliness and quietness. Based in large part on these scores, hospitals can either lose or gain up to 2% of their Medicare reimbursement payments. This percentage is expected to continue increasing along with the expansion of Medicare (an ACA mandate.) By implementing HCAHPS surveys, along with other qualitative measurement tools, CMS encourages healthcare providers and administrators to go beyond the moral imperative to provide high quality care by withholding reimbursement for subpar patient satisfaction.

There are a number of strategies to improve patient satisfaction scores, most of which emphasize improving practice and hospital environment. This costly method, however, may very well do the opposite. As Brenda E. Sirovich, MD, MS, of the Department of Veterans Affairs Medical Center in Virginia, explains, recent studies infer that efforts to cater to patient satisfaction may be ill guided, because by “implicitly encouraging health care providers to honor requests for (or to explicitly offer) discretionary health care services, such efforts may lead to overutilization, higher costs, and worse outcomes.”[1]

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Supporting Families and Staff with Palliative and Bereavement Care in the NICU

No one ever expects that when they become pregnant, their baby may not be born alive or may pass away after birth. And yet this is the reality for an unfortunate number of new parents every year. Many of these babies—whether they are born extremely prematurely, or with birth defects or other significant life-limiting conditions—come through the neonatal intensive care unit (NICU). As such, all who provide care in the NICU need to be prepared to provide sensitive and caring emotional support to parents who find themselves in this difficult situation of neonatal death and infant loss.

NICU Palliative care involves transitioning a baby from life-saving interventions to providing “comfort care,” understanding that when it is offered, any interventions that might once have been considered “life-saving” would not change the ultimate outcome in favor of survival. Comfort care consists of providing warmth, enteral nutrition (only if desired by parents), pain medication, and simple interventions such as nasal cannula oxygen if it is thought it would make the baby less distressed. Most importantly, comfort care involves intimate contact and unrestricted holding between parents and their baby, as well as time with extended family, which is not usually possible to the same degree when baby is undergoing intensive care. The emphasis is on the family’s quality of life during their time spent together.

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Better caregiver education means better patient care: how to successfully leverage the CARE Act

As value-based care initiatives slowly shift the focus of the business of healthcare from “transactions” to sustainable health processes, regulatory bodies have been issuing guidelines at a frenzied pace. Growing research on caregiver influence on patient compliance and legislation have physician and healthcare vendors looking for ways to reach these new stakeholders. To maximize the impact of care post-discharge, 30 states have elected to take part in the CARE Act (Caregiver Advise, Record, Enable), which requires providers to 1) record the family caregiver’s name on the patient’s medical record, 2) inform the family caregiver when the patient is to be discharged, and 3) provide the family caregiver an education on the medical tasks to be performed on the patient at home.  

Approximately 93 million US adults provide over $522 billion worth of caregiving every day, which often involves complex tasks such as wound cleaning, administering medication, and operating feeding tubes, not to mention emotional support and care. They are key stakeholders in the new, value-based healthcare landscape, with real influence on population health (70% of family caregivers spend between 10 and 40 hours a week performing medical tasks), and require a set of tools and systems to support patient outcomes. This growing body of research and data is leading healthcare industry experts to look for tools that would allow for a more holistic approach to patient care, taking socio-economic backgrounds, community support systems, and caregiving options into account, alleviating the heavy burden and potentially dangerous knowledge gaps that many caregivers contend with.

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How we can help doctors and hospitals feel confident with “breast is best”

Written by Jennifer Lincoln, MD, IBCLC

The term “breast is best” sums up exactly what leading medical organizations such as the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) believe: babies who receive breast milk as opposed to formula reap substantial benefits.

An increased focus on breastfeeding, as evidenced by more hospitals becoming certified as Baby-Friendly and the Joint Commission Perinatal Care measure tracking exclusive breastfeeding rates in newborn babies, means that the word is getting out about the importance of breast milk.

The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991, with the goal of educating maternity staff in hospitals to better support breastfeeding for their moms and babies. This program includes intensive education and training for all maternity staff, and it sets forth guidelines that aim to increase breastfeeding initiation and exclusivity while in the hospital.

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Leveraging Expanded Patient Education Libraries to Meet Clinical Initiatives

The modern hospital and healthcare setting offers many challenges for healthcare providers. They are now tasked with meeting patient education initiatives while simultaneously doing more work on the floor. In addition, they are asked to manage staff time constraints, making it harder than ever to effectively engage patients in understanding their condition and then following up to make sure they are complying with care directives. While this might feel daunting, reliable, integrated patient education tools are designed to help providers and their teams meet these challenges.

Customized patient education solutions that can be integrated into the EMR to streamline the clinical workflow, can help ease this patient education burden. The Wellness Network’s suite of customizable patient education products can help you satisfy clinical initiatives, increase education time, and improve the overall quality of care while streamlining workflow for providers, making it easier than ever to provide high quality, consistent, individualized patient education.

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Going full term and avoiding the allure of a scheduled C-section: how to get your patients on board

Written by Jennifer Lincoln, MD, IBCLC

When it comes to delivering babies, there is one thing that everyone can agree on: expecting parents, nurses, obstetricians, midwives, and pediatricians all strive for a healthy mom and a healthy baby.

However, sometimes it can be really hard to wait for that healthy baby. From parents wanting to know exactly when their baby will be born to obstetricians trying to schedule deliveries on the day they are at the hospital in the hopes of increasing patient satisfaction, there are more and more reasons babies are arriving via scheduled inductions or planned C-sections.Going Full Term

While it is certainly true that some babies need to be delivered before their due date, such as for complications related to preeclampsia, growth restriction, or poorly controlled maternal diabetes, more often than not it is completely possible—and in fact, desirable—to play the waiting game when it comes to labor and birth.

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The Link between Diabetes and Hearing Loss

Written by: Joanne Rinker, MS, RD, CDE, LDN, AADE Director of Practice and Content Development

As a diabetes educator, when I think of diabetes complications, I think of kidney, eye, heart and nerve damage. What I don’t think about is hearing loss.THE LINK BETWEEN DIABETES AND HEARING LOSS

In 2012, a colleague brought this to my attention and asked me what screenings I do for people with diabetes (PWD) to determine if they have hearing loss. I thought about it and realized this really was never on my radar and there was nothing in place. Then she asked me to think about how a PWD might feel if they also had trouble hearing. I realized that hearing loss would not only make life more difficult for a PWD but could also lead to depression. For a PWD who is already dealing with the pressures of a very complicated disease, adding hearing impairment to the list can be potentially devastating.

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“I’m a New Person”

Written by: Maria Lissandrello – Diabetes Health Monitor

Diabetes educator Michelle Sheldon Rubio, RN, BSN, CDE has collaborated with Milner-Fenwick, now a division of The Wellness Network, for many years. She has served as a content consultant on our patient education videos and PowerPoint teaching units. Diabetes Health Monitor tells the story of Michelle and her patient, La’Juan Way. We believe you will find it informative and inspiring.

When La’Juan Way met certified diabetes educator Michelle Sheldon-Rubio in 2015, she was taking multiple pills and three shots a day to manage her type 2 diabetes. Although she had been diagnosed with the disease in 2008, she hadn’t taken it seriously. “I was a mess” admits La’Juan. “I didn’t want to accept that I had diabetes.” But in 2015, the then 50 year­ old had no choice. She was at work, when she felt lightheaded and short of breath. “When I went to stand up, I got up and hit the floor. I went out in an ambulance and woke up in the ER with an IV in my arm,” says La’Juan.

After narrowly escaping a diabetic coma, La’Juan agreed to see a doctor and a dietitian, but the regimen was overwhelming. Despite oral medication, she was waking up with blood sugar levels in the 300 to 400 mg/dL range. And the nutritional advice was confusing, too: “I thought I could still eat the way I used to-bread, fried food and soda-just moderate my portions and dilute my drinks. But it made things worse. They added more pills and shots twice a day. Then three.”

“I finally started listening”

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The 2017 ADA Updates on Caring for Patients with Diabetes

Written by: Joanne Rinker, MS, RD, CDE, LDN, AADE Director of Practice and Content Development

If you care for a person with diabetes (PWD), it is important to pay attention to the annually updated standards of care from the American Diabetes Association (ADA). The 2017 ADA updates can be found here: Living

This year’s report contains some key updates that will affect caregivers and PWDs who are working to self-manage their disease. Here are some of the highlights:

1. A PWD is an individual! Providers should focus on support that is specific to the PWD’s lifestyle. This means taking into account geography (e.g., urban or rural lifestyle), as well as the food culture and exercise environment in the community. Caretaker recommendations about healthy eating and active living should fit the PWD’s surroundings and available resources! PWDs should be aware of available support from lay health coaches, navigators, or community health workers.

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USPSTF Recommendations and Impact of Video Education

Written by: Jon VanZile, Medical Editor

When It Comes to Reaching Patients, Video Works

As the cost of medical treatment continues to rise, employers, insurers and hospitals are counting on preventive medicine to help reduce treatment costs for expensive chronic diseases.

The problem? Patient compliance. Getting patients to “follow their doctor’s orders”—even when the evidence is overwhelming—is hard enough. According to a recent paper published in Mayo Clinic Proceedings, up to 50% of patients don’t take their medications as prescribed. But when the evidence is equivocal and recommendations seem clouded in uncertainty or controversy, it can be nearly impossible.

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