Being diagnosed with cancer in his tonsils and lymph nodes in 2012 was a terrible shock for Dave Olson of Lino Lakes. Suddenly his life was in the hands of physicians who advocated for him, talked him through what he needed to understand and helped to guide him toward recovery.
"I could not have been happier with my doctors," Olson said. "It's the way they communicated with me and my wife, making sure everything was explained to me in terms I could understand." The voices of Minnesota patients like Olson can be heard more clearly today as the result of a new statewide survey about patients' experience of care from the Minnesota Department of Health and MN Community Measurement.
Results from the more than 230,000 patient-completed surveys on patient experience of care—known as the Clinician and Group Surveys – Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS)—from 651 clinics are now available for consumers to use along with other information on the cost and quality of health care providers. The data is collected as part of Minnesota's Statewide Quality Reporting and Measurement System and is the most comprehensive look at patient experience on a statewide basis in the country. Minnesota's 2008 health reform law set up this system which requires clinics to report their performance on a standard set of quality measures. MDH partners with MN Community Measurement to collect the data, and MN Community Measurement reports results onhttp://www.MNHealthScores.org. Clinics can also use survey results to see where they are performing well, and identify areas for improvement.
"Patient experience, cost, and quality are important features to consider in the overall delivery of care," said Minnesota Commissioner of Health Dr. Ed Ehlinger. "With the addition of the patient experience survey, Minnesota strengthens its position as a national leader in health care reform and reaffirms its commitment to helping Minnesotans make quality decisions about their health care."
Overall, many Minnesotans are happy with their care in terms of getting care when needed; being listened to and receiving information and instructions they understand; experiencing courteous and helpful office staff, and being satisfied with their provider.
"For the first time, people in Minnesota can get information about the experience that other patients, like them, have had at physician practices across the state," said Jim Chase, MN Community Measurement president. "The survey includes important information for patients about access to care, communication, and interactions with staff. Sharing this information can help patients know what they should expect and help physician practices learn what they can do to improve the results."
Nevertheless, the results also show variation in how clinics perform on these four categories. For example, 60 percent of all survey respondents said they experience the top-level of access to care at their clinics. In one clinic, however, only 33 percent of respondents reported top-level access to care; at another clinic, 83 percent of respondents reported top-level access. This variability indicates an opportunity for learning from high performers about how to re-engineer aspects of care delivery. In terms of the other three areas of patient experience of care:
- Ninety percent of respondents described communication from their providers as top-level. For individual clinics, the range was from a low of 66 percent to a high of 98 percent.
- Ninety-two percent of respondents gave the office staff at their clinics top marks for being respectful and helpful. One hundred thirty-five clinics performed above average in this category; 86 were below average.
- 78 percent of respondents gave their provider a top rating of 9 or 10 on a 10 point scale. Individual clinics ranged from a low of 47 percent to a high of 93 percent of providers receiving a top rating.
Two clinics in Minnesota ranked in the top 10 performers across three of four survey categories: Lakewood Health System – Pillager Clinic, and Essentia Health St. Mary's Innovis Health Clinic – Frazee. The Pillager clinic was ranked first across all Minnesota clinics in office staff and provider ratings. "It's wonderful the patients have acknowledged us," said Craig Wolhowe, Vice President of Clinic and Hospital Services with Lakewood Health System, whose main clinic is located in Staples, Minnesota. "We really encourage our providers to take time with their patients."
The CG-CAHPS survey is the national standard for objective reporting of patient experience, making appropriate apples-to-apples comparisons across clinics. While some clinics have long conducted internal surveys to understand their own relationships to their patients, a statewide survey allows for accurate comparisons to be made across care systems. The same questions are asked nationwide and used by providers to improve how they care for patients. Individual responses are pooled for a broad, objective analysis of how patients perceive their care. The data are adjusted to account for differences among patients and allow for more accurate comparison of the results.
Minnesota providers and patients made major contributions to this initiative as well. Several provider systems built the groundwork for today's news through two rounds of voluntary pilot testing in 2008 and 2010 in which more than 100 clinics submitted data for analysis. That data was used to test the statewide survey collection process, and has been used to set goals for improving patient experience at clinics. Patients contributed by providing feedback through the surveys.
"These initial results are just the beginning of what we can learn from the data," said Stefan Gildemeister, who directs the initiative at the Minnesota Department of Health. "We are eager to better understand how well patient experience relates to improved clinical outcomes and performance as high-value, efficient providers."