CHUM achieves its quality improvement goals

About CHUM

The University of Montreal Hospital Centre (CHUM) provides specialized healthcare services to local and regional clientele in the province of Quebec. Within its local community, CHUM also offers general and specialized healthcare and hospital services and contributes to promoting general health and well-being. CHUM’s mandate also includes teaching, research, and the assessment of technologies and healthcare methodologies.

The Challenge

Understanding patient perceptions of their healthcare experiences plays an important role in determining how a healthcare provider can continuously improve the quality of healthcare delivery.

“Since you cannot improve or manage what you have not measured, valid patient feedback is one of the necessary inputs for process improvement and management decision-making at all levels,” said Elsa Salomon, CHUM Quality Coordinator.

Surveys meant to measure customer satisfaction within healthcare can be viewed with apprehension by staff who feel such surveys might be used to measure their job performance and by management who feel the results can lead to demands for greater expenditures when budgets are limited, admits Ms. Salomon.

The Process

The organization could have designed its own survey tool – a laborious and often costly process. It would have involved creating survey questions, validating these questions and building a survey application and database to store survey results so benchmarking data could be preserved for historical and comparative purposes. Instead, CHUM’s Quality and Risk Management group selected the Androfact™ Healthcare Survey System.

The Solution

CHUM selected Androfact for two “crucial” reasons, said Ms. Salomon. The questions in the survey bank were validated for patient care experience and the survey data was stored so CHUM could establish a benchmark to compare the results of future surveys to ensure that any actions taken to improve customer satisfaction were effective.

After all, as she explained, if your goal is to continuously improve your processes, then you want to be able to determine if changes made based on the results of one survey have led to improvements in patient satisfaction. That requires the ability to compare results of new surveys against an historical benchmark.

In 1992, CHUM conducted its first patient satisfaction survey using Androfact’s predecessor version SEQUS, and has been conducting patient surveys ever since. Over the years, CHUM has created and validated new survey questionnaires for various departments and service areas. These questions are added to the Androfact system as the tool is versatile and allows for full customization.

“The Androfact survey allows for complete customization, benchmarking and the comparative analysis that is so crucial to continuous process improvement,” said Ms. Salomon.

Results

“What we discovered when we conducted our first patient survey was fascinating and it has assuaged any resistance staff and management may have had concerning the survey process,” said Ms. Salomon.

CHUM discovered that patients used discretion in their assessment. They did not ask that CHUM be turned into a holistic health spa, for instance. It was as if they intuitively understood the constraints of a publicly-funded healthcare organization and did not ask for services that the health care organization could not deliver. Instead, they wanted small changes that had mostly to do with continuity, security, dignity, empathy and understanding – a few more smiles, a little more time spent on listening and explaining and so on.

With the survey results and analysis shared with all internal stakeholders as well, CHUM’s multi-disciplinary healthcare teams suggested changes and readily bought into the need to improve because “they had the facts and assessment in hand,” said Ms. Salomon.

Since CHUM’s Continuous Quality Improvement strategy is to improve the service and care of its clients, the hospital created a benchmark of patient satisfaction and a Patient Value Declaration. Both the benchmark and Declaration served as a roadmap against which patient satisfaction could be measured on an ongoing basis as the hospital worked to continuously improve quality and patient satisfaction.

CHUM now conducts patient surveys to measure patient satisfaction and to measure the results of implemented changes on an ongoing basis. “When we conduct patient surveys, we want to validate the values that patients have identified as being important. We want to ensure that we maintain and respect those values and we want to measure improvements year-over-year,” Ms. Salomon said.

Last year, CHUM created a new questionnaire using the customizable Androfact survey tool and surveyed all its personnel, including doctors and volunteers, on the quality of the workplace environment. CHUM is presently proceeding with a satisfaction assessment among its students and interns concerning their internship. IT is also in the process of developing a survey tool for the internal client supplier relationship with such services as Finance.

All of this is being done to help the hospital to continuously implement quality improvements that will keep the hospital aligned with its stated core values.

The Future

Surveys to date have been paper-based and the Androfact data entry capability makes it easy to enter the right data in the right place, reducing any margins of error, Ms. Salomon said. However, CHUM will soon go online and use Androfact’s Web-based survey capabilities.

By providing validated questions, multi-mode data collection capabilities and built-in analytical tools with the ability to share results in real-time over the Internet, Androfact automates and streamlines the feedback gathering process making it more cost-effective.

Hospitals in Quebec are now part of integrated health networks. Using Androfact, CHUM will be able to compare survey benchmarks with other Androfact clients in Montreal and throughout the province since they will be using the same survey tools and receives data in the same format on the same server. This will allow for collaborative analysis and the implementation of continuous process improvements province-wide.

Visit the Knowledge Centre to read or download the full CHUM Case Study.