Table 3:

Examples of using patient experience data to meet PCMH standards

PCMH Standard	Exemplar Quote
Team-based care and practice organization	Yes, I would say the CAHPS-PCMH survey was helpful to reorganize the practice to be more patient oriented because patients wanted to see more educational, information stuff in our waiting area, things that were beneficial for them, and that we’ve added on our big screen in our waiting areas to provide more information that’s for the patient. The surveys did help us change certain methods of communicating and providing information to the patients.
Knowing and managing your patients	We decided we would figure out who our “high risk” patients are, because some patients never “no show” and some patients “no show” all the time. So, we made a list of the patients that we thought we really need to call personally before every appointment. Not a robocall, a personal call. And we started doing that, and it did help cut down our “no show” rate. Basically, we implemented this new policy of calling specific people given we know their habit. Then the second part, we planned to call all long appointments. So, any patient coming in for a physical the next day was going to get a personal phone call. Any patient coming in for an annual wellness visit the next day was going to get a personal phone call. We created extra work for ourselves managing the patients, but it did cut down on the amount of “no shows” because then they would say oh gosh, that’s right, I can’t make it. But at least we would know ahead of time so when we got three phone calls in the morning, we could fit those people in.
Patient-centered access and continuity	One thing that’s been useful with our patient experience survey, the CAHPS-PCMH survey, is in structuring our afterhours care. We had a shared coverage arrangement with a group of practices in our area and the survey helped us to realize that those specific afterhours providers weren’t providing the best of patient care, which we have since changed and been able to bring that coverage in-house, improving those patients experiences.
Care management and support	We used the CAHPS-PCMH survey to work on our follow-up for labs and diagnostics. When we started Patient-Centered Medical Home, it was different, we had not tracked labs before. We had not called with normal results, and it was a big change, to track everything. Everybody gets a phone call or a letter. We’ve had improvement, but we’re still trying to drive that one forward.
Care coordination and care transitions	Well, the ones we feel that we have the most control over have to do with setting of appointments and then the management of things like labs and referrals, and how patients feel that they get that information in a timely way. So, I think we’ve looked a lot at patient experiences around notification of their test results and their referral consults, and do they have their appointments scheduled and all that. So those are two areas we changed by using CAHPS data. And we feel like we have control over most of those measures.
Performance measurement and quality improvement	Improving medication decisions was a focus for us last year for PCMH because that was one of the areas that we were particularly low in relation to our region and the national numbers and we were lower than we wanted to be. So, we paid particular attention to those items on the CAHPS-PCMH survey. In the past, we’ve also paid attention to the mental and behavioral health aspect of care, so we did make a change there with QI and using the CAHPS items. With PMCH we also worked on QI related to communication and involving the individuals in their own plan of care, so that is what measures we focused on in for QI and patient experience in the last couple of years.