Establishing a value framework for cancer-specific patient satisfaction (PS) across a large health system.

100 Background: The Mount Sinai Health System and the Tisch Cancer Institute (TCI) includes 7 hospitals and 6 ambulatory oncology centers in New York City, with over 9,000 new cancer cases seen annually. In order to address PS across these multiple sites, we established a framework to enhance value encompassing 4 domains: Infrastructure, Responsibility, Outcomes and Monitoring.

METHODS: Infrastructure. A quality dashboard was developed and distributed across all system sites. Inpatient oncology Dyads (D) (inpatient medical director and nurse manager) and ambulatory oncology Triads (T) (ambulatory medical director, nurse manager and administrator) and Quadrads (Q) (including radiation therapist) were established. Responsibility. DTQs at each location were given collective responsibility for PS performance.

OUTCOMES: The relevant HCAHPS and Press-Ganey PS scores were defined across all groups; expectations for initiatives to improve PS were delineated. Monitoring. Each DTQ reported PS performance and progress on initiatives at a quarterly system-wide meeting of the TCI QI committee.

RESULTS: The quality dashboard provided a comprehensive PS report for all system sites and the DTQs identified specific individuals responsible for PS at each site. Within 6 months, establishment of the value framework more than doubled the number of quality initiatives, including ones focused on pain management, goals of care discussions and distress screening. Required participation in the TCI QI committee resulted in 100% compliance with reporting to a high level oversight group.

CONCLUSIONS: The value framework involved the complete reorganization of how PS was reviewed, which individuals were responsible, and how initiatives to improve the patient experience were developed and monitored across the health system. Standardized dashboard-based reporting of PS facilitated review of critical information and creation of the DTQ structure facilitated engagement by key stakeholders, leading to numerous quality initiatives. Regular reporting elevated the level of attention ascribed to PS and the oversight group provided ongoing guidance for the process.