12 Replies Latest reply on Feb 1, 2018 8:15 AM by George Soler

    HCAHPS dashboards

    George Soler

      Hello Everyone,

       

      I posted one of my HCAHPS dashboards so everyone can take a look and maybe collaborate with me on some best practices in visualizing this information. Some background information: we use PressGaney and I have a script written to download our XML files from the ftp server on a weekly basis then parse it using SSIS we can then bump it against our EMR and Registration data to bring in any additional fields we want. So any thoughts or example would be greatly appreciated. Thanks!

        • 1. Re: HCAHPS dashboards
          Derek Cyr

          Hi George,

           

          Have you considered a weekly run chart (perhaps wrapped in a SPC wrapper) like Jonathan has described here: User Defined Functions and Process Control Charts | Drawing with Numbers

           

          I like weekly vs. monthly since it provides consistent weekend/weekday ratio for each point.  You could also use a bullet chart to show YTD performance against a goal or against CMS %iles (Summary Analysis ) (90th, 75th and 50th is a good place to start)

           

          To make it more palatable for Customers who may not be up to speed on Shewhart Charts, you could use colored bands instead of lines or simply color the "actual performance" line when a signal is detected.

          You could then use colored bands for goals and have Unit as a Filter.

           

          Another idea is to augment your SSIS job to create a second source with a row for every word and consider using a word cloud to visualize the comments...  (size on frequency, color on 9 or 10 perhaps)...

          • 2. Re: HCAHPS dashboards
            Anna Kisting

            HI George-

             

            My response is a bit late, but hopefully it can still be helpful.  The cross tab at the top is redundant, it looks like the data is represented elsewhere visually, so i would remove it completely.  (at the very least shrink it down.)

             

            Also, your response distribution - if you put it into a gannt chart, it would be a lot easier to see problematic areas - see example below.  Steve Wexler has written a lot about visually survey data.  Data Revelations – Interactive visualization development, consulting, and training  

             

            I've reported with survey data at our hospital, and I'm happy to answer questions.

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            • 3. Re: HCAHPS dashboards
              Hope Stiles

              George,

               

              I spend about 80% of my time on Patient Experience for our Health System.  Thanks for starting the conversation and sharing what you have.

               

              As background, we also use Press Ganey, and get a weekly XML file that is then loaded into a data source on our tableau server for my use.  We have Enterprise dashboards on the server for HCAHPS and ED Satisfaction.  The data source is updated every two weeks.

               

              It looks like what you are working with here is ED Satisfaction data.  I'm surprised to see that you are using mean score.  With ED CAHPS on the horizon I would consider switching people over to thinking about it in terms of top box as they do for HCAHPS.

               

              I agree with Derek that using the CMS benchmarks is most beneficial.  Unfortunately, we don't have that for ED yet that I'm aware of.  That said, we are currently comparing to the PG 90th percentile.  I only update that value twice a year even though they update it monthly.  I don't like to give folks a moving target and the changes aren't huge.

               

              The first thing I created was a table.  It is not the most effective, but it was a way to ease folks into Tableau and give them something similar to what they were used to.  I have a parameter that allows them to choose between a quarterly or monthly view.  I discourage looking at patient experience any more than monthly.  Although if your system is like ours, leaders hate waiting that long. 

               

              I see you built a table also.  It looks like it takes a lot of real estate on your dashboard.  I might make it a little more narrow and use the space for the visualizations that are easier for users to gain insight from more quickly.

               

              Depending on how big your system is, we developed a view that would allow the different EDs to compare against each other.  That way they can reach out to one another and look into best practices.

               

              The next view allowed them to view a monthly line graph of each question within a section.  So they filter to Arrival and then see a row for each question.  The next update will implement our Patient Experience Statistical Significance indicator that identifies points (among the last 6, with at least 30 surveys) that saw a score unlikely to be due to normal variation in the data.  This work was inspired by Steve Wexler, mentioned above by Anna.  We adjusted the methodology for our need but use it in our HCAHPS dashboard and are pushing it out to ED this week.

               

              For the overall comparison to nation, I might remove the colors there.  The labels show which section it is and then you could use color to indicate how they are doing compared to the nation.  We use a green when they have met the 90th and gray otherwise for the ED work.  You might also consider coloring the reference lines and removing the labels by using a legend.  Then you could show the score on the label for a quicker comparison.  Attached is an image I use as a legend on one of my HCAHPS dashboards to do this.

               

              Thanks,

              Hope

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              • 4. Re: HCAHPS dashboards
                mark.welsh

                Hello everyone,

                 

                We've gone so far as to pull the XML data into SQL Server, but once we realized the XML files didn't contain benchmarks we put the project on hold.  I see OPs dashboard has comparison's to nationwide data and a few of you mention CMS benchmarks.  Where are you guys getting benchmark data and how are you pulling it in / joining it to Press Ganey. 

                 

                Many, many thanks!

                 

                Becca Schickling

                • 5. Re: HCAHPS dashboards
                  Hope Stiles

                  Mark,

                  We get the data each year when CMS publishes the updated 90th and 50th percentile.  Then we create a table that we join to our data.

                  Hope

                  • 6. Re: HCAHPS dashboards
                    mark.welsh

                    Thanks Hope.  I googled it, but I may not be searching for the right thing.  Do you have a link to the last posted benchmarks?

                    • 8. Re: HCAHPS dashboards
                      mark.welsh

                      Thanks again! 

                       

                      How do you join this with your XML data?  We noticed that ours doesn't have high level groupings such as "Communication with Nurses" - instead it has each individual question. 

                      • 9. Re: HCAHPS dashboards
                        Sean Ramsdale

                        Here's a link where you can download the benchmarks (90% percentile) and thresholds (50% percentile) used in the hospital value-based purchasing system.

                         

                        They call it the patient experience of care domain, so maybe that's why it was difficult to find.  You can download as an Excel or csv - I forget which.  At any rate, I was able to get it into an Oracle database.

                         

                        https://www.medicare.gov/hospitalcompare/data/patient-and-caregiver-centered-experience-of-care-care-coordination-domain-scores.html

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                        • 10. Re: HCAHPS dashboards
                          Jonathan Drummey

                          Hi Mark,

                           

                          Many of the individual HCAHPS survey questions are rolled up into several domains so the easiest way to join this is to create a crosswalk table that joins the questions to the domains. I don't have a crosswalk handy, you can build it from the survey itself - the headers identify the domains: http://www.hcahpsonline.org/globalassets/hcahps/survey-instruments/mail/jan-1-2018-and-forward-discharges/click-here-to-…

                           

                          Jonathan

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                          • 11. Re: HCAHPS dashboards
                            mark.welsh

                            Jonathan - Ok, that helps clear things up.  I was wondering if you all were creating your own crosswalks, or if you found a way to join XML to the benchmarks without a crosswalk.  Thanks!

                             

                            Sean - thanks for that link.  Super helpful!

                            • 12. Re: HCAHPS dashboards
                              George Soler

                              So, to be honest i handed off all dashboard builds to other people and work mostly with underlying datamarts and ETL but hopefully my attachments will help those who are wondering about grouping and benchmarks.

                              Ideally all of my master tables are in SQL tables to make managing them easier and joins are much more efficient that large case statement in tableau but for this dashboard we just left them in the calculated field.

                               

                              attached:

                              calculation for domain

                              calculation for top-box

                              calculation for benchmark

                               

                               

                              -GS