What reports are provided to our hospital?
The following reports can be accessed in the Reports application on PRCEasyView.com®:
The Executive Summary outlines the methodology of the survey, gives a brief interpretation of the findings, and provides information on goal setting. It is appropriate for senior leadership.
The PowerPoint presentation provides a starting point for presenting results to key constituencies and understanding the entire set of data. It details results from the questions and Key Driver of Excellence® analyses.
Individual Service Area Reports are provided for the use of department heads.
If you do not have your PRCEasyView.com® user name and password to access the reports, please contact us at email@example.com.
How are rankings determined?
Throughout the survey, physicians’ perceptions are measured using a five-point scale of “Excellent,” “Very Good,” “Good,” “Fair,” or Poor.” “Percent Excellent” indicates the percentage of physicians who responded “Excellent” to the question. This top box of “Excellent” ratings is the only thing considered in rankings (Excellent Percentile). “Excellent Percentile” indicates how your organization ranks against other organizations in PRC’s National Medical Staff Database.
Because the rankings consider only those physicians who responded “Excellent,” a low ranking may not indicate a problem. If physicians do not rank something as excellent, do not assume they rank it poorly. In most instances when physicians do not respond “Excellent,” they still respond with an answer on the positive end of the scale (“Very Good” or “Good”).
A common misconception is that a ranking (Excellent Percentile) of 0 indicates that zero physicians responded “Excellent” to the question. While that is a possibility, keep in mind that the ranking considers only those who responded “Excellent.” If every physician responds “Very Good” to a question, the ranking is 0.
What are Key Drivers of Excellence®?
Key Drivers of Excellence® are the areas that are most influential to physicians’ overall perceptions; in other words, they provide you with a more specific place to focus your efforts. Every survey question provides information, but not every piece of information is equally important to your physicians. Key Drivers of Excellence® are re-analyzed each time the study is conducted.
Key Drivers® are not necessarily areas in which your organization is performing well or poorly, but simply areas that have the greatest influence on physicians’ overall perceptions. Key Drivers, then, are best understood as aspects that truly separate an environment that simply meets physician expectations and an environment that exceeds those expectations.
Key Drivers® are determined using one of two statistical analyses, either Regression or Discriminant Analysis, depending on the quantity of data. The key difference between a regression and a discriminant analysis is that the regression analysis considers all responses from physicians (“Excellent, Very Good, Good, Fair, and Poor), while the discriminant analysis considers only the “Excellent” and “Very Good” responses. In other words, the discriminant analysis identifies which issues are most influential for physicians to rate the question as “Excellent” versus “Very Good.”
PRC runs the Key Driver® analysis at two levels:
- Overall Key Drivers: For the two overall areas – Quality of Care and Place to Practice Medicine – PRC runs the Key Driver analysis to discern which three of the Service Areas are driving these overall measures. In this type of analysis, the dependent variable is the Quality of Care or Place to Practice Medicine question, and the independent variables are the overall questions for each service area. It reports the Key Drivers® in order of importance (i.e. #1 Key Driver impacts the overall measure more than the #2 Key Driver, which impacts the overall measure more than the #3 Key Driver).
- Service Area Key Drivers: For each of the service areas (e.g., Pathology, Administration, Patient Safety, etc.), the Key Driver analysis determines which one of the specific questions drives the perceptions of that service area. Here, the dependent variable is the overall question for the service area and the independent variables are the individual questions that concern that service area.
In this example, the three Key Drivers for Quality of Care are Patient Safety, Nursing Care, and Surgical Services. The Key Driver for Patient Safety is Initiatives to Improve Patient Care Relative to Safety Issues; the Key Driver for Nursing Care is Care/Treatment of Patients; and the Key Driver for Surgical Services is Surgical Equipment. Remember, only surgeons are asked about the individual questions for Surgical Services, so the Key Driver for this area is important to surgeons, not necessarily the broader physician population.
How do I look at the results by specialty?
In the PowerPoint presentation provided to your organization, you can see how physicians responded to the Key Drivers of Excellence® questions, segmented by physician specialty. If a specialty had less than 5 doctors answer that question, it will not be segmented and will appear only in the bar that includes all of the physicians.
This example shows how different specialties (Anesthesiology, Radiology, OB/Gyn, Pediatrics, General Surgery, Emergency Medicine, and Urology) feel about Initiatives to Improve Patient Care Relative to Safety Issues. This graph is representative of what you might see in your results – it displays varying degrees of perceptions of a service area based on the specialty of the physician. Here, Anesthesiology is rating Initiatives to Improve Patient Care Relative to Safety Issues so highly that it ranks at the 100th Excellent Percentile. At the other end, Urology ranks at the 0 Excellent Percentile ranking. This, however, does not necessarily indicate that 0% of Urologists answered “Excellent” to the question. It also does not necessarily indicate that Urologists believe Initiatives to Improve Patient Care Relative to Safety Issues is a problem. Remember, if all physicians rate something as “Very Good,” the ranking is 0.
To see additional breakdowns by physician, please contact firstname.lastname@example.org.
What does “medical records,” “safety,” “competency,” etc. mean?
PRC asks physicians the questions believed to be most important to physicians to point you in the right direction when it comes to building relationships with physicians. The questions PRC uses to measure physician perceptions are deliberately general. To respect physicians’ time, the study gathers perceptions on the most important issues to your physicians. (PRC cannot ask physicians every question that may be important to physicians and expect physicians to take the time out of patient care to answer them.) Results are merely the beginning of the conversation, not the end. The survey results help you understand how physicians feel about the most important issues and help shape conversations to dig down into improvements needed and opportunities available.
The best way to learn what a question means to YOUR physicians or how they are interpreting a question is to talk to them. Concepts such as “safety” can vary depending on the type of service being delivered, the facility, or even the expectations and past experiences of the physicians.
Leaders mistakenly assume a low ranking on a “competency” question means physicians are stating that service area is “incompetent.” In fact, many time physicians are merely rating that service area as “Very Good.” The key, then, is to transform perceptions not from negative to positive, but from neutral to positive.
Why are some service areas harder to achieve a higher ranking in than others?
The normative database (the scores your hospital is compared to) which is used to determine rankings is different for each service area. For some service areas, 70% of physicians need to respond “Excellent” to be ranked at the 90th percentile; for other service areas, only 40% of physicians need to respond “Excellent” to be ranked at the 90th percentile.
Remember, only physicians that respond “Excellent” to the question are considered when determining rankings.
Some service areas, like Anesthesiology, are very competitive. In highly competitive service areas, it takes a large percentage of physicians responding “Excellent” to obtain a high percentile ranking. Other service areas, like Administration, fall at the other end of the spectrum, meaning it takes a much smaller percentage of physicians responding “Excellent” to obtain a high percentile ranking.
PRC’s normative databases are updated on a yearly basis. Requirements to achieve the 50th or 90th percentile this year are different than last year and will be different next year. Most of the databases continue to improve, meaning that it takes more physicians responding “Excellent” to achieve a high ranking, with the exception of Patient Safety. The norm for this service area has been gradually declining. A breakout of responses for this question reveals it is typically not an area where physicians are dissatisfied and answer “Fair” or “Poor.” Instead, many physicians are simply responding “Good” or “Very Good.” Physicians are increasingly aware of safety issues and see potential for improvement, but do not necessarily classify hospitals as “unsafe.” This explains why, if this is a repeat study for your hospital, you may find that the percentage of physicians responding “Excellent” to the overall safety question went down, and yet the ranking increased.