Read the article: "The Changing Landscape", which is found in the "Short Term Stay" attachment. Post to the discussion board your opinion of what you read in the "Short Term Stay".

In the past 10 years, this nation has seen a much greater range of options for seniors in need of care and services. As a result, the number of shortstay admissionsthose staying 30 days or lessis growing at a rapid rate. There are, at any one time, about 1.5 million residents and patients in nursing facilities across the country. The majority (80%) of these are the traditional long term care resident with an average length of stay of approximately one year. At the same time, however, there are 2.5 million short-term stays of fewer than 30 days in skilled nursing facilities in a year. This illustrates the shifting balance toward the short-term patient and should highlight the importance of this population to the senior care profession. WHAT IS THE SHORT-STAY PATIENT LOOKING FOR? The short-stay patient comes to the nursing home with very different goals and much different expectations. Perhaps she is looking for rehabilitation in order to return to her independent, productive life. Or she may simply need 24- hour nursing care to recuperate from surgery or an illness. Her experience during that physically and emotionally challenging period will be the story she shares with her family, friends, and neighbors. It should be a story that the provider can be proud of. It should be a story of loyalty. It should be a story that leaves the listener feeling confident that, if the need arises, there are caring, professional people ready and willing to provide the care she deserves. In If Disney Ran Your Hospital, author Fred Lee said, Patients judge their experience by the way they are treated as a person, not by the way they are treated for their disease. Providers need to take a critical look at the consumer experience. Are the services being provided consistent with the treatment of the patient as a person, or is the focus more on the processes of care? Providing a level of service that will engender loyalty implies understanding patient needs, acting on them, and treating the patient as a person.While providers must continue to listen to the long-term resident, it is now critical that they listen clearly to the expectations of the short-stay patient. As a profession, we have to take a hard look at our service to these patients.We need a very detailed understanding of the patients, and their familys, wants, needs, and expectations.We need to have a reliable, valid way to measure our success in meeting them. WHAT DO WE KNOW ABOUT THE SHORT-STAY PATIENT? Acustomer satisfaction survey, designed by My InnerView researchers, specifically measures the needs of the short-stay patient. This instrument differs from standard long term care surveys in that it addresses the discharge and admission process, setting and meeting rehabilitation THE CHANGING LANDSCAPE from long term care to short-term stay What are your short-stay customers saying? goals, and assistance with services and equipment needed upon discharge. In 2007,My InnerView used this survey to gather data from more than 38,000 patients soon after their discharge from a nursing facility. Ninety-one percent (91%) of the respondents had stays of less than three months. The short-stay population differs in important ways from longterm residents. Short-stay patients are significantly younger, only 46% are above the age of 80, whereas 68% of long-stay patients are over 80. The short-term patient is much less likely to comparison shop than other residents, relying on recommendations from others to make their selection. Short-term patients are also visited much more often than longterm residents. Almost three-quarters (73%) of them were visited daily, as compared with 36% of the long-term-stay residents. By a significant majority, shortstay patients are satisfied with their experience with the nursing facility. Seventy-seven percent (77%) expressed overall satisfaction with their stay, while 40% would recommend their facility as Excellent to others. Satisfaction results were similar comparing Quality of Life (82% Satisfied), Quality of Care (80%), and Quality of Service (79%) domains. The area in which respondents have the strongest Excellent response is Quality of Care, at 43%. In the other domains, respondents are more likely to rate the service as Good than as Excellent. This is consistent with the patients focus on healing and rehabilitation. Global satisfaction with the facility is actually lower for the short-stay patient than with the long term care resident (77% vs. 82%). Possible explanations for this include the very different expectations that a short-term stay patient has when coming to the facility. The difference underscores the importance of understanding this populations unique needs. The short-stay survey evaluates the perceived needs of the patients using a correlation analysis. Every item on the survey is correlated with the extent to which the patient would recommend the facility to others as a place to receive care. The items with the highest correlations are considered to be the most important to the patient. Items of importance to shortstay patients include the concern and competency of staff, the ability of the facility to meet their choices and preferences, the responsiveness of management, and the quality of both medical and licensed nursing care. The areas in which the patients are most pleased include the quality of rehabilitation therapy, the respectfulness and care demonstrated by staff to patients and visitors, and the quality of both licensed nursing and certified nurse assistant care. WHAT WILL THE SHORTSTAY PATIENT SAY TO FRIENDS ABOUT HER EXPERIENCE? Short-term stay patients bring a unique perspective. Unlike the family members of long-term residents, these patients have recently experienced these services directly and will be asked repeatedly to share the experience. That is why the ques- 2 My InnerView Inc. May 2008 Patients reserve their good word of mouth and loyalty for hospitals where they feel their needs were anticipated and met by a courteous, caring staff. Fred Lee < 60 6% < 60 9% 6079 26% 80+ 68% 6079 45% 80+ 46% 3+ 9% Only 1 14% None 36% Only 1 11% None 67% Two 13% Two 24% 3+ 26% 3% Once week or more 47% Daily 36% Daily 73% Once month or more 9% Once week or more 23% CHARACTERISTICS OF SHORT-STAY PATIENT CONSIDERABLY YOUNGER. Only 46% of short-stay patients are over age 80, compared with 68% in long term care. LONG-TERM SHORT-STAY LESS LIKELY TO COMPARISON SHOP. In short-stay, only 33% visit at least one facility, compared to 64% in long term care. VISITED MORE FREQUENTLY. In short-stay, 73% of patients are visited daily, compared with 36% in long term care. Source: My InnerView Inc. LONG-TERM SHORT-STAY LONG-TERM SHORT-STAY tion, What is your recommendation of this facility to others? is a cornerstone of any good customer satisfaction instrument. The willingness to recommend is a measure of customer loyalty.We have all heard it said that a satisfied customer will tell three people, an unhappy customer will tell 10 people, but a loyal customer will tell everyone who will listen. One way to earn loyalty is to change the way we think about the customer experience.With the 30-day length of stay, what was once an annual admission has now become 12 different admissions per year. The opportunity to develop a relationship with the patient and ability to create a loyal customer has just gotten more complicated by a significant factor. Not only is there less time to interact with, get to know, and earn the trust of the short-stay patient, but a much greater percentage of the time spent with that patient is taken up with the processes of care. At the same time, it is important to consider how the short-term patients needs differ from those of the traditional resident. The short-stay patient is focused on healing and returning to his or her prior place of residence. So it is critically important that we provide the high-quality clinical and rehabilitative care, but not at the expense of the customer experience. HOW CAN WE TURN THE SHORT-STAY PATIENT INTO A LOYAL CUSTOMER? For the provider interested in earning the loyalty of the customer, mere satisfaction is not enough. The provider must focus on providing a level of service that their customers will rate as Excellent, which is a much more important indicator of loyalty than Good. The all-important question is, What is your recommendation of this facility to others? but that recommendation is going to be based on the elements of service that are found throughout the survey. Providers have to carefully review their opportunities with all elements of service and work to improve those in which patients rate them as less than excellent. Admitting 12 patients per year where, in the past, providers admitted one, we see an environment where the provider is focused on the admission process and the discharge process rather than the customer experience. Providers who only focus on the process will lose the opportunity to have a personal relationship with their patients. Earning the loyalty of this important group will pay dividends to the skilled nursing provider in the future in terms of an enhanced reputation in the community and an increased ability to attract short-stay admissions. As the trend to shorter stays, more acute patients, and more admissions and discharges continues to grow, providers reliance on this population for their success becomes ever more important. Word-of-mouth recommendations can be your most powerful form of advertising. According to McKinsey & Co., more than twothirds of economic activity is driven by word-of-mouth recommendations and shared opinions. Your patients recommendations are driven by satisfaction and loyalty. Loyalty is earned by anticipating and meeting the needs of the customer. My InnerView Inc. May 2008 3 Loyalty A loyal customer: n Will give you the benefit of the doubt; n Will use you again; n Will recommend you to others; and n Will enhance your reputation in the community. 31% 15% 3% EXCELLENT GOOD FAIR POOR 51% 36% 13% 10% EXCELLENT GOOD FAIR POOR 41% 34% 13% 5% EXCELLENT GOOD FAIR POOR 48% 40% 11% 12% EXCELLENT GOOD FAIR POOR 38% 39% 13% 6% EXC GOOD FAIR POOR 43% 43% 13% 7% EXC GOOD FAIR POOR 37% 39% 14% 8% EXC GOOD FAIR POOR 40% OVERALL SATISFACTION. Long-stay patients gave more Excellent or Good ratings (82%), compared with short-stay residents (77%). GLOBAL SATISFACTION RECOMMENDATION TO OTHERS. Short-stay patients willingness to recommend the facility to others (78%) was lower than long-term residents (82%). SATISFACTION OF SHORT-STAY PATIENT BY DOMAIN QUALITY OF LIFE QUALITY OF CARE QUALITY OF SERVICE Source: My InnerView Inc. LONG-TERM SHORT-STAY LONG-TERM SHORT-STAY This article was written by BRAD SHIVERICK, CPHQ, Chief Quality Officer for My InnerView. For more information, visit www. myinnerview.com or