Pilot Study of Kano “Attractive Quality” Techniques to Identify Change in Emergency Department Patient Experience

Bellamkonda, Venkatesh R.; Kumar, Rajan; Scanlan-Hanson, Lori N.; Hess, Jennifer J.; Hellmich, Thomas; Bellamkonda, Erica; Campbell, Ronna L.; Hess, Erik P.; Nestler, David M.

doi:10.1016/j.annemergmed.2016.02.005

Cited by 9 publications

(19 citation statements)

References 11 publications

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“…Disadvantages of the Kano questionnaire are its length and requirement of time and commitment on the part of the respondents. More recently, investigators from Mayo Clinic 11 utilized a novel strategy of using only 1 question per respondent (of 4 possible) regarding the effects of 4 proposed interventions on patient perception. They had an 88% response rate for this survey (158 of 180).…”

Section: Discussionmentioning

confidence: 99%

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Identification of Critical to Quality Elements for Intensive Care Rounds by Kano Analysis

Tripathi

Henrekin

Read

et al. 2017

Pediatric Quality &Amp; Safety

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Background:Pediatric cardiac intensive care unit rounds require high levels of efficiency in data transfer and decision making to achieve optimal performance. Traditional survey methods do not discriminate and prioritize effectively the elements of rounds essential to a provider. In this study, we describe our experience with a novel survey method (Kano analysis) to assess customers’ (surgeons, intensivists, cardiologists, advanced practice nurses, and nurses) requirements from rounds.Methods:A 26-point survey divided into 3 domains (presentation, decision, and process elements) was conducted among Pediatric Intensive Care Unit (PICU) providers. Based on the survey, attractive, must be, performance, indifferent, and reverse categories were identified using methods described in the literature. Average satisfaction and dissatisfaction coefficients and percentages of attractive and mandatory elements in subgroups were compared. Results from the quantitative analysis were charted on a categorization plane.Results:The survey was returned by all providers with 96% valid responses. The highest satisfaction coefficient in the presentation domain was for “one line statement about the patient” (0.76), in the decision domain “rhythm/anti-arrhythmics” (0.54), and in the process domain “reformatting presentation script” (0.77). The highest dissatisfaction gradients were for “overnight events” (-0.91), “rhythm/anti-arrhythmics” (-0.71), and “asking families to join rounds” (-0.49). Among the 5 subgroups, surgeons required the largest percentage of items as mandatory or attractive and had the highest dissatisfaction coefficients in all 3 categories.Conclusion:Kano survey can provide rapid and precise actionable data to restructure a new process. Further research potentially also involving patients and families in the Kano survey may provide insight on patient-centered care models.

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Section: Discussionmentioning

confidence: 99%

“…Kano’s model has been previously used in the manufacturing industry 8 and more recently in health care. 9 – 11 This article describes our experience with design and implementation of a Kano survey and analysis to identify “customer” requirements from the rounding process.…”

Section: Introductionmentioning

confidence: 99%

Identification of Critical to Quality Elements for Intensive Care Rounds by Kano Analysis

Tripathi

Henrekin

Read

et al. 2017

Pediatric Quality &Amp; Safety

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“…To better evaluate priorities for development and evaluation, the quality improvement team used the Kano evaluation model to better categorize features as ‘Must-Have,’ ‘Attractive,’ ‘Indifferent,’ ‘Questionable,’ ‘Reverse,’ or ‘One-Dimensional’ (Fig. 3 ) [ 12 ]. Due to the small sample size of users and high degree of agreement, further calculation of satisfaction and dissatisfaction coefficients were not deemed necessary.…”

Section: Methodsmentioning

confidence: 99%

“…First, the six individuals who would use the dashboard (MS, MLS, KP, AT, GB, and BD) were (Fig. 3) [12]. Due to the small sample size of users and high degree of agreement, further calculation of satisfaction and dissatisfaction coefficients were not deemed necessary.…”

Section: Plan-do-study-act Cyclesmentioning

confidence: 99%

Development and implementation of a Telenephrology dashboard for active surveillance of kidney disease: a quality improvement project

et al. 2020

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Background Kidney disease accounts for more than 49 billion dollars in healthcare expenditures annually. Early detection and intervention may reduce the burden of disease. We describe a quality improvement project to develop a telenephrology dashboard that proactively monitors kidney disease. Methods One hundred eighty-four thousands Veterans within the Iowa City Veterans Affairs Health Care System were eligible for telenephrology consultation. The dashboard accessed the charts of 53,085 Veterans at risk for kidney disease. We utilized Lean-Six Sigma tools and principles and the Define-Measure-Analyze-Improve-Control Framework to develop and deploy a telenephrology dashboard in 4 community-based outpatient clinics (CBOCs). The primary measure was the number of days to complete consultation. Secondary measures included number of electronic consultations per month, distance and cost of Veteran travel saved, and number of steps for completion of consult. Results The data of 1384 Veterans at the 4 CBOCs were analyzed by the telenephrology dashboard, of which 459 generated telenephrology consults. The number of days to complete any type of consultation was unchanged (48.9 days in 2019, compared to 41.6 days in 2017). The average Veteran saved between $21.60 to $63.90 per trip to Iowa City. Between March 2019 and August 2019, there were 27.3 telenephrology consults per month. The number of steps needed to complete the consult request was decreased from 13 to 9. Conclusions Utilization of the telenephrology dashboard system contributed to an increase in consultations completed through electronic means without decreasing face-to-face consults. Electronic consults now outnumber traditional face-to-face consultations at our institution. Telenephrology consultation improved early detection and identification of kidney disease and saved time and costs for Veterans in travel, but did not decrease the average number of days to complete consultation requests.

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“…This approach on average added 3 to 4 minutes to the consultation time, but the range was wide. In the context of ED care, investing this time may not always be feasible given concurrent high-acuity patients, but doing so when possible provides the opportunity to personalize care, improve the patient experience of and satisfaction with care, 22 and potentially obviate an overnight observation unit stay, 9 thus decreasing the downstream workload of the entire clinical care team. Clinicians, on average, correctly used 6 of 10 key features of conversation tools without extensive training.…”

Section: Sdm: From Axioms To Mythsmentioning

confidence: 99%

What Is Shared Decision Making? (and What It Is Not)

Kunneman

Montori

Castañeda-Guarderas

et al. 2016

Academic Emergency Medicine

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118

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Pilot Study of Kano “Attractive Quality” Techniques to Identify Change in Emergency Department Patient Experience

Cited by 9 publications

References 11 publications

Identification of Critical to Quality Elements for Intensive Care Rounds by Kano Analysis

Identification of Critical to Quality Elements for Intensive Care Rounds by Kano Analysis

Development and implementation of a Telenephrology dashboard for active surveillance of kidney disease: a quality improvement project

What Is Shared Decision Making? (and What It Is Not)

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