What We Do and How We Do It

Excellence 24/7, our focus and our specialty is Ambulatory Care, more specifically, Ambulatory Care pre-appointment.

Through our work together, Excellence 24/7 clients:

• Increase patient satisfaction
• Reduce appointment no-shows
• Increase completion rates
• Increase revenues and operating income
• Strengthen team engagement

A simple version of the outreach process is presented in the following flowchart:

Below you will find:

• A more detailed description of the process
• Patient comments relating to the process
• Client comments relating to the process
• Client testimonials
• A sampling of the results experienced by client organizations
• Press coverage of the Excellence 24/7 Patient Outreach process

The Process

The basic Excellence 24/7 Patient Outreach process is as follows:

• Client securely transfers data to Excellence 24/7 via a safe location on the internet, generally three days prior to appointment, or as desired by client
• Excellence 24/7 accesses the supplied data, re-formats as may be required and subsequently launches the outreach for the day in question
• The outreach is launched to patients via e-mail that is delivered from the appropriate e-mail address within domain of client
• The body of the e-mail will contain such specifics as:
• Date and time of appointment
• Location of appointment
• Google Maps link or similar which makes driving directions, driving time, etc. conveniently available to the patient
• The e-mail may include study specific preparation instructions
• Topical subjects are addressed in the body of the e-mail, i.e. currently we address COVID-19 screening and safety precautions as specifically defined by client
• Link to the online outreach document
• Explanation of what can be done via the online outreach document

Based on client preference we do as well support the e-mail launch with an SMS. A message such as the following may be sent to the patient several minutes after the e-mail is sent in order to increase the probability that the patient will view the e-mail: “This is a friendly reminder for your upcoming Radiology/Imaging exam at XXX on #day_date#. Please check your email for a message with additional details.”

Patients following the included unique URL will:

• Be offered a choice of which language they would like to proceed in
• Presented all appropriate data for the scheduled study as has been included in the unique URL
• Asked to:

1. Confirm the appointment
2. Reschedule the appointment
3. Cancel the appointment
4. Share any billing or insurance questions they may have
5. Submit any questions or requests they may have

Based upon the selection made by the patient from the above, the patient will be directed to:

An appropriate thank you page if they chose to reschedule or cancel the appointment or if they indicated they had a question on billing or insurance

If the patient chooses to confirm the appointment or if they choose to submit a question or request, they are then provided the opportunity to submit questions/requests directly to the healthcare provider. They also are provided the option to visit an on line site to view a description of their scheduled study, i.e.:

Upon submission of the form, patients receive by e-mail:

• A PDF of their submission
• A PDF of appropriate preparation instructions for their scheduled study

Upon submission of the form, client receives by e-mail:

• A link to the patient submission sharing complete details of the patient request

We would be delighted to present you with a live document to test and use as a patient would enabling you to experience the process as the patient experiences. Additionally, participating in in the test will allow you to experience firsthand the variety of tools available to our clients.

Post Appointment Inclusions

As stated above, the focus of our work is pre-appointment. However, the pre-appointment outreach also enables us to provide a unique post appointment feedback program. Utilizing the same data that we receive to launch the pre-appointment outreach we can reach out to patients post appointment. Generally, the post appointment outreach is kept very simple, asking just several questions.

• Did your experience at XYZ Healthcare Provider exceed, meet or fail to meet your expectations?
• Please share any comments or observation you have of your experience at XYZ Healthcare Provider.
• Did you encounter a “Star Performer” on the XYZ Healthcare Provider team, an individual that provided exceptional service, during your visit? If so, please let us know so we can recognize their efforts. (If you met more than one, please mention them all!)

The post appointment outreach will ideally be conducted at end of day on day of appointment. This part of the process is extremely valuable in identifying strengths and weaknesses within the client organization as patients are submitting their input just hours after the completion of the study, everything is still fresh in their mind. Additionally, the ability to instantly recognize employees that have made a positive impact on the patient can be a very powerful motivating factor.

A few examples of the types of data generated by this post appointment effort are as follows:

Several Comments on the Excellence 24/7 Outreach from Patients

• The Pre-exam e-mails are super helpful for confirming and getting any special instructions.
• The communication is great. I always know when and where I need to be and any preparations that are needed.
• Email and portal availability improve access to staff and records. As a patient from out-of-state this is most useful and appreciated.
• I appreciated all communications regarding this appointment They kept me informed and prepared before-hand; and I like that I’m given the chance to give my feedback.
• I feel like the communication has always been good, but I like the extra steps now with the emails for checking in that I received with these appointments. There was a different level of streamlined info for the appointments.
• Great! And a wonderful display of accountability on your part.
• I love the 1-page instruction sheet. It is amazing.
• The emails were very informative. Kept me updated on everything I needed. Please continue with emails, Thank you!

Several Comments on the Excellence 24/7 Outreach from Clients

• “Our guests are much more relaxed and less stressed coming to a procedure that they have been able to have all concerns regarding the unknown addressed prior to arrival. In radiology, the term '24/7' has become simply part of our vernacular. The staff knows that excellence is expected and that is the goal to strive for when customer service is the topic.”
• "Parents and guardians love this system! It helps that they can just submit a question and we are personally calling them back to answer questions and help to alleviate some anxiety about the exam, prior to arriving here for the exam."
• “The ability to handle issues and concerns prior to the patient's arrival is a tremendous help for both the patient as well as the staff. The ability to give that added 'we really care about you' is hard to measure. I think we have experienced an added bonus by having the modality-specific issues routed to the individual areas.”
• “The very culture of our radiology department has been changed. We have gotten to the point now that patients will say I had questions, but I knew someone would reach out to us before our visit, so I was completely prepared for the exam. Which is amazing because that tells me that not only have we changed the culture of our department, but that of our patient’s expectations as well.”
• “Quantitatively we experienced customer satisfaction scores higher than we had ever seen. The scores continued a steady upward trend month after month. But the element that can't so easily be measured, that intangible special something that you don't see on graphs was present too. There is a real feel of an entire culture shift. The appreciation shown by the parents was off the charts. People reported that they felt that they were being genuinely cared for.”
• “We continue to receive good reviews from patients on the email reminders, they're welcome and very helpful according to the patients. We continue to refine the scripts and adding other languages. The post exam surveys are highly successful. Very effective.”

Results from the Excellence 24/7 Process as Reported by Our Clients

UPMC's Children's Hospital of Pittsburgh, Radiology/Imaging

As reported by Kristen Harman MHA, R.T.(R)(MR) MRSO (MRSC™)

The radiology department saw a change in Press Ganey scores only four months after implementing the Excellence 24/7 Patient Outreach Process (E24/7).

• Reduced MRI Cancellations through scheduling and clinical collaboration - MRI (Main) OP cancellations decreased by 10.06% since prior year; MRI (South Satellite) OP cancellations decreased by 12.81% since prior year
• 438 Star Performers named by Radiology Leadership resulting from Excellence 24/7 feedback as of September! Some employees were named multiple times – Great Staff recognition!
• Increased patient satisfaction - Met/Exceeded Patient Expectations 90.21% in Excellence 24/7 Patient Feedback responses (1,087 positive / 1,205 overall responses)

Testimonial as submitted by UPMC's Children's Hospital of Pittsburgh

How has Excellence 24/7 impacted our department? Ours is a radiology department at one of America's top 10 pediatric hospitals. So, we must be doing a pretty good job, right? Well we were, but we could, of course, do better. But it wasn't until we began a trial with Excellence 24/7 that we saw just how much better our radiology department could be and how much more we could do to serve our patients. Quantitatively we experienced customer satisfaction scores higher than we had ever seen. The scores continued a steady upward trend month after month. But the element that can't so easily be measured, that intangible special something that you don't see on graphs was present too. There is a real feel of an entire culture shift. The appreciation shown by the parents was off the charts. People reported that they felt that they were being genuinely cared for. What were we doing differently? By utilizing Excellence 24/7's pre-surveys we were able to give our scheduled out patients the opportunity to ask questions and address concerns before they arrived for their visit. This was also liberating for the clinicians; we could know of a patient's special needs and requests before he or she arrived and prepare accordingly. Regarding the post-surveys, no longer did we need to wait for 4--6 weeks to know is we had fallen below a guest's expectations. We could know within minutes of their procedure's completion. We could then reach out to the patient's family and receive invaluable feedback from them. We could then make it right or change our process if needed. Many of the post survey concerns that have been brought to our attention have had a rippling effect and many patients have benefited from just one person bringing something to our attention. Our motto has become "we can't fix it, if we don't know it's broken..." Excellence 24/7 has been a wonderful tool to help assist with our customer's experience.

—Helen Bradley RT (R) (VI) ARRT, President PSRT, Lead Technologist, Children's Hospital of Pittsburgh of UPMC

As reported by Eric B. Lo Monaco, Director of Diagnostic and Interventional Radiology

According to information published by Diagnostic Imaging in October 2016, the overall quality rating of the radiology department improved as follows: (Updated with 2017 data as of February 2018)

Per the Society for Healthcare Strategy & Market Development, "On a national scale, the Radiology Department went from the 69th percentile in 2016 to the 90th percentile in 2017 among hospitals receiving patient satisfaction ratings of 'excellent' for 'overall quality.' For 2017, 83.08 percent of people surveyed rated the overall quality of the departments surveyed as 'excellent' and another 14 percent rated it as either 'good' or 'very good.'”

Improved Completion Rates

Community Hospital has been operating with the full implementation of the outpatient pre-engagement process for US, CT, and MRI across three locations for 18 months. With a previous no-show rate of 3-5%, the number of no shows is now almost 0%. (Included are patients that arrived for the scheduled procedure but were not able to complete based on a variety of factors.)

Significant not only to achieve operational efficiency but for patient satisfaction and return on investment.

Client Evaluations of Our Services

As a course of business, we reach out to our clients and their staff that work directly with our service on an annual basis to gather feedback and to ascertain where we may improve our offerings. The following charts present he findings of this year’s outreach from two of our major clients.

Press Room

Achieving 24/7 Excellence—as Measured by HCAHPS

Excellence 24/7 as presented on www.radiologybusiness.com

Excellence 24/7 (E 24-7), which began in the radiology department, is based on QR bar codes displayed throughout the hospital to initiate and manage real-time, patient-initiated electronic communication at a cost of $1,500 per month. Using a free scanning app and a smart device, the scanned bar code triggers one question: “Please tell us about your experience with Community Hospital of the Monterey Peninsula.”

Capture Real-time Patient Experience Feedback in Imaging

Excellence 24/7 as presented on Diagnostic Imaging

Real-time Experience Tools Can be Individualized, Straightforward, and Cost Effective

To elevate the quality of imaging services, practices need to get the conversation started but with the right tools, on an individual-basis, and at a time that is most comfortable for the patient to discuss their experience. In addition, organizations need to be willing to act upon what those conversations reveal.

LoMonaco partnered with a consultant business focused on hospitality and developed a QR code system called Excellence 24/7 that obtains a singular response at a monthly cost of $3,000 per month.

Early Action Boosts Patient Satisfaction

Excellence 24/7 as presented on Imaging3.0

Key Takeaways:

• The Community Hospital of Monterey Peninsula (CHOMP) developed a system to receive real-time feedback from patients that allows staff to address patient needs immediately.

• Following the success of the real-time feedback program, the radiology department developed an appointment reminder email that gives patients pre-exam information and allows them to ask specific questions before they arrive for their appointments.

• By anticipating and addressing issues early and recognizing employees for positive responses, the radiology department has received “excellent” ratings from 90 percent of patients and no-show rates have virtually evaporated in the radiology department.

How One Hospital Repositioned Their Brand Through Consumer Strategies

Excellence 24/7 as presented on blr|further

Mr. LoMonaco’s solution was based on the lightning-fast speed with which dissatisfied patients communicated with each other: Excellence 24/7, a program designed to rectify challenges in near-real-time, while patients are still in the building.

Excellence 24/7

• Instant communication initiated by the patient
• Anonymity for the patient
• Instant service recovery opportunities while the patient is still in the building
• Instant rewards for staff who exceed expectations
• Instant concerns are documented to share with staff for corrective action

How to Improve Patient Experience in Real Time

Excellence 24/7 as presented on HealthImaging

Patient experience is very serious to LoMonaco, who works at the Community Hospital of the Monterey Peninsula in Monterey, Calif., as the director of diagnostic and interventional radiology. And he wanted to take it to the next level.

In his presentation, “Achieving Excellence 24/7—As Measured by the Human Experience,” LoMonaco shared the story of how he transformed patient experience at his facility, and others, using a straightforward approach that bypassed pricey consultants and extravagant company-wide training sessions.

How did he do it? By developing a 24/7 hotline designed for patients to reach out with questions and concerns. One thing that made LoMonaco’s program different from previous patient surveys was that patients were asked about their experience while still in the facility. Posters were placed all over the radiology department, giving patients a QR code they could scan, a number they could call, or an e-mail address they could reach out to with their phone. Their feedback would then be sent directly to LoMonaco, who took action immediately.

Patient-Centered Radiology Strategies: How Radiologists Can Demonstrate Value By Putting Patients First

Excellence 24/7 as presented on Radiology Business

“Empowering patients—and employees, for that matter—to communicate with us in real time has been and continues to be a game-changer when it comes to raising patient satisfaction levels,” LoMonaco says. “It’s easy to turn a situation around while the patient is still at the hospital. Once the person is out the door, it becomes much more difficult.”

The hospital also sends emails to patients prior to their appointments. In addition to a “thank you” for choosing CHOMP for their imaging exams, these communications feature a link patients can click to convey any needs or questions they may have before the appointment. Other specifics provided in those messages include the location of the exam and what the co-pay will be, if there is one.

“Empowering patients to control their own experience is a cornerstone of patient-centric care, and this is just another method of empowerment,” LoMonaco says.

Using Consumer Insights to Improve the Patient Experience

Excellence 24/7 as presented on SPECTRUM | Society for Healthcare Strategy & Market Development

Learn how a California hospital is implementing consumer-oriented strategies to optimize the patient experience.

Many healthcare organizations are looking to develop advanced consumer knowledge and consumer-oriented strategies to optimize the patient experience. Other industries have long employed tools and techniques to better understand and reach consumers, and proactive hospitals and health systems are looking to those industries for valuable insights to meet rising consumer expectations.

Thank you very much for your consideration of Excellence 24/7