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Customers (Category 3) Listening to and engaging customers provides long-term marketplace success. At Sentara, our mission is to improve health every day with the purpose being to be the trusted partner to individuals and the community in their journey to health and well-being. In order to determine how we can best serve our patients; it is imperative we give our patients a voice in order determine what is important to them. Sentara prides ourselves with having people in our core values and we have committed that we will always listen and respond to you as well as keep you informed and involved. This is achieved through our various efforts to aid the customer. This category asks how you engage patients and other customers for long term marketplace ‐ success, including how you listen to them, serve, and exceed their expectations, build relationships with them, and enhance the customer experience. 3.1 Customer Listening Purpose The aim for customer listening is to capture meaningful information in order to exceed patient expectation ( Baldridge Criteria Commentary, 2023). Patient surveys are one way Sentara does this. The patient satisfaction survey is offered via email and SMS text message to selected Sentara Medical Group patients within a few days following their appointment. Patients are asked to complete the survey and provide comments to then be used to improve and enhance the care that is offered. At Sentara, we are committed to full transparency with our patients. Both positive and negative reviews are posted with a few minor exceptions ( Patient satisfaction surveys , n.d.). Along with Sentara’s own developed patient satisfaction survey, we also participate in the nationwide Centers for Medicare and Medicaid Services (CMS)

patient satisfaction survey. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey evaluates patient experiences with three broad goals of providing hospitals with information on patient experience, create incentives for hospitals to improve quality of care and most importantly provide consumers with information to help them make the best healthcare decisions ( Patient satisfaction , n.d.). Measurement, Analysis, and Knowledge Management (Category 4) Sentara is strategically focused on innovation and creating an extraordinary health experience for our patients and members. Sentara has been and continues to be a pillar in the community for pushing data-driven healthcare. We developed a system in which we began to understand the importance of delivering high reliable quality care with a consistent high rate of improvement across our entire health system. Through this process, Sentara has established four guiding principles:  Reduce variation in our clinical and operational processes by consistently implementing best practices  Prioritize the patient experience  Embed change across the entire continuum of care in all regions  Enhance culture and decision-making tools (Kern, 2021) Along with these four guiding principles, we overhauled the leadership structure with procedural decisions being made by a centralized clinical leadership council with representation from each hospital and division and leadership which now is executed in two directions, vertical and horizonal. This overhaul allows Sentara to operate more consistently with a true systemness approach to quality. Through this initiative, Sentara has been able to eliminate the

unintended variation that all the hospitals took from being scattered on the six key quality indicators to now being in the same quadrant which is no easy task for a large organization such as Sentara. Other successes from using our guiding principles and new high-performance leadership structure were:  Compared to 2015 baseline numbers, our improved clinical leadership structure helped lower readmissions by 13,075. Solutions focused on improving discharge medication adherence, ensuring post-discharge primary care visits within seven days and sending home heart-healthy diet information with patients when they were discharged.  Against baseline numbers, we recorded 196 fewer mortalities 30 days post-discharge in 2018.  Compared to baseline numbers, mortalities from sepsis decreased by 67. We used artificial intelligence that processed more than 4,000 data points to track patients before they got sepsis and intervened based on algorithms.  We reduced lengths of stay days by 16,000 over our baseline metrics (Kern, 2021) Along with the newly established guiding principles and high-performance leadership structure changes, Sentara also focuses on preventing errors through the use of the Serious Safety Event Rate (SSER). Sentara had an 80 percent decrease in serious safety event rates across its hospitals from 2003-2010. In-hospital mortality also declined at this time by 23 percent across seven Sentara hospitals. Through a collective effort of safety initiatives across the organization this was able to be accomplished. Those safety initiatives are: innovative technology such as the eICU telemonitoring system and barcoding technology for bedside medication verification; dedicated hospitalist physicians to care for inpatients and

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multidisciplinary teams for patient rounding in ICUs; and medication error prevention techniques, such as the use of unit-based clinical pharmacists and electronic clinical pharmacy alerts (McCarthy & Klein, 2011).

References McCarthy, D., & Klein, S. (2011). Sentara Healthcare: Making Patient Safety an Enduring Organizational Value. Commonwealth Fund , 8 . Kern, H. (2021, February 5). High performance design: How improving leadership structures dramatically improved clinical outcomes at Sentara Healthcare . Becker’s Hospital Review. https://www.beckershospitalreview.com/hospital-management-administration/ high-performance-design-how-improving-leadership-structures-dramatically-improved- clinical-outcomes-at-sentara-healthcare.html Patient satisfaction . Sentara. (n.d.). https://www.sentara.com/aboutus/quality-and-patient- safety/patient-satisfaction Patient satisfaction surveys & ratings . Sentara. (n.d.). https://www.sentara.com/Policies-and- Agreements/Patient-Guide-to-Patient-Satisfaction-Surveys-and-Ratings Baldrige Criteria Commentary (health care) . NIST. (2023, February 10). https://www.nist.gov/baldrige/baldrige-criteria-commentary-health-care

Tm Prjct

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