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This blog focuses on the latest products, devices, and ideas to improve emergency medicine practice. Brief news releases and photographs are welcome, and must be submitted electronically. Images must be 300 dpi, in tiff, jpeg, or eps format, and at least 4“x4” in size. Please send information to [email protected].

Tuesday, March 17, 2015

An Electronic Survey Methodology

Emergency Medicine News spoke with Jeff Strickler, RN, the associate vice president of University of North Carolina (UNC) hospitals about Bivarus, an electronic survey methodology. He discussed why UNC’s ED made the switch, how it works, and the differences between Bivarus and paper-based survey tools.

Why did you decide to try this analytics company? Did it have anything to do with Press Ganey dissatisfaction?

The satisfaction with Press Ganey is maybe a strong word but I think it had a lot to do with the limitations related to what was our current customer service survey methodology, which happened to be Press Ganey. But Press Ganey’s not much different than any of the other companies that would’ve been out there. They all have the same limitations, particularly as it relates to emergency departments. We had a very small response rate. The only people that are getting surveys are those patients that are discharged from the emergency department. So for our emergency department, which is admitting 30 percent of our patients, we felt like we were losing a significant voice of people that were not just admitted but tend to be the more severely ill or injured and able to describe their patient experience. So we really kinda felt like that was, you know, missing.


Can you briefly explain how Bivarus works?

So, the person only gets a 10-question survey, so you don’t get the survey fatigue that you get from many of the traditional paper-based survey tools or like HCAPS. So there’re only 10 questions, but those 10 questions are dynamic. They change for each patient. So, there’s a 100-question bank and 10 different categories looking at various things in care, so like, safety, looking at processes of care, looking at communication, etc. The other traditional tools also allow people to write comments but the thing about Bivarus, because it’s electronic and research bears this out, that people tend to be more responsive in electronic survey methodologies versus paper-based tools, and that’s been our experience as well. We receive a lot of comments. So, we have a provider scorecard that we’re able to give to our providers where they can look at what their overall scores are across all of those questions.


In what ways did using Bivarus and achieving such positive results improve patient safety?

During a 12-month period that we looked at it, we noted from the Bivarus review, 242 safety-related comments. And again, it’s key to understand this wasn’t so much questions as much as these were comments. And when those 242 cases were drilled down, we discovered 12 adverse events, 40 near misses, ultimately of which 31 were further evaluated to be preventable. There 23 medical errors with minimal risk, and 167 general safety-related issues. Then we looked at that number, particularly of the 52 adverse events/near misses, and found that only 10 percent of those were actually found in an existing safety event reporting system that our hospital and most hospitals have. So what really kind of dawned upon us was using Bivarus and the patient experience as a patient reportable safety occurrence tool and it enables us to really drill down and make positive change.

          Our interests related to the limitations of the paper-based tools: We think that using electronic survey methodology is a valid way to go now and give them the wide penetration of electronic access. We have found that the representative group from the Bivarus responders to be very similar to the overall ED population. So, we’re not perceiving that there is a statistically significant population that’s being missed by using electronic survey methodology.


To listen to the interview in its entirety:


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