In October, Keck Medicine of USC sent out its first Pulse Survey to give employees an opportunity to provide anonymous feedback regarding their satisfaction with the organization, how well values are being upheld and to gauge awareness of key initiatives. The response was overwhelming.

One out of every four employees and faculty, 1,183 in all, responded with answers to the three questions included in this first online survey. Over 85 of these responses were from physicians. The turnout exceeded expectations, and the results were enlightening.

“We were also very pleased with the positive sentiment expressed through the responses to the survey,” said Tom Jackiewicz, senior vice president and chief executive officer of Keck Medicine of USC.

In answer to the question, “Overall, I am satisfied with the organization,” more than three-quarters of respondents said they tend to agree or strongly agree. Almost as many, 75.9 percent, responded positively to a question about whether we uphold one of our values: “We deliver quality health care through uncompromised service excellence.”

Additionally, 274 thoughtful comments were received, said Felipe Osorno, associate administrator of performance management at Keck Medicine of USC. Those comments either highlighted great successes in the organization or offered suggestions about how to further improve.

“The survey proved to be an innovative, nimble and dynamic way to understand the current pulse of the organization,” Osorno said. “We typically do employee surveys once a year and realized that frequency was just not enough in a quickly changing environment. This tool will allow us to listen to our employees and respond more effectively and quickly.”

Osorno highlighted five primary themes that emerged from the comments:

• Improve communication
• Leadership visibility and support during times of change
• Seek input from employees before change is implemented
• Fix specific operational and patient experience issues
• Department-specific workplace opportunities

“All senior leaders have reviewed every single comment in a lot of detail, and we are crafting a detailed action plan to ensure we respond to the common themes that arose,” Osorno said. “Showing change and responsiveness will be key to maintaining trust and engagement, ensuring our staff and faculty will continue to leverage the Pulse Survey to voice their opinions.”

The surveys will be a regular part of the organization’s efforts to improve. The next one is expected to launch Dec. 7, with a focus on further exploring some of the opportunities identified in the first survey, especially around communication and patient safety culture.

One of the survey questions has already led to a specific action. Three Town Halls took place in November to provide information about the R3 initiative, which seeks to streamline operations while maintaining the highest levels of quality and patient satisfaction. In the Pulse Survey, a third of the respondents said they wished they knew more about R3 or said they didn’t know anything at all about it.

“The Town Halls were very eye opening,” Osorno said. “Our staff and faculty want to be part of the change, to help in Keck Medicine of USC’s journey. They just wanted to be more informed — once you explain to them the R3 initiative and encourage frank dialogue and tough questions, folks want to jump on board. The question shifts from ‘What are you talking about?’ to ‘I have several ideas, where can we start?’”

The response to the Pulse Survey was vast, but it was also broadly based, with responses coming from throughout the organization. Facilities with the most employees, Keck Hospital of USC and USC Norris Cancer Hospital, had the most respondents, but a significant number of surveys originated elsewhere, including many from Soto offices, USC Verdugo Hills Hospital and the Alhambra business office.

The respondents themselves were also varied. The biggest percentage of responses came from nurses (22.1 percent), but significant percentages of the surveys came from attending and resident physicians, other clinicians, clinical support staff, administrative employees and other staff.

“We want to hear from everyone — we will not evolve as a health system until everyone is involved in improvement, and we understand what our starting point is,” Osorno said. “Hearing from such a wide variety of staff, and especially from physicians from every corner of our expanding health system, was very exciting.”

The Pulse Survey originated from the FY16 Operational Goal Deployment. As senior leaders were developing priorities for the fiscal year, developing a methodology for engagement was top of mind.

“The Pulse Survey rose to the top of the priorities; engaging our staff leveraging current technologies is fundamental to ensure our people are heard and on board to tackle all the challenges ahead of us,” Osorno explained. “Putting our employees and faculty first is essential to our success.”

Osorno sees the surveys as a key component of his role to accelerate the organization’s journey into a culture of continuous improvement and empowerment focused on improving the value of health care delivery from the patient’s perspective, known as Lean.

He said the focus of the Lean continuous improvement journey over the next 12 months is four-fold:

• training people on the methodology so we can expand our problem-solving capability;
• the measurement of value in health care so we can understand how to deliver care with highest outcomes and satisfaction with optimal resources;
• reducing the length of stay of patients in our hospitals;
• improving the efficiency and utilization of the operating room.

“We cannot achieve any of these without significant engagement of staff, physicians and our patients,” Osorno said.

These frequent updates in answer to brief questions are valuable, but they are not a replacement for the comprehensive annual Press Ganey employee surveys, which are scheduled to take place in early 2016.

“We will continue doing the Pulse Survey every two months, being completely transparent about the responses and clear about what actions are being taken,” Osorno said. “We hope to respond effectively and solve issues that currently affect satisfaction. We hope to see an increase in satisfaction and hope to see even greater participation in future Pulse Surveys.”

— Les Dunseith