Managers at Christus Santa Rosa Health System are making strides in improving the patient experience by using tools that have little to do with electronic health records, mHealth or big data.

Instead, nurses at the San Antonio-based system’s general acute care hospitals are using pen and paper to record the responses of daily surveys they are conducting with patients.

The goal is to use the results of the three-question survey to identify gaps in meeting patient needs in as close to real time as possible and, in doing so, improve its monthly HCAHPS results. Christus Santa Rosa was targeting its responsiveness as part of a performance improvement road map it follows that keys in on getting actionable data.

“Our concern is that the [HCAHPS] data is old by the time you get it,” says Patricia Toney, vice president and chief nurse executive for the system. “It’s not real time, so it’s difficult to react to it in real time.”

To get the needed data, each nurse in the system’s hospitals — excepting its children’s hospital — is required to survey one patient a day not under his or her care using three questions and a zero to 10 scale:

1. If you needed help getting out of bed, how quickly did we respond to your needs?

2. When you requested help — for instance, pushing your call light — how readily did we respond?

3. How effective were we in meeting your needs?

Comments on the responses also are recorded, Toney says. In devising its three queries, system executives also took care not to ask questions that mimicked or resembled those in the HCAHPS survey, which is forbidden by the program, she says. Data are collected at the end of shifts by managers for compilation by a single person in each facility. The scores are graphed and posted publicly the next day. Any problem areas that surface also are noted publicly.

Rick Morrow, a consultant who assists Christus Santa Rosa with its performance improvement, says that its management’s commitment to good data — a tenet pushed by quality guru W. Edwards Deming — has been key to its performance improvement success. “This group has been so successful in setting up timely measures in the process,” says Morrow, vice president of quality, safety and reliability for Healthcare Performance Partners.

Toney says that just the act of collecting the data when they began in June created a positive halo effect. “The numbers started to improve before we even did anything, before there was any performance improvement initiative,” in this area, she says. Since then, the patient experience scores have kept rising, Toney adds.