title: Comprehensive Unit-based Safety Program (CUSP) to Improve Patient Experience: How a Hospital Enhanced Care Transitions and Discharge Processes.
abstract: To determine whether Comprehensive Unit-based Safety Program (CUSP) teams could be used to enhance patient experience by improving care transitions and discharge processes in a 318-bed community hospital.
  
  
  
  In 2015, CUSP teams produced feasible solutions by participating in a design-thinking initiative, coupled with performance improvement tools involving data analytics and peer-learning communities. Teams completed a 90-day sprint challenge, involving weekly meetings, monthly department leader meetings, and progress trackers. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used, and the percent top (best) scores were reported for overall hospital ratings, discharge information, and care transitions.
  
  
  
  The percentage of patients choosing the top score increased from 61.0% preintervention to 68.0% postintervention for overall hospital rating and from 71.4% to 80.7% for recommending the hospital. The top scores increased from 76.0% preintervention to 84.5% postintervention for the discharge information domain and from 49.2% to 53.6% for the care transitions domain.
  
  
  
  CUSP teams improved patient experience. The teams could expand their scope to be the unit-level resource focused not only on safety but also on external quality measures to which patient experience is a broad category for HCAHPS scores, and potentially on value in future work.
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland (Drs Pottenger, Allen, and Pronovost and Ms Sawyer); Sibley Memorial Hospital, Johns Hopkins Medicine, Washington, District of Columbia (Drs Davis and Miller); The Johns Hopkins Hospital, Baltimore, Maryland (Dr Allen); and Departments of Anesthesiology & Critical Care Medicine, Surgery, and Health Policy and Management, Johns Hopkins University, Baltimore, Maryland (Dr Pronovost).
authors.forename: Brent C
authors.initials: BC
authors.lastname: Pottenger
authors.forename: Richard O
authors.initials: RO
authors.lastname: Davis
authors.forename: Joanne
authors.initials: J
authors.lastname: Miller
authors.forename: Lisa
authors.initials: L
authors.lastname: Allen
authors.forename: Melinda
authors.initials: M
authors.lastname: Sawyer
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D010351:Patient Discharge; D061214:Patient Safety; D017060:Patient Satisfaction; D058996:Quality Improvement / Q000458:organization & administration*