Improving Quality Outcomes through Patient Engagement: An EVMS Medical Group Case Study

• EVMS Medical Group’s Quality Office believes that patient experience strongly correlates to clinical outcomes. They use data from Feedtrail surveys and campaigns to drive their quality improvement projects.
• Engagement from leadership and a proactive team put EVMS’s initiatives on a solid footing from the start. The Quality Office analyzes negative results to root out methodological flaws and organizational barriers to success.
• EVMS publicly shares positive patient messages to boost morale. Residents receive feedback across their academic career as a learning tool, and to reinforce the relationship between patient experience and health.

 

What defines quality in healthcare?

At Macon & Joan Brock Virginia Health Sciences EVMS Medical Group at Old Dominion University — a Virginia academic medical center with around 200 clinicians, 300 residents, and 500 students — quality is about ensuring excellent patient care while continually improving outcomes. But it also encompasses excellence in teaching, research, and community outreach.

How does EVMS maintain quality in alignment with its mission? That’s the work of the Quality Office, led by Chief Quality Officer Margaret Baumgarten, MD, and Assistant Quality Officer Leslie Nestor.

“We are big believers that patient experience is correlated with clinical outcomes, there is data to support it” Margaret told me, explaining how EVMS uses Feedtrail’s real-time data and feedback to drive its quality improvement projects. “We want the ability to have internal benchmarking to compare our performance,” she adds. “We’re applying it [not only] to our value-based contracts, but also in the academic setting.”

The primary goal of EVMS Medical Group in utilizing Feedtrail is to listen to and understand patient perspectives. According to Leslie Nestor, “We like to say that their perception is their reality. Whether it’s true or not, it’s how they perceive that they are experiencing their care.” This understanding drives their commitment to align with their vision of achieving excellence in patient care, education, and research, while being recognized as a community-oriented service provider.

Since partnering with Feedtrail in October 2022, EVMS Medical Group has integrated real-time patient feedback into their quality metrics. “With Feedtrail, we wanted to have real-time experience data and feedback that we could drill down to an individual provider, and we can see what our issues are,” Baumgarten explains.

I had a great conversation (watch the webinar) with Margaret and Leslie in which they shared five real-life examples of how they’re using Feedtrail patient surveys, feedback, messaging, and engagement to have a measurable impact on quality in their organization.

 

1.   Missed appointment campaign

The EVMS Quality Office sends Feedtrail surveys to patients’ cell phones with carefully crafted questions addressing everything from the front desk to administration to physicians. Missed appointments affected both the organization’s bottom line and the health outcomes of patients, so reducing their occurrence became a priority initiative.

 

“We put a proposal together showing that if we could cut our no-show rate — which for our organization is 14% — by 1%, we’d have the funds to pay for Feedtrail. That’s how we got buy-in.” 

 — Margaret Baumgarten, MD, Chief Quality Officer, Macon & Joan Brock Virginia Health Sciences EVMS Medical Group at Old Dominion University

 

 

Building a solid foundation

The Quality Office formed a committee to understand why patients were missing their appointments. “We typically have several meetings to see what we’re trying to resolve and what we can do together,” Margaret explains. “For projects to be successful, you need to have multiple team members representing different parts [of the organization].”

The Feedtrail initiative is also fortunate to have the engagement of EVMS’s medical directors, chairs, and CEO, who share the Quality Office’s vision and assume accountability for the outcomes. The active support of both team members and the organization at large was crucial to shaping and refining the success of the campaign.

 

Define, refine, repeat

Feedtrail surveys revealed that the two main reasons for no-shows were forgetting appointments and transportation issues. So Margaret’s team decided to change the frequency and timing of reminders — from two to three messages, starting seven days before the appointment.

“We completed our first cycle and we didn’t see an improvement,” Margaret recalls. “We were puzzled because the intervention seemed to be good; we thought we did everything right.” If the frequency of messaging wasn’t moving the needle, maybe there was something about the methodology behind the reminders that would.

The Quality Office sat down for a series of meetings with the IT and EHR (Electronic Health Record) teams to thoroughly understand the ins and outs of how reminders get sent. Not surprisingly, Margaret says, they realized that the system was not pulling files every day — meaning that patients who made appointments up to six days in advance were not receiving reminders. 

“There are flaws we wouldn’t have discovered if we had seen the result we hoped to see. Basically, a negative result taught us that there are improvements we need to make in our system, and we made those improvements.” 

— Margaret Baumgarten, MD, Chief Quality Officer, Macon & Joan Brock Virginia Health Sciences EVMS Medical Group at Old Dominion University 

The Quality Office also looked at patients who were having transportation issues, and then reached out to insurance vendors to see if they could provide support. “We got that information out to our practices, so they could get it out to the patients,” Leslie explains.

Recommended reading: How to Use Patient Feedback to Drive Quality Goals in Healthcare

 

 

2. Changing telehealth vendors

As part of the effort to decrease the number of missed appointments, the Quality Office decided to take a look at why telehealth failed to catch on at EVMS. On Feedtrail surveys, 50% of patients said yes to telehealth, and 25% said maybe. Capturing even that 50% with remote appointments would be an effective reduction to the no-show rate. 

So why wasn’t telehealth use more widespread? It turned out that the clinicians weren’t fans of EVMS’s current provider. That realization allowed the organization to change course and sign with a different vendor. “We’ve launched a new product and a new platform, but the driver for all this is the data we’re getting from our patient surveys,” Margaret says.

 

3. Diabetes broadcasting campaign

The diabetes broadcasting campaign was another successful effort in using Feedtrail messaging capabilities to improve patient outcomes. EVMS sent a message to diabetics who either didn’t have a hemoglobin A1C test result or whose test result was high, asking them to contact their physician to either administer the test or change their medication.

“We broadcasted this message to our patients and the [response from] our Feedtrail group was about 50% versus 25% for phone calls and other methods of communication,” Margaret explains. The campaign resulted in a 41% uptick in hemoglobin A1C results reported. “It was a successful intervention and it directly links us to improving clinical outcomes,” she adds. 

However, Margaret knew that EVMS only had one full-time phlebotomist doing blood work in the clinical practice, so it took some careful planning and scheduling to avoid overwhelming that person with 60 extra patients in one week. “You need to close the loop of communication with all your team members,” she recommends. “Each of these interventions requires teamwork.”

 

4. Mammogram awareness campaign

EVMS also used Feedtrail to remind patients who were due or overdue for a mammogram to schedule an appointment during Breast Cancer Awareness Month. “Our focus here is to be proactive, not reactive,” Leslie says.

“We know that our patients need some screening to maintain their health, so any way we can try to get in touch with our patients, we are. It’s an easy way for us to communicate [with them] and improve their health outcomes.” 

— Leslie Nestor, Assistant Quality Officer, Macon & Joan Brock Virginia Health Sciences EVMS Medical Group at Old Dominion University

 

5. Positive feedback for clinicians

The patient feedback collected through Feedtrail is essential for shaping and measuring successful campaigns to improve patient experience and health outcomes.

But the EVMS Quality Office also shares positive messages received via the platform to boost engagement and morale across the organization. “We use messages on closed-circuit TVs all over campus, visible to patients, visitors, everyone,” Margaret explains. There are also monthly prizes given to practices that receive the highest feedback scores.

Despite some hesitance from the CEO, the Quality Office also uses patient feedback to evaluate residents’ clinical competencies at different stages of their academic careers. “We felt that it was such a big and important step because it’s very hard to improve if you don’t know how you’re doing,” Margaret says. “We’re teaching residents that experience influences clinical outcomes.”

 

Looking Ahead

EVMS is a compelling example of how healthcare organizations can drive quality improvement and deliver superior healthcare experiences through data-driven interventions. By understanding patient perceptions, setting clear goals, and implementing targeted projects, they have made significant strides in enhancing patient care.

As EVMS Medical Group continues to refine and expand their initiatives, they remain committed to leveraging patient engagement to drive quality improvement. “We are always looking at our data and seeing what we can do better,” Baumgarten concludes. “It’s a continuous process, and we are dedicated to making a positive impact on our patients’ lives.”

 

 

 

About Mallory Magelli McKeown, Customer Success: Meet Mallory, a healthcare professional dedicated to improving the patient experience. With a background in roles like chaplain and family advocate, Mallory’s mission is simplifying healthcare for patients and families. From advisory councils to patient advocacy, she amplifies the patient’s voice. At Feedtrail, she redefines the patient-provider relationship, asking vital questions to guide healthcare leaders toward patient-centered changes. Her goal: revolutionizing healthcare by putting patients’ needs first.