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Patient Experience: Above and Below the Surface

Posted By Don Prisby, Monday, March 02, 2015
Updated: Wednesday, February 25, 2015

Can listening to icebergs teach us something about listening to patients?

One morning last week, I was tuned in to National Public Radio (NPR). The feature story was about a gentleman who "listens to icebergs." Listens to icebergs? Really? In some way, I sensed a kindred connection with this Arctic audiologist of sorts. But I just couldn’t put my finger on it.

As the story unfolded, I learned that the majority of an iceberg’s structure is under water, beyond our field of vision. That which can be readily seen relays only partial information about the iceberg’s actual state. What was asserted in this radio interview is that each iceberg emits audio clues that, once aggregated into patterns, can be considered correlative indicators of that iceberg’s current state, be it melting or perhaps moving. The iceberg’s voice can also reveal what it’s about to do - either cascade into the deep, dark blue or worse, menacingly float into the shipping lanes.

Then it dawned on me why this story inspired me. Why is that, you ask?

Because you and I, in our various healthcare roles, are like the iceberg attendant. By listening to patients’ input about their care on a daily basis, we gain insight about conditions, behaviors and processes that impact the patients’ well-being. Additionally, similar to icebergs, most of what our patients are really experiencing is below the surface. When we listen to our patients intently, we are likely to avoid being caught unprepared for immediate concerns or finding ourselves on a "patient-care Titanic," about to hit an obstacle below the surface.

One of our missions as patient experience professionals is to track immediate and long-term trends based on patient feedback. We seek to hear, in real-time, insights from our patients, gleaned from attending deeply to their verbal, emotional, psychological and physical concerns - those that we can observe right away, and those that we understand only by actively listening.

But what does actively listening to the patient mean? Lagging data from 45-day-old survey responses is important - yet not enough. Actively listening on a daily basis requires the commitment to:

  • Hear in real-time the urgent concerns of our patients
  • Turn that input into insight · Share that insight with our front-line staff
  • Look for team members or practices that can be coached or improved right away
  • Discover trends that tell us more about our future success
  • Act on leading indicators
  • And listen. Again. And again. And again. Daily.

Leading hospitals I’ve worked with have realized dramatic increases in operational and clinical performance by actively listening, in real-time, to the patient. Then, they take active steps to improve behaviors often associated with improving HCAHPS scores. These same hospitals have also achieved other benefits such as engaging non-clinical staff in the mission of care and increasing staff loyalty through the daily sharing of input that has come directly from their own patients. An iceberg will not thank you for your concern, but a patient can - and often will.

With real-time insight and rapid-cycle improvement, we will gain new awareness. We will improve clinical and operational processes. We will assure a healthier and more effective care environment. And we will avoid the financial, reputation and patient-care disasters that might otherwise be lurking, unknown, unseen, unheard, under the surface and up ahead – for the next shift, or for the next patient.

For more insight about how some organizations are using leading insight to improve clinical, operational, staff engagement, safety and care improvement, The Beryl Institute has recently published this Case Study about the VA New Jersey Health Care system success using real-time insight for improvement.

Don Prisby is a business development executive with Minneapolis-based TruthPoint, a technology enabled performance improvement firm focused on delivering patient insight and performance improvement services to healthcare systems nationwide. Don is an avid reader and recently was a guest speaker at Concordia University’s (St. Paul, MN) MBA program presenting the topic "Intrinsic and Extrinsic Elements Influencing Culture Change.”

Tags:  HCAHPS  listen  patient engagement  Patient Experience  real-time 

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