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The Beryl Institute invites members and guests to submit posts on patient experience related topics. For guidelines and information on submitting a post for consideration, contact michelle.garrison@theberylinstitute.org.

 

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Why Your Hospital is Competing with the Apple Store

Posted By Julian Hutton , Monday, January 9, 2017

At a recent patient experience leadership forum, the question was posed “Who is your competition?” Predictably the initial discussion revolved around the merits and reputations of other local or specialist hospitals and how their patient experience was judged to compare. But who else is the patient comparing your hospital to when they give a verdict on the service they have received? What other experiences form the benchmark when evaluating how highly they should rate their hospital experience?

The United States is now a service economy in which we are spoilt for choice on which stores, malls, restaurants, supermarkets, automobiles, hotels and electronics to spend our time and money. As products and services, at all levels of cost and quality, have proliferated, one of the major differentiators has become the customer service experience both at point of sale and for as long as we own the product. Although it is an investment, training staff in the skills to make customers feel valued and respected is a great deal more cost effective than slashing prices. It also has swift return with minimal impact to the bottom line and, if you get it right, earns you enduring customer loyalty. When you buy a $4 Big Mac, you can be fairly certain that somebody will greet you (occasionally with a smile), ask what they can do for you, take your order and deliver the right product. From that standard, the bar for customer service keeps getting higher – for less than $100 a night, a limited service hotel receptionist will welcome you warmly, inquire as to how your journey was, efficiently check you in and show you to a room with clean sheets and small, tastefully designed, bottles of gold, frankincense, and myrrh in the bathroom. (Coming soon to a chain hotel near you.)

When you go into an Apple store, you’ll be greeted by somebody who seems genuinely pleased to see you. They are friendly and professional. They give every impression of being sincerely interested in helping you. They listen attentively, they make sure they have understood what you have told them, and they then tell you who is going to be helping you. They introduce that person and hand off to them by repeating what you have said to them and inquiring if, before they go, there is anything else that they can do for you. During your whole experience with Apple, whether you are buying something, or getting help with an existing Apple product you already own, you are kept informed of the process, how long it is estimated to take, what is going on behind the scenes that you may not know about and when the person helping you will be back. At every stage, there is a handover from one person to the next. If the person helping you needs to go somewhere and you are by yourself, it is only a matter of minutes before an Apple employee asks you if you are being helped and if there is anything they can do for you. You are never left wondering if anyone has forgotten you or what is going on. And however intractable your issue is, you are never made to feel you are being a burden.

Can hospitals ever operate as smoothly as an Apple store? No. But can hospitals learn from the kind of customer service culture that companies like Apple have trained their staff on? That has set them apart from their competition, earned the loyalty of their customers and set a standard of customer experience that other services are judged by? Fairly or unfairly, hospitals are being judged by patients on the constantly improving standards set by the service culture they experience in their everyday lives.

Julian Hutton studied leadership at Britain’s Royal Military Academy Sandhurst and was an officer in the Scots Guards. From there he went into the hotel and hospitality industry, working all over the world for some of the industry’s best known names. For the last 10 years, he has been increasingly involved in developing leadership and hospitality service training programs providing the highest standards of guest and patient experience.

Tags:  competition  customer experience  Customer Service  Hospitality  Leadership  service excellence 

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“I don’t do direct patient care.”

Posted By Ahmanielle Hall, Monday, August 15, 2016
Updated: Monday, August 15, 2016

“I don’t do direct patient care.”

Every time this phrase comes up in conversations I get the tiniest cringe at the emphasis of “do.” As healthcare administrators, we are responsible for sharing the narrative of how great our patient care is and how many services we provide, yet to say one does not “do” direct patient care implies that there is no connection to what takes place on the floors daily.

Of course, not every role in healthcare physically touches the patient, but it is important that all support roles in healthcare organizations understand the impact of their contributions to the patient experience.

Correction: If you work in healthcare in any capacity, you do participate in direct patient care. Maybe it’s the use of the word direct, perhaps that should be eliminated so that there isn’t a scale of responsibility that implies there are two groups in healthcare—those employees in the trenches doing everything they possibly can to provide for the actual care of the patient and others doing everything they can without having what can be perceived as a direct stake in the patient experience.

There appears to be a divide in healthcare into clinical and administrative silos. Two different approaches to healthcare, but both are supposed to have one clear objective: make patients and their families the number one priority. There has to be a way to tie the two functions together to see not only how each group not only takes part in creating the patient experience, but also how both roles need to be symbiotic in creating value for the patient.

Everything we do as healthcare administrators has an impact on care. Whether it’s engaging employees around major strategic initiatives or doing a media story that connects our community to the services we provide, yes—we touch the patient experience. Every piece of collateral, every project, every report in some way has an effect on someone else and their ability to take care of those who trust us with their health.

Clinical teams are able to make this connection easily; however, making the patient experience real for administrative roles in an organization takes more time and effort. It is often said that it takes a special kind of person to be a physician or nurse, but it also takes special people in IT, finance, communications, human resources, parking—all of these areas need special people who see the value in what it is they contribute to healthcare organizations to make patient care effective and meaningful.

Dear healthcare provider, clinical or administrative—you provide direct patient care. You are important and you have a role that connects you in some way to the quality and delivery of patient care. What you do daily has the power to impact or detract from someone else’s experience. We all have a responsibility to provide the best interactions between colleagues, patients and families to create value. Encourage those around you to contribute their very best. Smile, be courteous, help motivate teams to see how providing their best efforts and being strategic about their work can make all the difference in patient care.

Ahmanielle Hall, MSPR serves as a Senior Communications Specialist at Cedars-Sinai. Her experience in public relations, social media marketing and internal communications has provided insight into the importance of building and strengthening relationships not only across healthcare organizations but also in the communities they serve.

Tags:  employee engagement  leadership  patient and family engagement  patient care  quality of care 

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Connecting to our Purpose in Patient Experience

Posted By Alison Tothy, M.D., Tuesday, July 26, 2016
Updated: Monday, July 25, 2016

What if bringing visibility to positive experiences helps connect us to our sense of purpose? In a recent shift in the Pediatric ER, I watched an interaction between a nurse and a child. We were getting ready to sedate an eight year old boy. The nurse engaged the patient and made him smile, while gently preparing him for the sedation and the upcoming orthopedic bone reduction. I watched as the patient relaxed under her calm hands and in turn, the father waiting on the bench next to the child took on a calm demeanor, his shoulders visibly unclenching as he observed his child receiving amazing care that was kind, compassionate, and gentle. As the physician, I spoke with the child and the parent, explaining the procedure thoroughly, but with easy to understand language. I answered all questions, and then in partnership with the nurse and the orthopedic resident, proceeded to sedate the patient and reduce the broken arm.  With the sedation and reduction completed, I informed the father that everything went well and that his son was doing great. I left the sleeping child and the less anxious father in the hands of the nurse to continue my shift, taking care of at least another thirty patients that evening.

 

Walking out at the end of my shift, I saw the nurse that helped me with the child during the sedation.  It would have been so easy just to walk out the door, wave over my head, and shout "Thanks for all your help, good night, see you tomorrow” - isn’t that the usual sign off after finishing a shift? But instead, I stopped, paused, and then said "Thank you so much for your help with the child that we sedated. You were so good with that child. Did you see how he relaxed when you talked to him about how he looked like an astronaut with the oxygen tubing in his nose? You made him smile. Did you see how he was relieved he was only ‘getting a hug’ from the blood pressure cuff? And, did you notice how reassured the father was, when you alleviated the worry and suffering of his son? Thank you!” Then, I watched the nurse… her eyes lit up, she smiled and sat up straighter.  Not much later, I walked out and got in my car, drove home and went to bed. I did not imagine I would think about it again, but I did.  Strange, because it was not the usual case that I perseverated over, such as the complicated case, the stressful trauma, the new diagnosis with a bad outcome -- instead, I thought about this powerful interaction I shared with my colleague. 

 

I would like to believe the nurse left her shift with a sense of pride that was always there, but maybe had not felt in a while. I hope that she saw for a moment what I saw in her, the impactful way she cared gently for a patient. I wanted her to realize what it meant for the patient and parent and what her interaction meant for both of us. This interaction led to a moment in which I had the opportunity to highlight how she helped someone in a time of stress and to perhaps help the nurse feel more valued and appreciated. In emphasizing her connection with the patient and parent, I was also able to link back to my own sense of purpose.  

Sometimes I forget how much I enjoy taking care of patients and their families. As a Pediatric Emergency Medicine Physician and the Chief Experience and Engagement Officer (CXO), I often have oversight of caregivers as they interact daily with patients and their families. The above interaction reminds me that there is much more than just looking at an x-ray and diagnosing a fracture or looking in an ear and searching for an infection. This encounter above could have been exactly that. Imagine that scenario If I had just walked by and did not stop and chat with the nurse and did not thank her for the work she did? If I had not helped her recognize how she helped changed this patient’s world in the moment? It could have happened, has happened, often happens. It is easy to get bogged down in the clinical work as a physician and the administrative work as a CXO. The day to day grind is exactly that, normalcy that moves me through standard work, allows me to complete tasks.

However, recently I have been increasing my efforts to take a step back and reflect on my work and the efforts of others taking place around me. I have begun to ask "what if”? What if I stop and help someone remember why they went into healthcare? What if I stop and say how can I help this patient, this family, this colleague be healthier, happier, have a better experience and stay engaged? What if I move from bettering individuals, to helping my department, the hospital, and the community engage in their health? These are not far reaching goals if I begin with the basics and consciously make an effort to pause and reach out, when it is easier at the end of a shift to just say a quick goodnight and thank someone without meaning behind it. Changes take effort, but good changes are worth the effort.

So, I chose to make an effort to change. Both as a clinician and as an administrator, I began to pay more attention to engaging those around me. I endeavored to notice how my interactions affected others and how other’s interactions affected patients, families and colleagues. Then, I started to call these moments out. I began to work with others to remember why they chose the job they did, often asking the question "Why did you go into healthcare?”  I would provide subtle ways that demonstrated how important each interaction was to another and then tie it back to a sense of one’s purpose.  Subsequently, this was connecting me back to my purpose as well.

 

Several weeks ago I began to think about how my journey has led me to change how I care for patients and care givers and why I continue to ask "what if” questions.  As a visible leader in patient experience, I turned the "what if” question back onto myself. What if I could use my leadership to not only give a voice to the importance of strategies, but to also influence how each of us see ourselves as caregivers and its importance collectively as a community of caregivers?

 

About a year ago, as part of the journey to continually develop my skills as well as improve the experience for my patients, families, and colleagues, I researched the new Certified Patient Experience Professional Certification through the Patient Experience Institute. By definition, a certified patient experience professional (CPXP) is a formal or informal leader who influences the systems, processes, and behaviors that cultivate consistently positive experiences as defined by the patient, resident, and family in settings across the continuum of care. This certification fit my journey both as a physician and administrator. I enrolled, completed the necessary training, passed the exam, and became part of the inaugural certified class this past spring. This is a piece in my ever continuing training to become a better leader, and helps strengthen my ability to cultivate a community of caregivers that can reconnect to the importance of what they do each and every day.

 

In closing, I would ask each of you to think about the "what ifs” and how that can help us all connect to our purpose in the significant work of healthcare.

  • What if we all carry this forward?
  • What if we all pay attention to actions that positively affect others?
  • What if we help others see the beautiful interactions that occur day in and day out while we care for our patients, their families, and each other?
  • What if we were all more connected to purpose?
  • What if we advance our skill set so that we can become exemplary leaders in the world of patient experience? 

 

As the Chief Experience and Engagement Officer for the University of Chicago Medicine, Alison Tothy, MD leads efforts to optimize patient experience and engagement across the medical system.  From high level strategic planning to oversight in development, implementation, and optimization of national best practice standards, patient-centered care strategies, and innovative approaches to patient care, Dr. Tothy strives to improve patient outcomes through strengthening patient, family, and caregiver engagement.

Tags:  Community  healthcare  Leadership  patient experience  person-centered care  physician  physicians  voice 

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PX Body of Knowledge – Worth It?

Posted By Bryanna Gallaway, MPA-HSA, CPXP, Thursday, May 26, 2016

Having the opportunity to work for an organization like Stanford Health Care, a pioneer of science and experience innovation1, I wasn’t sure whether the Patient Experience (PX) Body of Knowledge program would be of great benefit to our organization. Through my love for learning and trust in the high quality work of The Beryl Institute, I pursued the program anyway. This blog serves as a brief reflection on my experience with the PX Body of Knowledge program.

Upon receiving my PX Body of Knowledge account information, I was flooded with an exhilaration that I hadn’t felt since enrolling for classes freshman year of college. I was eager to plan out my learning path, but nervous in knowing I had to balance this with an already very busy schedule (then with collegiate sporting events, mixers and bonding with my dorm mates – now with a fulfilling career, professional board responsibilities and visits to wine country). I was pleased to find a great amount of flexibility in the course schedule, both in the order of topics and in dates offered for the virtual classrooms.

As someone who suffers from the all-too-common multi-tasking condition, I was delighted with how engaging the on-demand online modules were. The navigation was easy, the visual design was pleasing, the content was progressive and the built-in gamification was a fun way to test information absorption. The most helpful game was the Policy and Regulatory Issues Jeopardy Challenge, and my overall favorite activity was the interactive Touchpoint Journey Mapping, as it brought visibility to the real flow of a patient’s experience, including handoffs, the environment and their emotional highs and lows.

The virtual classrooms are where the content really comes to life. With guidance from The Beryl Institute’s facilitators, participants share stories and insights related to the course topic. The dialogue deepens the understanding and application of the on-demand learning modules. An effective feature of the virtual classroom is the chat function, allowing for questions and networking to occur throughout the session. Though everyone chooses a unique course sequence, I enjoyed connecting with a cohort of familiar names and voices throughout the duration of the PX Body of Knowledge program.

Overall, I found that some of the content wasn’t brand new to me, but a much needed refresher and validation that we as a healthcare institution and I myself as a healthcare executive are on the right track. I was introduced to enhancement ideas for programs we currently have in place, and I certainly learned many new approaches to problems or unmet needs of our patients, families and staff. The PX Body of Knowledge program was also a helpful guide in preparing for (and passing!) the Patient Experience Institute’s Certified Patient Experience Professional (CPXP)2 exam.

Without spoiling too much of the PX Body of Knowledge plot, these were a few of my key takeaways, which I have been able to incorporate at Stanford Health Care:

  • The Platinum Rule, "Treat others how they want to be treated”, and other patient-centered care best practices
  • Cultural sensitivities, training, and competency assessment (e.g. workforce generations, beliefs and customs, and the nine elements of cultural competence)
  • Evolution of patient experience, patient advocacy and glossary of healthcare policy acronyms (e.g. NQF, MOC, AF4Q, CMMI, PQRS, SIM, HEDIS, and many others)
  • Employee engagement drivers and coaching toolkits (e.g. Harvard Business School Model: how to identify issues before beginning to coach, encourage employees, highlight skills, praise, conduct respectful inquiries, offer sound and confidential advice, provide guidance)
  • Patient experience statistics refresher (standard deviation, correlations and run charts, oh my)
  • Many additional fun facts that were included in Stanford’s Patient Experience Week Trivia game3

To answer the question posed by the title of this blog, is the PX Body of Knowledge Program worth it? I’d say absolutely!  

Sources:
1
Stanford Health Care People Magazine, C-I-CARE Program Overview, pages 6-7: https://issuu.com/stanfordhospital/docs/shc_people_4.26
2Patient Experience Institute and CPXP: http://www.pxinstitute.org/
3Stanford Health Care Patient Experience Week Overview and Jeopardy: http://c.ymcdn.com/sites/www.theberylinstitute.org/resource/resmgr/PX_Week/C-I-CARE_Patient_Experience_.pdf and http://c.ymcdn.com/sites/www.theberylinstitute.org/resource/resmgr/PX_Week/C-I-CARE_PXTrivia.pdf

Bryanna Gallaway, MPA-HSA, CPXP, is the Director of Service Excellence at Stanford Health Care. Bryanna is driven and inspired to create a positive impact on the patient, family and colleague experience through design thinking and process improvement, empathy and compassion training, servant leadership and team development, and collaboration across national patient experience and healthcare leadership communities. Stanford Health Care has been on a patient experience and process improvement journey for some time now. Over the past five years they have improved their inpatient patient satisfaction scores from the 63rd to the 89th percentile and cancer center scores from the 22nd to the 90th percentile. Stanford has cultivated a culture of compassion through the C-I-CARE Program, not only improving patient experience, but also improving their overall employee engagement from the 61% to 75%.

Tags:  body of knowledge  certificate program  leadership  learning  professional development 

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Rounds for Change

Posted By Irene Brennick, Monday, April 25, 2016

As a volunteer director, I often make patient rounds with my CNO. At my hospital, staff and volunteers alike make patient satisfaction a top priority. We frequently round on patients, not only to assess their needs, but to also find out what didn’t go right so we can learn from it, correct it and make things better for everyone. During one particular interaction, I discovered how easy it can be to change a patient’s perception of the hospital from negative to positive.

My CNO and I walked into a room and encountered a female patient and her husband. We inquired about their experience, and their response revealed an opportunity for improvement. The woman said she was admitted through the emergency room, sent to another unit and finally arrived at the room she was currently in.

The patient told us how sick and scared she was. Her experience in the ER was somewhat of a blur, but she remembered very clearly an abrupt nurse in one of the units. She said the nurse didn’t listen to her, and her husband echoed the lack of attentiveness on behalf of the nurse. Once she was brought to her private room, however, she said she had received nothing but the best treatment.

After she recounted her story, my CNO told the patient "I am very sorry to hear that, because what I hear is that the care is very good. I will investigate the situation, and again, I am sorry.” I too have always heard about the exceptional treatment people receive in our facility, and was quite surprised to hear anything negative at all regarding the care. This patient and her husband started to protest a bit stronger. They repeated their story about how the nurse treated them in the unit.

I thought to myself, remember it is the patient’s perception of care and sometimes we have to do our best to make the patient experience better. When this patient goes to fill out a patient satisfaction survey we want to have eliminated or decreased the negative impression of our hospital. Before we left the room, I looked closely into the woman’s eyes and simply said, "I’m sorry you believe you didn’t receive the treatment you deserved. It’s not ok, and we need to do better.”

I wanted to let the woman know that I too heard her. If I were a patient and felt I was not treated compassionately, I would be upset as well. What happened next was pretty amazing. As we started to get up and walk out, the woman said, "Well, people are only human and everyone has a bad day. I don’t want to get anyone in trouble and really my care was very good.” At that moment I knew, just by being heard and acknowledged, the woman went from being upset, to all smiles, as she chatted about how she was feeling much better and hoped to be discharged soon.

I learned that day that making rounds is very important and we must really listen to what our patients are telling us. If a patient claims to have had a bad experience, they had a bad experience. It is our job as hospital staff to make the situation better, rather than be defensive. It is much better to just listen to our patients. Their information is a gift, and we should acknowledge their concerns. We should apologize, investigate and correct. Only then, will our patients begin to forgive any imperfections that occurred during their stay, and they could even become our greatest advocates. We want our patients to have the best experience when in our facility.

Since 2003, Irene Brennick has managed over 700 volunteers at Los Robles Hospital in Thousand Oaks, California and puts on health and education events as their Director of Community Services. She has a total of 24 years of experience developing and implementing dynamic volunteer programs. She has also addressed tens of thousands of people and her story has been featured in the L.A. Times, Daily News, and on television and radio. Ms. Brennick also speaks on topics that include, finding one’s purpose in life, the importance of giving back through volunteerism, and how anyone can be an inspirational public speaker.

Tags:  compassion  leadership  listen  patient advocate  perception  rounding  volunteer 

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Sacred Ground

Posted By Dr. Bryan K. Williams, Friday, January 22, 2016
Updated: Thursday, January 21, 2016

There are certain places in this world that I truly consider to be sacred. One of those places is a healthcare facility. Whether it is called a hospital, doctor’s office, nursing home, or hospice is irrelevant. In that moment, when someone needs to be cared for and healed, it is a sacred one. One that healthcare providers should never take for granted.

As a patient, I am annoyed that I don’t feel well, and I’m even more annoyed that I have to go visit a healthcare provider. My schedule has been disrupted. I have anxiety about the diagnosis. I might even have more anxiety about how much the medication will cost. The one thing I don’t need, however, is to feel like I am a bother to those I am seeking help from. The healing truly begins way before patients actually meet the provider. It begins with the warm smile from the person at the registration/admissions desk. Or perhaps it begins with whoever answers the phone when the patient calls seeking answers.

Recently, I was facilitating a training session at a healthcare organization. The attendees were comprised of senior and mid-level leaders. Towards the end of the session, one leader asked me, "Under what circumstances should the leader not tolerate negativity from the staff?” At first, I thought the leader meant it as a rhetorical question, but then I realized that she was completely serious. In fact, as I looked around the room, EVERY leader was leaning forward and eagerly awaiting a response. I realized that it was a much more common issue than I previously thought.

After thinking for a moment, I told her that no negativity should be tolerated. Ever. In fact, the healthcare environment is sacred ground, and it should be considered sacred in every way. Especially by those who work there. On the way home, that leader’s question lingered in my mind. Early the next morning, I wrote the following:

Sacred Ground

This is where healing takes place.
This is where caring takes place.
This is where the ultimate expression of hospitality takes place.
Everything I say and do should declare that "I see you...I honor you...and you have unconditional worthiness".
Let there be no gossip.
Let there be no negativity.
Let us only lift each other up, as we lift up those we take care of.
Let us be grateful that there are people who entrust us with their health.
People who need us and depend on us.
May we never take that for granted or grow complacent.
This ground is not sacred because of my degrees, or certifications, or expertise.
It is sacred because "caring" happens here. Healing happens here. Love happens here.
From this day forward, I will consistently put the "care" in healthcare, as I care for my patients, care for my colleagues, and care for myself.
As long as I have breath, I will do everything I can to keep this ground sacred.
-Bryan K. Williams

 


Dr. Bryan K. Williams is a keynote speaker, consultant, and author who champions service excellence and organizational effectiveness. His clients include Baldrige-winning hospitals, award-winning school systems, and Forbes 5-Star Luxury Hotels worldwide. Bryan’s passion is to serve others so they may better serve the world.

Tags:  culture  Leadership  patient advocacy  patient engagement 

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Of Heads, Hearts and Hands

Posted By Paul Westbrook, Friday, June 12, 2015

In the first article of this series entitled, "A Thin Line, The Nature of Care,” we discussed the inherent challenges discovered in our three-year patient experience transformation at Inova Health System. Our commitment to addressing those challenges, by focusing on hospitality principles was addressed. In the third and final section, we will present, "The Return on Hospitality,” indicating the objective and measurable success we’re achieving. Today, in this second installment, "Of Heads, Hearts and Hands,” the call of moving from the head – to our hearts and hands, from plans and strategies to actions and tactics is examined. As we get started, enjoy this quote:

"A person's most useful asset is not a head full of knowledge, but a heart full of love… and a hand willing to help.” – Anonymous

As we commenced our journey of patient experience transformation at Inova Health System, our first objective was to re-examine strategies and tactics, of uniting heads, hearts and hands in fulfilling the Inova Promise. The initial SWOT analysis revealed sobering realities and opportunities for growth. Through the valuable introspection of the newly formed Patient Experience Transformation Team, it was determined that the most effective channels for change would be to re-inspire five core work streams. This system-wide evolution across core work systems continues today at Inova as we embrace and fulfill our promise:

"We seek every opportunity to meet the unique needs of each person we are privileged to serve – every time, every touch.” Inova Promise

The Five Core Work Streams

  1. Culture.The heart of the matter of service excellence in healthcare is creating a culture that endures across all care areas and locations. With a passionate commitment to our promise, we embody a culture of making emotional connections. Where service is individualized. Where every action is built on intentionality and purpose – in an atmosphere of mutual respect.
  2. Communication.Information is power. Through open communication about mission and vision, staff members are empowered, have a sense of pride and see their roles as critical in the delivery of care. Leaders convey inclusion and respect by sharing insights through multiple channels such as recognition meetings, huddles, executive rounding, newsletters, blogs and other media. Consistent and cohesive communication is foundational to building a culture of shared values.
  3. HR Processes.To be the best, we strive to attract and retain the best. Through a combination of behavioral interviewing and setting the expectation early, we commit to attracting, selecting, orienting, on-boarding, rewarding/recognizing and nurturing the best people we can find, keeping a constant focus on the balance between talent and cultural fit.
  4. Leadership Development. Healthcare leadership requires clinical excellence coupled with interpersonal and administrative acumen. We foster well-rounded excellence in medical competence and leadership that invites and inspires and that is engaging, efficient and effective.
  5. Service Excellence. Our day-to-day engagements include developing champions and driving service essentials like rounding, white board completion and shift-to-shift handoffs. Moreover, we consider one another as internal customers and endeavor to pleasantly surprise each other and our patients with the unexpected anticipation of needs and desires.

The patient experience at Inova Health System embodies a three-stage effort of 1.) Approach 2.) Deployment and 3.) Results. As I’ve discussed the deployment of action through these five core work streams, the next blog post of this three-part series will present the results – results that illustrate a system’s integration of "heads full of knowledge,” and "hearts full of love and hands willing to help.” I will share results that show the impact of a system-wide transformation of service to those "we are privileged to serve – every time, every touch.”

*This is the second piece of a special three-part guest blog series focusing on various components of patient experience excellence, including patient and family care, culture and leadership and employee engagement. Read Part 1 and Part 3 here.

Paul is the Vice President of Patient Experience at Inova Health System. Prior to joining Inova, Paul began his service delivery consulting company, Westbrook Consulting, LLC, with the mission of transferring his 35 years of hospitality service in branding, strategic deployment, and operations to other service industries, to give back to his community and make a meaningful difference in peoples’ lives. Paul is also part of The Beryl Institute's Patient Experience Executive Board.

Tags:  communication  culture  Leadership  patient experience  team 

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A Thin Line - The Nature of Care*

Posted By Paul Westbrook, Thursday, June 4, 2015
Updated: Thursday, June 4, 2015

The etymology of the word hospital indicates that it derives from two rather divergent concepts. The first is the Latin hospes, from which we get warm words like "hospice”, "host” and "hospitable.” The second, also from Latin, is hostis, the root for the rather alarming concepts like "hostile” and "hostage.” As the saying goes, "There’s a thin line between love and hate.” For us in the hospital profession, perhaps we also walk on a thin line.

In my work with a renowned healthcare system in Northern Virginia, I noticed that there are day-to-day elements surrounding us that seem both hospitable (hospes) and hostile (hostis) in the care environment. Hospitable concepts include ideals: emotional connection, welcome, compassion, service, intrinsic joy, extraordinary care, empathy and excellence. Seemingly hostile topics include realities such as: regulatory pressure, profit preoccupation, command and control, task driving, growth planning, provider centrism, compensation concerns, and too many patients and not enough time. Perhaps on any day, we might forgive ourselves when instead of acting as hosts, we catch ourselves treating our patients as hostages. When even small feelings of hostility supersede a spirit of hospice and warmth. Maybe and simply that’s the human nature inherent in the nature of care.

I came to healthcare from 27 years’ executive service with Ritz Carlton and the Marriott Corporation. In the hospitality industry, hospes should always prevail, yet often doesn’t. Again, human nature. Over the past three years, I’ve had the privilege of leading the transformation at Inova Health System in its desire to achieve patient experience excellence. The commitment, collaboration and the results are inspiring, yet have not been without their challenges.

Central in this transformation was our focus in examining 5 key work streams: Culture, Communication, Human Resources Process, Leadership Development and Service Excellence and inculcating these with hospitality principles. As noted, in our introspection, we found both hospitable and hostile elements, both the hospes and hostis.Again, human nature inherent in the nature of care.

Given the power of human nature and our propensities, especially under the many pressures that we face each day both on the business-side and the care-side of healthcare, how do we keep ourselves focused to "deliver the unexpected,” to provide "extraordinary care” and to experience transformation expressed in "service excellence?” At its base, perhaps such service requires a spirit of genuine intentionality, and if I can borrow a word from the hospitality industry, maybe it takes a spirit of "Concierge,” which etymologically means to act "with service.”

Hospitality and hospital share the same linguistic roots. Hospitality principles like making emotional connections, individualizing service, recognizing and celebrating success and striving for service excellence guided us at Inova in our transformation. Integrating these hospes ideals into our work streams helped us gain immediate and sustained patient experience success.

 *This is the first piece of a special three-part guest blog series focusing on various components of patient experience excellence, including patient and family care, culture and leadership and employee engagement.

Paul is the Vice President of Patient Experience at Inova Health System. Prior to joining Inova, Paul began his service delivery consulting company, Westbrook Consulting, LLC, with the mission of transferring his 35 years of hospitality service in branding, strategic deployment, and operations to other service industries, to give back to his community and make a meaningful difference in peoples’ lives. Paul is also part of The Beryl Institute's Patient Experience Executive Board.

Tags:  culture  healthcare  hospital  Leadership  patient experience 

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Adapting and Cooperating to Scale a Shared-Decision Making Program to Improve Patient Experience and Outcomes

Posted By Gloria Stone Plottel, MS, MBA, Wednesday, April 1, 2015
Updated: Thursday, April 2, 2015

Global payment structures and evolving reimbursement calibrations are driving innovation in healthcare to improve patient experience, become more patient-centric and manage for population health. The magnitude of these changes requires individuals and organizations to willingly adapt and cooperate to develop the processes and programs to thrive in this altered landscape. It is worth pausing and reflecting on these efforts, especially when done well.

We’ll take an in depth look at a successful change initiative from Partners HealthCare, an integrated health system seeking to more fully engage patients in their own care so as to improve patients’ health and care outcomes. Partners HealthCare was founded by Brigham and Women’s Hospital and Massachusetts General Hospital and, in addition to its two academic medical centers, the Partners system includes community and specialty hospitals, a managed care organization, community health centers, a physician network, home health and long-term care services.

As part of its patient engagement strategy, Partners wanted to scale a successful Shared-Decision Making (SDM) program at Massachusetts General Hospital across its 10 hospitals, so patients throughout the health system would benefit from SDM. SDM helps patients who need to make significant medical decisions with their primary care provider and specialist by providing patients with evidence-based, balanced decision aids and coaching services. Decision aids give patients information (written and video) about diagnoses, different treatment paths and variables to consider as they think about treatment options that best reflect their values, life style and health goals. After reading and viewing the decision aids, patients meet with their coach – physicians, nurses, or other licensed healthcare professionals trained to guide this type of conversation – and together evaluate treatment options, the patient’s goals and values and decide on a treatment path that will work best for the patient.

Scaling this program involved a number of departments throughout the health system:

  • Legal and Finance to obtain rights to use patient decision aids in the other hospitals
  • Training of clinicians and staff – doctors, nurses and medical assistants needed to be trained to use patient decision aids and have shared decision making conversations with patients and family members
  • Worksheets and other tools needed to be developed to support shared decision making conversations when there are no patient decision aids available
  • IT needed to develop applications within the electronic medical record to notify physicians when patient decision aids were available for a diagnosis, and to enable ordering of decision aids and access through the patient portal, and to document delivery of patient decision aids
  • Mail Services was needed to deliver hard copies of patient decision aids to patients who did not have portal access
  • Physician office staff in some specialty practices needed to implement new protocols to incorporate delivery of decision aids to eligible patients when scheduling a visit
  • Leadership was needed to prioritize and champion this initiative
  • An advisory group with representatives from the major hospitals and patient representatives was created to provide input on the expansion strategy

Seven departments at a minimum and their staff were involved in scaling the SDM program across the health system. SDM aims to engage patients in making informed decisions about their treatment path, and in so doing increase patient satisfaction, increase patient adherence to treatment plans and improve patient outcomes. The initial expansion targeted primary care practices and orthopedic departments, specifically spine and hip and knee arthoplasty. At the time of writing, the expansion has been underway for five months and several practices at four of the hospitals are now using the decision aids, and the roll out to the rest is underway.

Many individuals – physicians, nurses, clinical and administrative staff, and patients and family members – are involved in scaling the SDM program to make it available to thousands of patients. Scaling the program requires significant willingness on the part of individuals to adapt and work together to increase patient engagement, improve patient experience and improve outcomes. The degree of change in healthcare delivery is large and stakeholders need to work together to build the processes and infrastructure that will enable organizations to thrive. Are you and your colleagues willing to adapt?

Gloria Stone Plottel, MS, MBA is the Founder and CEO of GSP², a boutique consultancy focused on helping healthcare organizations develop and implement strategies and infrastructure for patient engagement, advisory councils, communications and marketing. Ms. Plottel consulted to Partners HealthCare to develop the patient engagement strategy for the health system and Pioneer ACO.

Tags:  healthcare  leadership  patient experience  shared-decision making 

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Five Key Lessons on Employee Engagement from "The Boys in the Boat"

Posted By Kevin Sheridan, Thursday, December 4, 2014
Updated: Tuesday, December 2, 2014

I just finished reading The Boys in the Boat, a fantastic underdog story about the University of Washington’s Crew Team and their quest to win Gold at Nazi Germany’s 1936 Berlin Olympic Games. Written from interviews, diary entries and memories of the crew members, Daniel James Brown captured what it was like to beat the odds through trust and teamwork. While I read this powerful story of nine young men embarking on a personal and spiritual journey, it amazed me how often I was jolted by the similarities of what these young men faced and what most organizations face on their journey to reach best-in-class status on Employee Engagement, both in and out of the healthcare environment. 

Here are five of the key takeaways that should prove helpful to your spirited glide up the river of engagement:

1. Employee Engagement is the Toughest of Management Sports
"Rowing is the toughest of sports,” said George Pocock, the man who built the crew team’s skulls. Just like rowing, reaching the finish line of employee engagement and winning gold is not easy. It’s truly an endurance sport.

Your call to action: Make sure you have the right coach/manager to inspire your employees’ minds, hearts and bodies so that they are able to endure the patient experience journey – both the pain and win.

2. Many Companies and Employees "Come from Nothing”
The majority of this book takes place during one of the darkest chapters in American history, beginning in 1933 and through the Great Depression. This remarkable crew team had a wildly different upbringing than their heralded counterparts on the east coast at Harvard, Yale and Princeton. They were the sons of loggers, dairy farmers and ship and mine workers. They knew how hard they would need to work to come out ahead, but they were deeply motivated, largely because of their coach. He regularly reminded his team of how meaningful their journey was, and how they could achieve anything through determination.

Your call to action: Focus on meaning and purpose as key ways of engaging your team. Make sure they know how they are contributing to the success of the organization as a whole and the impact they have on the overall patient experience.

3. Persevere – Don’t Give Up
All of the most engaged companies with whom I worked during my twenty-six year consulting career were as deliberate in their strokes as The Boys in the Boat. They realized that the journey to the finish line would not be easy and that their goal was to get better and better in anticipation of the next finish line. They were fervent believers in continuous improvement. None expected to achieve excellence overnight. When faced with myriad obstacles along the way, they hunkered down and either rowed through it or used their engagement to create new workarounds.

Your call to action: Keep moving! In hard times, momentum is a manager’s best friend.

4. Teamwork and Trust
Cultures of great employee engagement are ones in which team members trust one another and aim for the best teamwork possible. There were two unforgettable passages about teamwork and trust. One is where the crew member Shorty Hunt, who sat directly behind the book’s main character Joe Rantz in the skull, says "I got your back, Joe.” That kind of reassurance, especially from peers, is extremely strong, and adds core strength to the team, as it did for Joe Rantz in nearly every race. The second was where Joe Rantz realized that he would never achieve his full potential unless he trusted the other men in the skull. It was only after Joe proffered his full trust to all of them that he realized his full potential as the anchor of strength in the skull.

Your call to action: Support employee comradery and teamwork. An "every man for himself” culture won’t enable your organization to perform better than the competition. Employee collaboration is vital in improving the patient experience among team members and their patients.

5. Synchronicity and Rhythm
"By and large, every rower in an eight-oared shell does the same thing… But there are subtle differences in what is expected of individual rowers dependent upon which seat they occupy . . . . When working well, the entire boat operates like a well-lubricated machine, with every rower serving as a vital link in a chain that powers that machine forward.” The same can be said for a well-run company with highly engaged employees. To win gold in crew, you need to have the right person in the right seat of the skull.

Your call to action: Hire the right people for the right seat, move the people who are in the wrong seat and remove anyone who is rowing in the wrong direction.

When I began reading The Boys in the Boat, I thought I was reading a story about a crew team. By the end, I realized the book is about something much more personal and meaningful. Hard work, engaged behaviors, mutual respect, trust, teamwork, perseverance and consistency of rhythm not only work well in a skull, but work equally as well in a workplace.

Kevin Sheridan has spent thirty years as a high-level Human Capital Management consultant. He has helped some of the world’s largest corporations break down detrimental processes and rebuild a culture that fosters productive engagement, earning him several distinctive awards and honors in the process. Kevin’s newest product, PEER®, is consistently recognized as a long overdue, industry-changing innovation in the field of Employee Engagement, and his most recent book, "Building a Magnetic Culture,” made the New York Times, Wall Street Journal and USA Today best-seller lists. 

Tags:  employee engagement  leadership  patient experience  teamwork 

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