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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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Top tags: patient experience  healthcare  patient  Leadership  HCAHPS  culture  patient engagement  physician  communication  family engagement  healing  Hospital  survey  caregiver  community  empathy  employee engagement  pediatric  perception  person-centered care  physicians  voice  collaboration  compassion  consumerism  Continuum of Care  Customer Service  data  experience  family 

Give a Better Patient Experience by Introducing the Care Team

Posted By Julie A. Snow, Wednesday, February 1, 2017
Updated: Tuesday, January 17, 2017

As a patient, it can be uncomfortable and overwhelming to stay in a lonely hospital room with a seemingly neverending stream of unfamiliar faces coming and going throughout all hours of the day and night.

Hospitals can do a lot to improve the patient experience. One simple, yet surprisingly effective way to do so is by simply taking the time to introduce the patient to his or her care team professionals. This one act can improve a patient’s familiarity with their care team members, enhance their awareness of what to expect from each member and increase their confidence in the care that is being provided. When these things happen, the doctors, nurses and other hospital staff can also feel more connected with and more committed to providing the best care possible.

With both patients and providers quickly establishing a relationship with each other, patient satisfaction with their overall hospital experience can improve drastically while hospital staff feels more fulfilled in their work. It becomes a win-win situation.

Improve Patient Familiarity with Care Team Members

A team-based approach to patient care is widely used by hospitals. This is to ensure the best care possible for each patient. When the team is optimized by being composed of staff members who are working to the highest level of their expertise and abilities, the following can be accomplished:

  • Patients gain enhanced access to a team of experienced professionals
  • Patients are more satisfied with their stay
  • Care will see improved levels of quality, reliability, and safety
  • Hospital costs will reduce

If there is a downside to using a whole team of rotating professionals, it’s that the patient may not be given much of a chance to establish a relationship with each team member. This delays or reduces the chance for trust to be built. However, by keeping patients regularly updated on not only the name of their care provider but also their photo, title, and qualifications, it is easier to build a higher level of trust in a shorter amount of time.

Increase Patient Trust and Confidence

So what happens when patients are more familiar with the background, qualifications and certifications of each team member who is responsible for their care? Patients feel more comfortable in the hospital environment and even the confidence in themselves and their ability to heal is increased.

With this newfound trust and confidence, patients can become more empowered to voice their concerns, ask questions regarding their care plan or prescriptions and accept the advice of experts. After a patient leaves the hospital, they will be more likely to follow their doctor’s instructions and seek needed follow-up care.

A New Way for Introductions

A nurse can write his or her name on a whiteboard hung up on a patient’s wall, but now there is a better, more engaging way to make introductions. Hospitals are introducing their patients to care team members via an in-room television or even a digital whiteboard displayed on a personal tablet. This method has proven effective since the updates happen automatically, in real time, and patients are familiar with the format.

Easy access to information and enhancing patient awareness both play a big part in the encouragement of patients to open a consistent dialog with their care provider. A simple conversation can make all the difference in the health and wellness of a patient.

Patients are determined, more than ever before, to be fully engaged and educated in their own health care. By giving them the opportunity to be proactive when interacting with their care team, you are also giving them the opportunity to be more fully satisfied with their overall hospital experience.

 

Julie A. Snow is a health researcher and writer who has worked together with Sonifi Health to improve patient experience. When she isn’t working or mothering, you’ll usually find her in an Ashtanga Yoga arm balance or eating (sometimes both at the same time).

Tags:  Interactions  introduction  patient access  patient engagement  relationship  team  technology 

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Understanding Patient Experience through My Recovery Process

Posted By David Festenstein, Tuesday, January 10, 2017

I embarked on my patient experience journey when I suffered a stroke in 2008 that left me paralyzed on my right side and unable to walk. During this time, I used a lot of my communication expertise to help deal with the event and then subsequently to support and drive my recovery process.

The extensive diary and journal I kept during my recovery process helped me identify seven distinct steps of a recovery model. In hopes to educate other patients, especially at the beginning of a stroke, these steps provide hope to those who have struggled, or are struggling, to engage with their rehabilitation process. In addition, these steps to recovery also can help health professionals better understand what the recovery process looks like through a patient’s eyes as well as reflecting upon their own strategies to improve the overall process.

In reviewing your patient resources, consider the following:

  • How can you tap into great patient recoveries across all health disciplines and give those strategies to other patients to make their recoveries far easier? 
  • Can you identify health professionals within your organization who have wonderful empathy with their patients and outstanding patient engagement skills? 
  • Are you using the power of journaling for both your patients and health professionals?

I encourage you to join me in an upcoming webinar from the Institute on January 17th at 2pm ET where I will further discuss the distinct steps to recovery and focus on what engaging patients really mean.

David Festenstein, Communication Specialist, Coach and Professional Speaker, is committed to sharing his patient experience story and his 7 steps of a recovery model at workshops, trainings and coaching health professionals across the world. Learn more about making the most of your patient resources in one of his vlog’s here.

Tags:  global healthcare  patient education  patient engagement  patient stories  personal experience  recovery  resources  storytelling  stroke 

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3 Ways to Engage Patients Between Visits

Posted By Fred Altimont, Monday, November 21, 2016
Updated: Monday, November 21, 2016

Quality and cost. Two of the most important elements of the healthcare industry today, and key ingredients driving the shift from volume- to value-based care. Providers face tremendous pressure to deliver higher-quality care at a lower cost, and engaging patients in their own care can help on both of these fronts. On top of better health outcomes, engaged patients also typically report higher satisfaction levels.

The problem? Many patients’ interactions with their doctors are limited to the 10-minute in-person visit. Patients can often feel rushed and forget the questions they wanted to ask, and don’t have the time to process new information, leading to frustration. The patients return home, only to feel they’ve lost access to the personalized care and support of an in-person visit.

So, how can providers engage their patients between visits? There are a few ways technology can help bridge this gap.

Remote Monitoring

The proliferation of wearables and mobile devices means we are now more connected than ever before. Patients can monitor and report activity levels, symptoms, and even vital signs today from the comfort of their own homes. When shared with doctors, this data can not only empower patients to self-manage their care, but also inform clinical teams, creating a more productive in-person visit. Data overload for the physician is easily avoidable by setting mutually-aligned goals with the patient. The patient monitors his or her vital sign ranges, and the physician is only alerted when a vital falls outside that range.

Education

Often, a large portion of the office visit is spent educating patients about conditions and treatments. But when the patient only has a short, fixed amount of time with the doctor, retaining instructions or other information can be hard to do. What if that same education could be delivered virtually, though, freeing up more time with the patient to answer questions and have other discussion? For instance, a digital health program could educate patients about how to manage their allergies during the approaching pollen season, or teach them how to properly use an inhaler.

Communication

As simple as it sounds, a quick note to a patient between visits can improve patient engagement. In fact, a recent study from the International Journal for Quality in Health Care found that secure messaging “appears to be associated with higher quality diabetes care, particularly among at-risk populations.” By feeling more connected to care teams, patients often report higher satisfaction levels and may be more engaged in self-managing their conditions. The use of video can also propel the connected relationship for the patient. In seeing a provider’s face, patients can develop a deeper bond with the entire care team.

The in-person doctor visit holds a valuable place in the care continuum and cannot - and should not - be fully replaced. The relationships and trust built during face-to-face time are crucial in caring for patients in their health journey. With the right tools, however, these visits can be supplemented to facilitate even more trust and compassion, while delivering healthier outcomes. We’re committed to bridging this gap to improve patients’ lives and look forward to driving innovation in this area.

 

Fred Altimont is executive vice president at ViiMed, a digital health company that delivers customers’ care plans for acute, chronic, and episodic conditions through cloud-based software.

Tags:  cost  mobile devices  patient engagement  quality  technology  trust  wearables 

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Patient and Family Engagement to Improve Patient Safety

Posted By Tejal K. Gandhi, MD, MPH, CPPS, Monday, March 7, 2016
Updated: Monday, March 7, 2016

Patient engagement is an essential component of safe, appropriate, high quality healthcare. But what do we mean by patient engagement and how does it relate to patients’ experience of care?

A recent report published by the National Patient Safety Foundation (NPSF) notes that most definitions of patient engagement include the common themes of "partnership, communication, information exchange and respect.”

The Beryl Institute defines patient experience as "the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”

There are overlaps between patient experience of care and patient engagement. If patients are not respected as partners in their care and if clinicians do communicate with patients effectively, then it is highly unlikely that the patient’s experience will be a positive one. Moreover, research has linked patient experience to clinical outcomes, with a 2013 paper finding "patient experience is positively associated with clinical effectiveness and patient safety and [data] support the case for the inclusion of patient experience as one of the central pillars of quality in healthcare.”

The NPSF report, Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human, makes a number of recommendations for improving patient engagement to improve patient safety:

  • Training and education: Clinicians and health professionals need to be educated about concepts such as shared decision making, health literacy, cultural sensitivity and respect.
  • Ease of access to information: Patients and families need timely access to medical records, test results and tools and resources that help them understand complex medical information.
  • Patient representation: Members of the community served by a healthcare organization should be represented on the governing bodies and committees of those organizations. Only by such representation can we ensure that safety and quality initiatives and care processes that affect patient experience are designed with patients in mind.
  • Tools and strategies: From including families in bedside rounding to the use of tools like the Ask Me 3 program, which encourages patients to ask key questions about their health and care plans, there are tools and strategies that can help engage patients and improve their experience of care.
  • Reporting and measuring: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) serves to measure, to a degree, a patient’s experience of care while hospitalized. We also need ways to measure patient engagement, including ways to capture patient reports of safety lapses.

Arguing for greater patient and family engagement is not new to NPSF, and is in fact an issue that we and others have been advocating for some time now. While educational efforts such as the Agency for Healthcare Research and Quality’s Questions are the Answer campaign are useful for patients and consumers, we also know that even experienced health professionals sometimes have trouble speaking up when put in the vulnerable position of patient.

While patients should be encouraged to be full partners in their care, their clinicians are the ones who really hold the key to making that possible.

Improving patient and family engagement is one of eight recommendations in the new NPSF report, which is a focal point of Patient Safety Awareness Week, March 13-19, 2016. The theme of the week this year is United for Patient Safety, a reflection of the belief that clinicians, patients, policy makers, researchers and everyone involved in healthcare must be part of making care safer for everyone.

 

Tejal K. Gandhi, MD, MPH, CPPS, is President and Chief Executive Officer of the National Patient Safety Foundation, the NPSF Lucian Leape Institute and the Certification Board for Professionals in Patient Safety. She is advocating for patient safety at the national level, driving educational and professional certification efforts, and helping to create and spread innovative new safety ideas.

Tags:  healthcare  patient and family engagement  patient engagement  patient safety  research  service excellence 

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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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Why the Billing Experience Matters to Patients

Posted By Tomer Shoval, Friday, April 17, 2015
Updated: Thursday, April 16, 2015

Improving the patient experience tops the list of strategic priorities for many healthcare organizations. However, that attention often results in improvements to clinical care or to remodeled patient rooms.

What’s often overlooked is a hospital’s billing and revenue cycle.

With rising patient financial responsibility, people are bringing an empowered sense of "consumerism” to healthcare. Someone facing a significant medical bill is more likely to have high expectations for that experience. And this same person likely loves Amazon’s 1-Click checkout. They expect their hospital to not only be on the cutting edge of medical care, but also deliver a simple, easy-to-read medical bill that they can pay as easily as they do other bills.

Many studies have demonstrated that a patient’s payment experience colors their overall feelings about a hospital stay. As in retail, customer satisfaction is vital as patients begin to exercise greater choice, both in how much to pay and where to go next time. As they say, the last impression is a lasting one.

How to solve this problem? Many innovative providers are already rethinking the role of revenue cycle in overall patient engagement strategies, and are building a blueprint for the rest of the industry. They have discovered that a positive billing and payments experience can impact patient satisfaction and loyalty as well as reduce costs and raise revenue.

Here are three ways that hospitals can empower healthcare consumers through their patient revenue cycle.

Mimic consumer strategies. Online and self-service are mainstream in key industries such as retail, banking, and travel. 58% of consumers prefer self-service banking and 69% prefer to pay their energy bills online. Given the choice of greater transparency and convenience, people will choose self-service—and healthcare billing and payment options should mirror these trends.

Integrate your billing and payment experience. Challenge the traditional view of patient billing by incorporating a modern, clean, jargon-free design focused on driving patients to your website. ValleyCare Health System increased online payments by 2.5X and completely eliminated their early-out collections within 4 months of revamping their self-service payment options.

Optimize for self-service. Can patients quickly and easily find your website and pay their bill online? More the the point, ensure a clear call-to-action on your homepage to capture the inbound flow of patients seeking to make a payment. And once they’re ready to pay, make sure the payment flow is fast, easy, and secure.

Pioneering healthcare leaders are redefining medical billing by engaging their patients as consumers. If you build a system that empowers patients, your patient revenue cycle can quickly become a strategic advantage resulting in happier patients, higher collections, and lower costs.

Tomer Shoval is CEO and a Co-founder of Simplee. A veteran e-commerce leader, Tomer is a frequent speaker on the intersection of healthcare, technology, and consumers. He founded Simplee as a way to help people better understand and manage their healthcare bills.

Tags:  Hospitals  patient billing  patient engagement  patient experience  revenue cycle 

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Patient Experience: Above and Below the Surface

Posted By Don Prisby, Monday, March 2, 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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When it Comes to Experience Management Many Hospitals are Stuck in 20th Century Thought

Posted By Lou Carbone, Tuesday, November 19, 2013
Updated: Monday, November 11, 2013

Given the dynamic changes taking place in healthcare, it’s not surprising patient experience is a top priority for most hospitals. What is surprising, however, is the outdated mindset hospitals often have about how to improve the experience. Many are investing in quality and process improvement. They’re recognizing they have customers, and they’re integrating patient feedback in making tactical improvements in hospital design.

This mindset is deeply concerning. Hospitals need to realize that experience isn’t the result of a process improvement. They’re under leveraging how they’re using patient input because they’re still focusing on WHAT patients think versus on HOW they think.

Old school thinking focuses on asking for opinions and suggestions as input. Today, success depends on understanding how patients think about their experience, and then designing and managing the experience accordingly. However, many hospitals are suffering because they’re trapped in an outdated way of thinking in an industry that’s changing rapidly.

Hospitals need to be "clued in” to the patient experience. In other words, do you know how the clues you’re delivering are making your patients feel? Better yet, do you even know how your patients want to feel when they’re at your hospital?

Let’s tackle these questions. Know it or not, you’re constantly delivering a barrage of clues to your patients. What they see, smell, hear, taste and touch will create their "experience” and affect them emotionally, even though they aren't even aware it’s happening. That’s because research tells us that 95% of our mental processing takes place unconsciously; only 5% of your patients’ decisions are based on conscious rational thought.

To engage patients, you need to dig deep into this uncharted 95% of experience processing. Which helps us answer the second question. Most hospitals look at the experience from the company-out, focusing on what their brand must project to affect patients’ impressions of its service. I believe, however, the holy grail is thinking and looking at everything from the customer-back, identifying the emotions patients want to feel during their experience and then designing and managing the clues embedded in the experience to elicit these emotions.

I recently worked with Nemours (which has children’s hospitals and clinics in Delaware, New Jersey, Pennsylvania and Florida) to help improve the ED experience. Knowing that a trip to the ED is inherently stressful, we dug deeper and discovered that above all, ED patients and families want to feel understood, secure and confident. This trio of emotions became the framework around which the patient experience was redesigned.

Nemours learned that having the child seen swiftly by the physician upon arrival in the ED minimizes parents’ anxiety and reassures them their child is in good hands. So, there is now a physician in triage so the patient is seen right away upon arrival, as well as a "pivot nurse” who provides a fast assessment and quickly moves with the patient and family to the place where care will be provided.

To minimize the times patients and families have to tell the story of what brought them to the ED and their health history, they are experimenting with conducting intake interviews via "team huddles” in which the team of doctors and nurses interviews the patient and family together.

When nurses change shifts, the hand-off is now conducted at the patient’s bedside, involving the family in conversations about the patient’s condition, how care will be continued during the shift, upcoming tests and procedures, etc.

Given the variety of doctors, nurses and staff that are involved in a patient’s ED care, all hospital personnel wear color-coded uniforms so the patient and family feel more secure knowing what that person’s role is.

As Nemours learned, understanding the experience from the inside out helps you get into the minds of your patients. Once you understand the unconscious drivers that impact patient behavior, you can transform to intentionally designing and delivering experiences that give you a competitive edge.

Lewis P. (Lou) Carbone is the Founder, President and Chief Experience Officer of Minneapolis-based Experience Engineering, Inc., and the author of Clued In: How to Keep Customers Coming Back Again and Again (recipient of the celebrated Fast Company Reader’s Choice Award). Widely recognized as the founder of customer experience management, Lou has spent more than two decades leading the world in the development of experience value management theory and practice in a broad range of industries.
www.experienceengineering.com


Tags:  design  ED  emotion  feedback  patient engagement  patient experience  priority  process 

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