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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  patient engagement  culture  communication  family engagement  healing  Hospital  physician  caregiver  community  empathy  pediatric  perception  person-centered care  physicians  survey  voice  collaboration  compassion  consumerism  Continuum of Care  Customer Service  employee engagement  experience  family  interactions 

The Return on Investments of Empathy In Measuring Patient Experience

Posted By Dr. Avnesh Ratnanesan, Friday, March 10, 2017
Updated: Tuesday, March 7, 2017

Empathy in healthcare is both a traditional concept as it is a new-age buzzword. That’s because it has never lost its importance as a legitimate element of a patient’s healing process.

Simply defined, empathy is the capacity to walk in the shoes of another. Essentially, the ability to understand, appreciate and relate to someone else’s emotions. There is more chatter in the industry now about defining, teaching, learning and measuring empathy in healthcare than there has ever been.

Making emotions a visible part of your (formal or informal) measurement validates the feelings of patients which in turn, 3promotes patient satisfaction, enhances the quality and quantity of clinical data, improves adherence and generates a more therapeutic patient-physician relationship.

Ultimately, it all links back to the Net Promoter Score (NPS) or the Friends and Family Test (FFT). A key HCAHPS question, the NPS or FFT asks the patient point-blank if they would recommend the hospital to family and friends.

There’s your ROI.

EMOTIONS AND NPS

Human emotions are core to every patient experience. At every stage of the patient journey, there is a feeling, sentiment or attitude that will, collectively, define the experience for the patient at the end of their engagement with a healthcare setting.

Hospitals are often obsessed with benchmarking against other hospitals in term of their respective performance indicators, however there is a need to first benchmark against the EXPECTATIONS of your own patient population:

  • If the experience < expectations, then you have a satisfaction deficit which leads to frustration and anger
  • If the experience > expectations, then you have a satisfaction profit which leads to delight and excitement

Frustration and anger are detractors to the patient experience. If these emotions are experienced, then you can be sure that the patient is on their way to relay their negative experiences to others or not return, or both! Feelings of delight and excitement on the other hand naturally motivate patients to ‘promote’ your healthcare setting to others.

MEASURING EMOTIONS

Measuring emotions is key part of our 6E Framework, a step-by-step guide to producing a true holistic picture of patient experience. Its measurement impacts the full spectrum of this framework:

Understanding the real patient EXPERIENCE through EMOTIONAL data ENERGISES staff in their purpose and EXECUTION of solutions. Successes are repeated to produce EXCELLENCE in delivery and organizational capability in patient experience EVOLVES.

How do you draw these emotions out of a patient so you can understand, measure and respond appropriately? Some state it boldly, some 3hide their emotions through seemingly rational questions or casually drop a comment about their emotions, to test the waters on how it would be received in the healthcare setting. Pick up on these clues, don’t ignore it or change the topic.

For the uncertain and non-forthcoming patient, surveys are a great way to get emotional data. One would imagine that a survey asking about their emotions would not only surprise them but send a clear message that there is a space in that setting to talk about emotions, that a culture exists that encourages and supports emotions.

INTELLIGENCE FROM EMOTIONAL DATA

When the clinician and non-clinician are able to recognize the emotions around a patient, it allows them to be more authentic and honest in the support given to the person (not patient).

Clinicians are able to view the person’s emotions within a more accurate context and address it in specific ways: 2

  • Learning: Where the patient is fearful because of a lack of information, there is an opportunity for staff to help educate the patient to reduce his fear
  • Empowerment: Where the patient feels helpless in the face of his health, there is an opportunity for staff to develop the patient’s sense of power over the situation through education, tools and technology
  • Self-discipline: Where the patient is frustrated over their personal management of their health, there is an opportunity for staff to help the patient develop discipline through motivation, tools and technology
  • Feelings of control: Where the patient is overwhelmed with the amount of information around their diagnosis, there is an opportunity for staff to ensure that the communication of information is at a pace and volume that the patient is comfortable with and to involve the patient’s family members or friends in managing overwhelm.

When an organization can undertake the above in a systematic way, an ‘energy’ or a vibe starts to infiltrate through the ranks. Clinicians and non-clinicians start to discover or re-discover the meaning in their roles and the organization becomes more congruent with its purpose.

What’s the vibe like where you are?

Sources:

1. Empathy and Emotional Intelligence: What is it Really About?’, International Journal of Caring Sciences, Volume 1 Issue 3, Alexander Technological Education Institute of Thessaloniki, Greece http://internationaljournalofcaringsciences.org/docs/Vol1_Issue3_03_Ioannidou.pdf
2. Adapted/Inspired from information from a Chapter Abstract from Patient Emotions and Patient Education Technology:
http://www.sciencedirect.com/science/article/pii/B9780128017371000020
3. “Let me see if I have this right...”: Words That Help Build Empathy, Coulehan JL, Platt FW, Egener B, Frankel R, Lin CT, Lown B, et al. (2001). 

Dr. Avi Ratnanesan is a medical doctor with broad healthcare sector experience including hospitals, biotech, pharmaceuticals and the wellness industry. He is a leading expert who coaches and consults to senior executives, entrepreneurs, practitioners, organizations and governments.

Tags:  emotion  empathy  expectations  experience  NPS  Patient Experience  ROI 

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The Power of Partnerships: Unifying Patients Relations and Patient Experience

Posted By Sarah Fay, MBA, Friday, March 10, 2017
Updated: Friday, March 10, 2017

We can all agree that in order to have a well-rounded view of patient experience, we cannot look solely at the information that comes back to us in our patient experience surveys – they are just one piece of a larger puzzle that make up an organization’s culture. And culture is what drives the experience…for everyone. I believe that we must look at data from several vantage points. Some of these, include: 

  • patient experience surveys
  • employee engagement surveys
  • physician engagement surveys
  • information gathered during executive and leader rounding
  • patient stories
  • key human resource metrics
  • feedback from our patient and family advisory councils
  • quality and safety data.

If we leave one vantage point out, we risk losing the complete picture. And this picture must include patient relations data as well.

I oversee patient experience for Southwest General Health Center, a long-standing 354-bed community hospital in Middleburg Heights, Ohio. Last year, we merged our patient relations department with our patient experience department. Unifying these departments has not only helped me in my work – it has benefited our patients too.

The richness of the data collected by our patient representative is invaluable to developing and executing our patient experience strategy. By combining our patient relations data with our patient experience data, we have a well-rounded view of our patients’ perceptions. Trending our patient relations data is key to this.

  1. Trends helps us determine where we need to focus our efforts. The trends in concerns and complaints bring to light an area that we have an opportunity in, while the trends in compliments bring to light an area we can celebrate. When we combine these trends with our patient experience survey data, we are better able to prioritize our strategies, programs and celebrations.

  2. Trends help us pinpoint areas that need additional support. When we combine these trends with our patient experience survey data, I am able to hone in on areas, departments, units or individuals that may need specific training or one-on-one coaching. It also tells me where we need to focus our process improvement efforts. The trends in compliments show me areas, department, units or individuals that I can rely on to champion the cause. Those people can then help train and coach others.

  3. Trends help us conclude if the initiatives we have put in place on the front-end are working. Combining the patient experience survey data with the trends of both compliments and complaints, tells me if our programs and initiatives are having the intended outcomes. 

Our partnership extends beyond the data too. Our patient representative has a very unique skillset – one that I hope to transfer to the bedside through a robust service recovery program at Southwest General. With her distinctive skillset, she can help develop a program, train our staff and teach them how to embrace the skills necessary to handle concerns and complaints right at the bedside. This will shift her into a more proactive role and I believe that is the wave of the future.  

Sarah Fay, MBA, is the Director of Guest Experience at Southwest General Health Center in Middleburg Heights, Ohio. She may be reached at sfay@swgeneral.com

Tags:  data  engagement  partnership  patient experience  patient relations  surveys 

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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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Universal Children’s Day Reminds Us of Our Impact on Pediatric Patient Experience

Posted By Martie L. Moore, Sunday, November 1, 2015
Updated: Monday, November 2, 2015

"The one thing all children have in common is their rights. Every child has the right to survive and thrive, to be educated, to be free from violence and abuse, to participate and to be heard.”1 - Secretary-General Ban Ki-moon

As a former pediatric nurse and expert witness for child protection services, I’ve spent a lot of time caring for children in the hospital and home setting. I know one of the greatest things I’ve learned is that we as caregivers can empower children during difficult situations. The need to support the wellbeing of children extends beyond healthcare: It is a universal initiative.

Universal Children’s Day on Nov. 20—unlike the traditional Mother’s Day or Father’s Day recognized in the United States— was established by the United Nations General Assembly in 1954. All countries are encouraged to promote not only mutual exchange and understanding among children, but also to initiate action to benefit and uphold the wellbeing of children around the world.

Children in the U.S. may not always face the same frightening conditions as elsewhere in the world. But this day helps us to remember that we as clinicians still have a responsibility to create an atmosphere that supports the children under our care. We know that the less stress and anxiety a child has, the better their ability to cope in a stressful situation. Hospitalization is one of the stressful situations that we can do something about.

Improving patient experience is already a major target for hospitals, and hospitals are measured and paid based on HCAHPS surveys completed by adult patients. In October 2014, the Agency for Healthcare Research and Quality posted a pediatric version of the HCAHPS survey. This pediatric survey is under review this year as a possible benchmark on which to base hospitals’ Medicaid and Children’s Health Insurance Program reimbursements, leading to the expectation that this pediatric HCAHPS survey will ultimately factor into reimbursement as the adult equivalent does now for Medicare.2

Now is the time to be thinking about how to address this special population. The ways you care for children in your facility can go a long way toward producing a positive experience for both the patient and their loved ones.

Make the Hospital A Safe Place for Children

We all know hospitals can be a very scary place for anyone, let alone children. A child doesn’t know what to expect, and is constantly meeting new strangers. He or she may not understand what’s happening to them. They could be experiencing pain from their illness, the treatment, or both.

So how do we make the hospital a place where a child can feel safe, participate, and be heard? You can make a big impact with small changes: Start with what they’re wearing. Pajamas are a great source of comfort, and while the child’s personal pajamas may not be an option, your facility can still stock pediatric gowns that promote comfort and modesty, have kid-friendly prints, and feel soft like the pajamas they may wear at home. Consider pediatric gowns with MRI-safe plastic snaps that negate multiple gown changes.

While using pediatric gowns that evoke the comforts of home, also be sure that a child’s hospital bed is a safe place. Avoid performing any painful treatments while they are in their hospital beds so that it remains a haven that they can trust.

You can also help by communicating directly with your patients. Talk to them, not at or above them, so they understand what is happening. Speak at their level, both intellectually and physically, crouching or sitting down to look them in the eye.

You may even choose to draw pictures to help demonstrate what is going on inside their bodies or a treatment they are about to experience. Many children "play nurse or doctor” at home; offer to let them participate in their care by holding the stethoscope, counting with you for their pulse or heartbeat, or perhaps picking a favorite color for a bandage or cast. Your conversation may also help distract them from their pain. The fun prints on their gown featuring friendly animals or characters could be a conversation starter in itself. Ask them about pets, sports, movies, or their funniest joke. A good belly laugh does wonders for the soul!

Good communication involves good listening. Take the time to hear what a child says to you. You could learn that something as simple as a special toy or a quick trip outside for some fresh air could make him or her feel better.

Listening and observing may also help you uncover any signs of abuse. If you observe these signs, stay calm and report the suspected abuse immediately per your facility protocols.

You Make a Difference

Every day, clinicians make a big difference in the lives of the children they care for. Make yours a good difference. Delivering extraordinary care to our children can change lives, helping them grow up to be healthy and successful adults who can protect the next generation of youth around the world.

Sources
1. Universal Children’s Day. Available at: http://www.un.org/en/events/childrenday/. Accessed October 15, 2015.
2. CMS may use new child HCAHPS to adjust Medicaid hospital pay. Available at: http://www.modernhealthcare.com/article/20150108/NEWS/301089948. Accessed October 15, 2015.

Martie L. Moore is chief nursing officer of Medline Industries, Inc. based in Mundelein, Ill, a leading provider of medical products and clinical solutions across the continuum of care. In this role, Moore provides nursing leadership for solution-driven clinical programs, delivers product development to enhance bedside practice and launches quality initiatives across the continuum of care. With what she learned during the nearly 30 years of clinical experience and extensive executive leadership, Moore now develops forward-thinking solutions and programs for those in the field today.

Tags:  HCAHPS  Hospital  patient experience  patient safety  pediatric 

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Rare Care – The Specialty Pharmacy Patient Experience

Posted By Christopher W. Kennedy, MSM, Tuesday, October 13, 2015

Nearly 7,000 diseases are classified as rare in the United States. These disease states require some of the most cutting-edge and technologically advanced therapeutics. Patients with chronic rare diseases will often require long-term medications throughout their lives. The management of a rare disease requires a multidisciplinary approach to healthcare. Continuity of care is front and center as patients are transitioned from inpatient hospital settings or outpatient clinics to their homes. Many will require frequent treatments, nursing visits, on-going monitoring, medication adherence plans and disease state education.

The Patient Experience drastically changes for patients after they are discharged from traditional care settings. Advancements in the Patient Experience movement within inpatient hospital settings has set an example for specialty and home infusion pharmacies to follow. While some hospitals have found it difficult to determine where their inpatient pharmacies fit into the Patient Experience movement, other leading health systems have fully recognized pharmacy as the medium that crosses all levels of the healthcare continuum.

Regardless of the progress being made in the hospital setting, the Patient Experience has stalled on the doorstep of the specialty and infusion pharmacy industry. This challenge requires organizations to redesign their "customer service” models. Heritage Biologics is a specialty pharmacy providing nationwide infusion and rare therapeutic services. The pharmacy was founded by a rare disease patient who asked a really BIG question: How do we improve care for people like me?

We have established Four Fundamentals that guide the organization’s framework for creating a successful Patient Experience platform:

  • PARTNERSHIP: Customized solutions are designed to ensure the continuity of care between providers and all healthcare stakeholders.
  • COLLABORATION: Insights are captured and shared with healthcare partners to allow for better outcomes management.
  • EXPERIENCE: A new standard in pharmacy patient care is being established with our patient-centered solutions.
  • GUARANTEE: A clearly defined emphasis on placing the patient before the business allows for a commitment to rare care that is unmatched.

The complexities of the evolving healthcare system in the U.S. have posed significant challenges for rare disease patients. Pharmacies must team with healthcare providers, payers and manufacturers to coordinate care efforts. This creates an environment where therapeutic health outcomes become the common denominator for everyone involved. Collaboration is critical for patient healthcare, and we hope other pharmacies will join the Patient Experience movement.

 

Christopher Kennedy is Vice President of Business Development at Heritage Biologics. He has spent the last 14 years as an executive leader and innovator in the healthcare space. His background includes launching several entrepreneurial start-up ventures designed to help advance patient care.

Tags:  collaboration  environment  healthcare  patient experience  pharmacy 

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The Fine Art of Healing

Posted By Bruce W. Heinemann , Thursday, October 1, 2015
Updated: Thursday, October 1, 2015

It’s now been fourteen years since I had surgery for prostate cancer at the very dangerous age of 49. Like all who experience cancer, this period in my life has been a journey of fear, uncertainty, hope, but ultimately a realization of an opportunity that in illness often lies the very seeds of our own healing. But even more importantly an opportunity to heal the greater dimensions of our whole being. Much attention has been given to the concept of Wellness in healthcare in the recent decades. And that concept has been front and center in my consciousness in my years long journey of insight, understanding, and ultimately, transformation.

I have come to understand wellness is a way of living, a way of being. It is a way of understanding ourselves and our place in the world. Above all it is the profoundest realization of the inseparable oneness of mind, body and spirit. To this point I think of how the term "mind/body” connection is currently used in medicine and healing. To me, this very term is in itself highly descriptive of what has long been the perception that there would be a separation of the mind and body in the first place. My experience has taught me that there is no "connection” because there is no separation, all are but one. And as such, from my cancer experience, I have come to firmly believe that the patient experience that produces the best healing outcomes are ultimately rooted in the nurturing of our whole being.

Most illnesses, but cancer particularly, seem to most often illicit the immediate response: "Am I going to die”? I found that working through this fear was key to moving forward into healing. I consider myself most lucky because, as a fine art nature photographer, in my art there was an enormous cathartic opportunity to face this fear with not only courage, but unexpected insight. It has now become an endeavor of mine to share with others those insights and feelings that helped me through that process.

Toward that end, I have developed a series of short multimedia inspirational videos entitled: The Fine Art of Healing. Also as a musician who has throughout my career presented my images with music and words in concert, I am keenly aware of the profound power of these three components of our sensory awareness when experienced in consort. In my first video, Imagination Inspired, I encourage the patient to imagine their life beyond today and into a future healed, to understand that what we can imagine already exists. We need not assume that what we experience today is what we must experience tomorrow.

In the second video: Love and Gratitude Are The Fairest Blossoms Which Spring From The Soul, I explore the profound healing power of loving and being loved, for there is nothing more powerful in the healing process than this.

I have begun placing them in healthcare facilities for their broadcast on monitors and for use on iPads for patients to watch when undergoing treatments such as chemo or rehab. The value of inducing a state of relaxation and pleasure in these settings towards creating better patient experiences and resulting outcomes can hardly be overstated.

Connecting with a patient at the deepest emotional level during the healing process with images of beauty, inspiration, and yes, even thought provoking ideas, ideas to help them see themselves in their world as healed, and in a state of wellness, is to help them access the power of their own life force, from which ultimately, I believe, all healing comes.

My journey from cancer to healing has lead me to the realization that what we think, believe and feel, largely determines the conditions present in the state of our wellness. Thus, with this understanding, the providers of patient experience have the opportunity to create an environment in which these essential elements of our very being, are understood and nurtured, with the ultimate goal of producing the very best outcomes.

Lastly, it has been this realization that has made the last fourteen years, truly the transformational journey of my life. And as such, it is my desire to share this powerful and uplifting healing process with others, that they may find their own transformation in it as well.

Bruce W. Heinemann is a fine art nature photographer, writer, publisher and speaker. His speaking presentation includes his four videos and is entitled: The Fine Art of Healing: A Journey of Personal Transformation.

Tags:  healing  patient  patient experience  video 

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Making a Difference – Working as a Medical Interpreter

Posted By Jane Blackburn, Friday, September 11, 2015
Updated: Monday, September 14, 2015

The phone rings. The interpreter answers the phone knowing they may be moments away from changing someone’s life.

That’s a thought that goes through the mind of thousands of over-the-phone medical interpreters. These professional interpreters field the urgent calls—from doctors, nurses, paramedics, and even patients themselves—where time and accuracy are often the difference between a spiraling crisis and comforting relief.

In order to comprehend life as a a medical interpreter, we have to begin at the other end of the line, with the limited-English speaking patients. Life for them is trying enough. Add to it the pressure of an imminent baby delivery, a late-night medical emergency, or understanding complex insurance forms, and you begin to see the difficulties they face and the emotions they encounter ranging from exasperation to depression to outright panic. That’s where professional over-the-phone and video interpreters work their wonderful magic.

For instance, interpreter Ayan A. received a call from a terrified, sobbing mother who dialed 9-1-1 because her child was injured and having difficulty breathing. Hearing Ayan’s voice on the line helped to calm the mother so that she could understand and follow the CPR and first aid instructions needed to stabilize her child until the ambulance arrived. Fortunately, by the end of the call, the child had opened his eyes and the bleeding had stopped. Before hanging up, the 9-1-1 operator commented to Ayan that together they had saved a life.

And then there’s Ashi F. He received a call from a nurse who along with a doctor was helping a young woman in labor with her first child. With a calm voice, Ashi helped the medical team through the epidural and delivery of the baby girl. Before the call ended, Ashi heard the sweet cries of the newborn baby as she was placed into her mother’s arms.

A third interpreter, Firas A., was speaking on the phone with a nurse and her cancer patient while they waited for the doctor to arrive with test results. The wait seemed like an eternity, the patient wasn’t optimistic, and Firas began to expect the worst. The doctor finally appeared and declared that the patient was cancer-free. Overwhelmed by his own joy, Firas had to compose himself before interpreting the good news.

And there are countless other stories just like these.

However, these compassionate professionals do much more than interpret words from one language into another. It’s essential that medical interpreters receive specialized training and testing in order to practice their trade. That means they must be intimately familiar with medical terminology and protocols, trained to remain calm during a crisis, and schooled in cultural sensitivity. All of which helps prepare them for any situation that might arise. The use of professional medical interpreters enables accurate diagnosis, reducing unnecessary testing, increasing efficiencies and lowering the cost of patient care.

In addition to the many benefits of interpreting, what most interpreters value about their work is hearing the gratitude expressed by patients. Mario C. summed it up this way, "I have helped with transplants and delivering children, all using my voice. Interpreting makes a difference. I make a difference.”

Read the stories of patient encounters, in the words of professional interpreters, at Real Life Interpreter Stories.

Jane Blackburn joined LanguageLine Solutions in 2001 as a Customer Service Manager. Since 2013, Jane has been the Director of Interpreter Services with responsibility for managing the 8000+ LanguageLine Solutions Interpreter workforce. Jane has a Bachelors degree from California State University.

Tags:  language  medical interpreter  patient  patient experience 

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‘Sometimes’ is the Enemy of ALWAYS

Posted By Jake Poore, Friday, July 24, 2015

In Jim Collins’ famous book "Good to Great”, he says ‘good is the enemy of great’. His premise is that we often settle or become comfortable with good or good enough instead of striving for more... reaching for the last inch that drives great experiences.

Great companies not only create experiences that reach more heights (or go the extra mile), they also seem to get everyone in the organization to deliver it, consistently... creating a culture of always.

If good is the enemy of great in business, then ’sometimes’ is the enemy of ALWAYS in healthcare.

  1. If we say, "we’re always going to knock on the patient’s door, wait for their reply, enter, make eye contact, smile, wash hands and introduce ourselves”, and we do this often, sometimes or even most times... we fall short of a culture of always.
  2. Imagine seven nurses care for a patient of over a three-day stay. If five nurses do these behaviors always and two don’t feel this is important and skip it, we’ve created a culture of sometimes – and again, we’ve fallen short on the journey to become a culture of always.

Unintentionally, I believe, we’re creating a silo mentality where everyone does their own thing. That’s a fragmented way to lead any organization. It creates chaos, dissatisfied patients (and employees) and ultimately, low patient satisfaction scores.

For today’s healthcare administrators, this isn’t just something that’s nice to do; it’s a must-do. Federal financial reimbursement is tied to CMS surveys. And these surveys only give credit for "always” answers. If your facility scores a 0 to 8 (never to sometimes), you get zero credit. Clearly, a culture of always means survival.

The popular phrase "culture eats strategy for lunch” rings true. If your culture is weak, how your employees perform their daily job tasks will trump any corporate strategy. You may have good intentions, but they’re only as effective as the integrity of your organization’s culture.

Consider:

  • Some doctors shake hands with patients; some don’t.
  • Some sit and listen to the patient’s story before diagnosing; some interrupt within 18 seconds to "move along.”
  • Some nurses introduce themselves; some don’t.
  • Some offer to close your door for quiet from noise; most don’t.
  • Some food service workers offer to help elderly patients open plasticware and milk cartons; others drop and run.

Besides doctors and nurses, the average patient interacts with more than 100 care team members along their healthcare journey including call center employees, front desk reception, volunteers, transporters, security, food service, housekeepers, etc.

If culture is what we do every day, and we aim to create consistency to survive and thrive in healthcare, then we must create new daily habits as a team so everyone is on the same page. The key is redesigning the culture with input from every employee group.

It seems everyone is admiring this problem, but nobody has a clear solution. The real problem is we’re throwing spaghetti at the wall and hoping it will stick. The solution is to no longer teach to the test as a long-term strategy. To get to a culture of always, we have to change our culture.

Patients are like the canary in the coal mine. They’re sending up warning signals of a flawed culture because, just like the canary, they’re most susceptible in a toxic environment. And make no mistake - they’re calling us out on things that poison the patient experience.

How?
Through patient satisfaction surveys.
By telling friends and family about the level of care they received.
And by taking their business and their loyalties elsewhere.

 *Hear more from Jake Poore about patient loyalty and creating exceptional patient experiences at the upcoming San Francisco Regional Roundtable.

As Founder and President of Integrated Loyalty Systems, a company on a mission to help elevate the human side of healthcare, Jake (@jakepoore) knows what it takes to create and maintain a world-class service organization. He spent nearly two decades at the Walt Disney World Company in Florida helping to recruit, hire, train and align their 65,000 employees toward one end in mind: creating memorable experiences for individuals, not transactions for the masses. In 1996, Jake helped launch the Disney Institute, the external training arm of Disney that sold its business secrets to the world.

Tags:  culture  patient experience  patient loyalty  service excellence  team 

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Social Media and the Patient Experience

Posted By Andy Roller, Thursday, July 9, 2015
Updated: Tuesday, July 7, 2015

The patient journey is rapidly changing. The old patient journey went something like this:

  • Scenario 1: You got a referral from your primary care doctor and unquestioningly followed the directive. Based on your experience, you became a loyal patient, advocate (for better or worse), or indifferent.
  • Scenario 2: You asked a trusted friend or utilized some form of word of mouth. Based on your experience, you became a loyal patient, advocate (for better or worse), or indifferent.
  • Scenario 3: You became aware of a particular doctor, specialist, or practice – maybe through some form of traditional marketing (TV, Billboard, Newspaper, Direct Mail). You then considered and evaluated. You proceeded to set an appointment. You went through with the procedure or treatment. Again, based on your experience, you became a loyal patient, advocate (for better or worse), or indifferent.

Of course, every reputable practice will work to make the experience and the resulting word of mouth the best it can be. But my, how things have changed. With a rapidly increasing digital population, the patient experience starts much earlier. The journey-experience increasingly begins with online search. It continues through their experience with care they receive; then through online reviews and social media posts they publish.

According to 2014 Pew research, 86 percent of patients search online before booking a doctor’s appointment. And, as of 2013, 41 percent of patients were using social media to determine their choice of Healthcare Provider (HCP). 43 percent of medical visits originate from a search engine. These numbers are rising at a rapid pace.

A full 90 percent of patients 18-24 of age trust and make decisions based on what they find on social media. And over 25 percent of conversations on Facebook are about a health-related experience. Yet only 26 percent of hospitals in the US actively engage via social media. It's true that prospective patients don't often convert based on a single Facebook update. But the influence on patient decisions and advocacy is foolish to ignore. 

The new patient journey looks more like the following: 

The patient searches online related to symptoms, providers, reviews. They may share social updates and interact as they search. Keep in mind, what they're finding is largely the result of other patients who have posted about their experience. Marketers call this the the Zero Moment of Truth. 

 

 

 

 

 

 

Once the prospective patient finds what they are looking for, they make a decision to move forward. This is often called the First Moment of Truth. They may call or send an online form, make an appointment or schedule a consultation. Again, this moment may also be something they share with their social networks. 

The patient then attends their first appointment or procedure or hospital stay. This is their Second Moment of Truth. We most often think of this moment as the patient experience. It may be the core of their experience, but it's only part of the journey and experience. 

 

 

 

 

During and after the stay or procedure is when the majority of social sharing takes place. This sharing becomes the next prospective patient's Zero Moment of Truth. 

 

 

 

 

 

 

 


What will prospective patients find? How well are HCPs facilitating the patient experience along this journey?

At Expio, we teamed up with TCU's Neeley School of Business to create the following short report. We present the information in the context of a true story from the perspective of a Father dealing with his young son's medical care. View the full report here.

Andy Roller is the Founder and Owner of Expio. As a believer in the power of entrepreneurship for commerce and community development, he is also a community volunteer, board member of Panhandle Twenty/20 and part of Leadership Fort Worth. Andy was named one of Amarillo Chamber of Commerce’s Top 20 Under 40 Business Professionals in 2011. Andy is a fitness and health geek, guitar player, father to 5 super cool kids and husband of an Enchantress.

Tags:  Consumerism  patient experience  social media  voice 

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The Return on Improvement

Posted By Paul Westbrook, Wednesday, June 24, 2015

In this final article in our three-part series about the three-year patient experience transformation at Inova Health System, we present and examine the results of our efforts. In article one, "A Thin Line, The Nature of Care,” we spoke of adopting a "hospes” approach in healthcare, based on warmth, welcome and hospitality. In "Of Heads, Hearts and Hands,” we illustrated the transition from strategies to action, specifically by inculcating hospitality principles through five key work streams. Today, we must ask: What did we accomplish? What were the measureable results? How did we improve? What was the ROI, the Return… On Improvement?

Since objective and demonstrated numbers are visible evidence of improvement, let’s go there first. At Inova, while we established the foundations for change in the first 18 months of our effort, the latter part of the three-year period started yielding significant improvements across all of the HCAHPS domains. President/COO Mark Stauder reported, "In almost all of the significant areas, scores improved markedly. However there was more than metrics advancing. We were in, and continue to experience, a cultural transformation.” Domains such as, "Overall Rating of the Hospital,” "Nurse Communication,” "Doctor Communication” and "Responsiveness of Staff " scores each rose an average of 42 percentile points. The hospitality principles applied resulted in percentile rank growth from the ~30th percentile to the ~70th percentile in 8 of the 9 HCAHPS domains. Our largest hospital had its most success ever in Q2 of Calendar Year 2015, surpassing goals in 5 domains and being within 2 points of goal in the other three. "By unifying our efforts from the C-Suite to the bedside, we were fulfilling the Inova Promise. We were empowering intentional, genuine and sustainable change,” Stauder noted.

Two of the premises in the Inova approach are 1.) Patient Experience improvement is not a tactic, and 2.) Cultural transformation cannot be delegated. Sustainable performance improvement is a result of systematic inspiration and commitment at all levels of the organization. And it’s not merely about moving the numbers. By focusing on culture, communication, human resources, leadership development and service excellence, enterprise-wide improvement occurred concurrently on all levels as the organization took intentional and measureable steps in delivering the Inova Promise.

Among the learnings in this cultural transformation were the following:

  1. Culture, communication, human resources processes and leadership drive tactics
  2. Defining "Patient Experience” and repeating over and over "what success looks like” provides unifying focus
  3. Cultural transformation cannot be delegated
  4. Data vs. opinion changes behaviors and drives engagement
  5. Human Resource processes empower and sustain service excellence
  6. Leadership’s role is to enable service delivery by removing barriers
  7. Patients need to be part of every step of the process
  8. Clear expectations for improvement must be articulated
  9. Answers lie with those closest to the bedside
  10. Leaders ask great questions, listen intently and invite action

In the realm of patient experience, we speak about "cultural transformation.” Admittedly, it is somewhat nebulous, intrinsically qualitative and difficult to measure. In the same breath, we are also compelled and driven to deliver objectively verifiable and proven scores with the goal of mitigating financial and reputation loss. What a quandary. It is as though we are caught in the middle between the seemingly ambiguous and the fanatically measurable.

In embracing our first premise that 1.) Patient Experience is not a tactic, it seems that asking for a "Return on Investment” may be too narrow of a question, as if the result of our efforts is going to be the sum of multiple tactics. The traditional ROI question seems to head us in an almost transactional tactical approach of a "quid-pro-quod ethic” – do these things to get that result. Perhaps the more appropriate question to ask is rather, "What is the ‘Return on Improvement?’” At Inova Health System, by focusing on hospitality principles across five core work streams, and approaching patient experience as a collective commitment, we experienced transformative- rather than tactical-success.

As we move forward, the Inova Promise is being realized, the spirit of the organization is palpable and the numbers, well they speak for themselves. Three years ago, we returned to hospitality, to a service-discipline of relieving fear, anxiety and suffering. We embraced "hospes,” warmth and welcome – and are realizing each day, a more significant ROI, the transforming "Return on Improvement.”

*This is the final 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 2.

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  improvement  patient experience  return on service 

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