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5 Ways to Accelerate Your 2020 Experience Efforts

Posted By Stacy Palmer, Tuesday, January 14, 2020

I recently stumbled upon a list of New Year’s jokes. My favorite asked, ‘What’s the first thing you’ll say in 2021?’ The answer made me chuckle, ‘Hindsight is 20/20.’ I thought it was clever and kind of cute, but it also made me reflect on what I hope my hindsight on 2020 will be. And when we look back at this year, what do we hope 2020’s hindsight for patient experience will be?

In 2019, we saw great strides in the patient experience movement as we introduced the Experience Ecosystem highlighting the resources, associated organizations and solution providers supporting each of the eight strategic lenses of the Experience Framework. Also in 2019, our biennial State of Patient Experience benchmarking study revealed that patient experience efforts continue to mature and remain established within healthcare organizations. We saw a growing recognition that the types of organizations we build are foundational as people globally reinforced culture is vital in achieving positive experience efforts. Overall, 2019 marked a shift to patient experience not being something healthcare does but being who healthcare is.

When we look back at 2020, what will we have learned and accomplished? I believe that as a community we have built a foundation on which global experience efforts will continue to accelerate. As you plan for the new year, I offer some suggestions that may help accelerate your 2020 efforts as well:

  1. Acknowledge your organization’s strengths and opportunities. If you have not yet participated in an Organizational Experience Assessment, I encourage you to do so. The process is grounded in the Experience Framework and built on global research identifying factors seen as critical to positive experience outcomes by both high performing healthcare units and consumers of healthcare. Your assessment will provide a comprehensive picture of the strengths and opportunities you have in your efforts to improve the patient experience. 
  2. Enhance your team’s foundation in patient experience. When building a culture of patient experience excellence, it is essential to establish a foundation where all team members clearly understand what patient experience is, what it means to them and how they can positively impact experience excellence. Consider a program such as PX 101, a community-inspired resource for use in orientation programs and other staff education that shares patient experience knowledge on the front lines of care to positively impact experience outcomes.
  3. Celebrate your team’s patient experience efforts. Rewarding and recognizing great work is also an important component of building a culture of experience excellence. And the new year is a great time to evaluate, enhance or reinvigorate your internal recognition programs. Also, start planning now for Patient Experience Week 2020, April 27 – May 1. Patient Experience Week is an annual event providing a focused time to celebrate accomplishments, create enthusiasm and honor the people who impact patient experience every day. 
  4. Expand your personal patient experience network. One of the greatest benefits cited by members of The Beryl Institute is the power of the community – the ability to network, share and learn with others passionate about improving experience. Set aside designated time to follow and contribute to conversations on PX Connect where members share their experience challenges and successes. You will make new connections, learn from peers and help others by sharing your knowledge and expertise.
  5. Commit to your continued learning and professional development. Make it a priority in 2020 to seek knowledge that will advance your skills and best prepare you to impact experience efforts in your organization. Take advantage of membership benefits such as webinars, topic calls and publications. For more extensive learning, consider the PX Body of Knowledge courses which offer certificate programs in Patient Experience Leadership and Patient Advocacy. Also consider joining the over 1,100 individuals who have achieved Certified Patient Experience Professional (CPXP) designation offered through our sister organization, Patient Experience Institute. CPXP Prep Course workshops are available through The Beryl Institute to help you prepare.

Our commitment at The Beryl Institute is to support and elevate your efforts by continuing to offer the most relevant research, resources and connections. As such, our greatest hope for 2020 is that you will discover all the ways that the Institute can help you tap into this valuable and helpful collection of leading resources to kick-start innovation and build excitement in the new year. You can start by exploring one or all of the five ways mentioned above to enhance your own professional path as a leader and to accelerate your patient experience efforts as an organization.

We have tremendous respect and gratitude for the work happening globally each day to elevate the human experience in healthcare, and we will continue to provide a place for you to share, learn and celebrate together this year and into the future
When we get to 2021, we hope you will be proud of, and inspired by, the progress you accomplished this year. After all, hindsight will indeed be 20/20.


Stacy Palmer, CPXP
Senior Vice President & COO
The Beryl Institute

Tags:  celebration  choice  commitment  community of practice  culture  ecosystem  excellence  Field of Patient Experience  global healthcare  healthcare  improving patient experience  Leadership  member value  partnership  patient advocacy  patient advocate  Patient Experience  patient experience community  patient experience leadership  state of patient experience  team 

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From "How are WE doing?" to "How are YOU doing?": A New Perspective for Experience Measurement

Posted By Jason Wolf, Sunday, December 15, 2019
Updated: Sunday, December 15, 2019

In our first December blog in 2010 as we launched The Beryl Institute as a global community, I shared a quote from Maya Angelou. It read:

"There is no greater burden than carrying an untold story."

That idea has been essential to our journey at the Institute and a seed of the evolution of the experience movement itself. Every patient, family member or caregiver we serve in healthcare, every individual who wakes up each day to work in healthcare and every person who is impacted in the communities we serve in healthcare ALL have a story to share. This idea, this reality, is universal. We all have untold stories inside us to share.

I believe we have together pushed the conversation in healthcare to see people we care for not simply as a room number or a diagnosis on a chart, but as human beings with needs and wants, hopes and dreams, all rooted in their own story. At the same time, from the lenses of those that experience healthcare, we have heard loud and clear, and have seen reinforced in data from our own research, that the number one request from their healthcare experience is “listen to me”.1  When we take a moment to listen to those we serve in healthcare and those who serve in healthcare, we reveal a rich and powerful tapestry of our very humanity. When we create the space for stories to be told and ensure needs and desires are revealed, we create new and more powerful paths on which we can impact the human experience overall.

It was this realization that sparked a powerful idea at the heart of Michael Barry and Susan Edgman Levitan’s piece in The New England Journal of Medicine on shared decision making.2 In their perspective, they offered we must move from simply engaging people on “What is the matter?” to “What matters to you?” as an essential element of providing the best quality care. That very question “what matters” begins to crack open the doors hiding the untold stories people carry. It could be about the fears they personally carry, about the family they love and are worried they might leave behind, about the way a room is lit, to the name they are called. These are all driven by the stories of our lives as human beings.

And as I have long suggested, in healthcare we are simply human beings caring for human beings and therefore must acknowledge that these realities for people, whether revealed by asking or left hidden, will have an impact on how people are cared for and ultimately the outcomes they achieve. Simply stated, we cannot take the human out of healthcare, and so healthcare is ultimately built upon and must act within a patchwork of human experiences in our desire to provide safe, quality, reliable, consistent, service-focused and accessible care.

But there is also more to the story, for as “what matters to you” has grown into a global movement grounded in the clinical encounter of healthcare, the conversation on human experience in healthcare pushes us to move even farther. As the global community of practice committed to elevating the human experience in healthcare, we realized at The Beryl Institute that the idea of measuring experience itself could and must be informed by this very idea. When we look at the traditional way in which we have asked for feedback in healthcare or in most industries for that matter, we have tended to ask “How are WE doing?”. Questions we pose to our patients, our customers or our consumers are asking them to tell us about us. But where in these inquiries do we ask about them and their needs? Where do we take the step to help them reveal their untold story and better understand how we can help them in addressing those needs?

That very question had us think about the powerful opportunity to ask less about “How are WE doing?” to more about “How are YOU doing?”. Have you felt that spark in a conversation when someone asks you that question? It is an opening, an opportunity, an appreciation that you have a thought, an idea, a need, and yes, a story to tell.

When we flip the question to “How are you doing?”, we can then uncover what people need, what they want and what matters to them more broadly. And in doing so, we can also ask about our ability as healthcare organizations to meet those needs. When we ask “How are you doing?”, we invite a different perspective on how people see things, as Gerteis, Edgman-Levitan, Daley and Delblanco wrote in 1993,3 “through their eyes.” That is the opportunity we believe we have in measuring experience overall, and, yes, we believe in understanding your needs in The Beryl Institute’s global community as well.

The opportunity is now to find ways in which we ask others to rate us not only on how we did for them or if they would recommend us, to more directly what they need as our patients, customers and consumers and how well we met those needs. How will you ask those questions in your own organizations to uncover and address the needs of those you serve? What steps can and will we take to uncover the untold story?

At the Institute, we believe we can do this by flipping the question today as we engage the over 50,000 people in our community and beyond in a new type of inquiry. We will now ask “How are YOU doing?” and based on your answer, we will also inquire “What do you need from us?”. Finally, we will ask what we are doing and what we can do better to help meet those needs. It comes back to the idea that when we ask people about ourselves, it becomes about us; but when we ask others about themselves, it becomes about them. It is about their story and the insights shared, and it actually provides a more powerful window into what we can all be doing to support one another in what we do, what we offer, and how we work together.

It is not an easy switch for organizations to move from asking people ”How are WE doing?” to “How are YOU doing?”. While it is reaffirming and helpful, I think we can agree the first question  is limited and may miss the biggest opportunity of all. When we ask people “How are YOU doing?” there is acknowledgement for the un-acknowledged, there is space for discovery and there is the opportunity for connection and for the ability to meeting one another where we stand as human beings in healthcare and beyond.

In a world where the concerns of human discourse have turned sour across the continents and distance has been created between people versus bridges being built, we must accept this is our current reality. Perhaps in our willingness to ask others about themselves, we can begin to tighten the seams of humanity once again. When we each in our own way try to express our interest in others, and when we change the way in how we ask about the experiences of others, we all take one step closer to the power of the human experience that we look to foster every day in healthcare. We each can help catalyze this type of connection. My ask of all of us is that we work to do so. Our hope here at the Institute is to change how we ask you, our community, about your needs and to help start this subtle but significant shift. To that effort, we invite each of you to take a few minutes in the coming days via our inquiry to tell us how YOU are doing.

There IS no greater burden than an untold story. And there is NO greater means to connect and to better serve by working to share those stories. Here is to all the stories we will both share and create together in this new year and beyond.

Jason A. Wolf, PhD, CPXP

President & CEO
The Beryl Institute


1.     Wolf JA. Consumer Perspectives on Patient Experience 2018. The Beryl Institute; 2018.

2.     Barry MJ, Edgman-Levitan S. Shared Decision Making — The Pinnacle of Patient-Centered Care. New England Journal of Medicine. 2012;366(9):780-781. doi:10.1056/nejmp1109283.

3.     Gerteis M, Edgman-Levitan S, Daley J, Delbanco T. Through the patient’s eyes. San Francisco: Jossey-Bass, 1993.

Tags:  accountability  body of knowledge  collaboration  community  community of practice  Continuum of Care  engagement  Field of Patient Experience  global healthcare  Human Experience  improving patient experience  Interactions  Leadership  patient  patient engagement  Patient Experience  patient experience community  thought leadership  voice 

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It Takes a Village to Ensure Experience Excellence

Posted By Stacy Palmer, CPXP, Monday, November 18, 2019

The well-cited African proverb “It takes a village to raise a child” reinforces that an entire community of people must interact with children for those children to experience and grow in a safe and healthy environment. The villagers look out for children.

As a parent, I can’t agree with that more, and when I look back at my own childhood, I am reminded of the many people who encouraged and protected me – from teachers, neighbors and extended family to the nice sales clerk who helped me find my mom when I wandered off at Sears. It does take a village to raise a child.

It’s fair to say the village idea applies to most things in life and, as I am often reminded, that includes the patient experience. One of our earliest and most beloved videos at The Beryl Institute captured healthcare workers in many areas within a hospital environment – from medical labs, environmental services and radiology to admissions, pharmacy, spiritual care, volunteer services and more. After showing people in those areas performing parts of their work, the video came back to show each holding a sign with the hand-written message, ‘I am the Patient Experience.’

I believe the reason the video resonates with so many of us is that it reinforces we all contribute to delivering exceptional experiences. Every individual within the village of our healthcare organizations has the opportunity to help shape the experiences of patients and families. At the Institute, we love that healthcare organizations around the world have replicated the video with their own teams and use those videos to inspire, thank and connect with their staff and communities.

The African proverb can also be extended to the village that is our patient experience community at The Beryl Institute. In the nine years since we launched as a membership organization, thousands (literally, thousands) of you have committed time, energy and insights to help build this organization. It’s through the contributions of the village that the Institute has grown into the largest, independent community that builds the capacity of organizations to elevate the human experience in healthcare and develops individuals who impact experience excellence. 

As a small organization (currently we have eleven full time team members), we rely greatly on the contributions of the community. We’re thankful to have volunteers consistently step up to share case studies, write guest blogs, and present webinars, topic calls or conference sessions. Over 80 organizations have invited us into their spaces to learn about their patient experience journeys and share the findings through our On the Road series, and dozens have opened their doors to host regional roundtable or Pop-up events. Over 400 individuals contributed to the Patient Experience Body of Knowledge.

In addition to content collaboration and events, our community steps up often to provide insights on new programs and processes through virtual focus groups or project teams. Members of our Nurse Executive, Pediatric and Physician Councils and Patient Advocacy Community help ensure our resources remain relevant to members in their specific areas. Over 70 individuals volunteer to advise us regularly through our various boards including the PX Advisory Board, Solutions Advisory Board, Global Patient and Family Advisory Board and Strategic Advisory Board. It takes a village.

As The Beryl Institute continues to help build, support and expand the Patient Experience movement, the needs and opportunities for community involvement will increase. Currently we are recruiting member volunteers to evaluate the 2020 PX Innovation nominations, join virtual focus groups to share insights on exciting new research projects and contribute thought leadership through our guest blog. We’re also accepting applications for members to join our PX Advisory Board which helps ensure we maintain a focus on the topics of greatest importance to healthcare leaders and have a finger on the pulse of the critical issues influencing patient experience efforts.

I encourage all members of the Institute to consider opportunities to lead and contribute. In doing so, you will not only impact the evolution of this critical field, you will also become further engaged in a community of individuals and organizations passionate about providing the best healthcare experiences for patients and families, those who work in healthcare and the communities they serve. After all, it takes a village.


Stacy Palmer, CPXP
Senior Vice President & COO
The Beryl Institute

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An Orientation to Experience

Posted By Tiffany Christensen, CPXP, Monday, October 14, 2019

Some people will look at this picture and see a duck. Some will see a rabbit. The trick is that both are correct. The difference is how you are oriented to the picture. This is exactly the same in healthcare; we must always ask ourselves “How am I oriented?” (The duck-rabbit drawing was first used by American psychologist Joseph Jastrow in 1899)

At every moment of every healthcare interaction, there are two orientations at work: one of operationalizing experience and one of the personal experience of health/healthcare. Being oriented to operationalizing experience means you are thinking about things like whether or not:

  • The patient is being listened to by those caring for them and the organization as a whole
  • The patient/family is being spoken to in a way they can understand
  • The patient/family can easily find their way around the facility

Being oriented to the personal experience of health/healthcare may sound something like this:

  • “I am so tired and that walk from the parking lot was long. Will I have the energy after this appointment to make it back to my car?”
  • “What is that pain in my side? That wasn’t there yesterday. What does that mean? Is it worth mentioning it?”
  • “My dog is home alone. If they don’t finish tis appointment soon, I will need to just walk out.”

At some points along the way, these orientations compliment one another while, at other times, these dynamics appear to be completely discordant. The reality is that, either way, these dynamics can and MUST coexist. It is up to the healthcare professional to remain aware of how they are oriented—to operationalizing or to the personal experience--because both of these orientations are always present and are always appropriate.

To this end, The Beryl Institute is happy to share an extended version of The Experience Framework. The framework was built with the primary intention to help organize the areas of focus in examining and designing experience efforts. This, of course, is oriented to operationalizing experience.

The Beryl Institute’s Global Patient and Family Advisory Council has taken this framework and added the “personal experience of healthcare” orientation. We are excited to share this work as a companion to the “why” statements associated with The Experience Framework:


This is a great example of how ensuring any experience effort includes the sightline of those receiving care can provide balance and deeper meaning. When we orient ourselves to only one perspective, the rabbit or the duck, if you will, we may find ourselves missing out on meaningful perspectives that we need to inform and guide both organizations and individual interactions. We are so grateful to our Global Patient and Family Advisory Board for months of hard work that led to these illuminating statements regarding how each lens is EXPERIENCED by those receiving care.

We look forward to hearing from our community how they utilize this personal experience perceptive when operationalizing experience efforts! And, the next time you are working with a patient or designing the next experience/safety/quality improvement, ask yourself “how am I oriented?”


Tiffany Christensen, CPXP
Vice President, Experience Innovation
The Beryl Institute

Tags:  experience  global patient family advisory council  healthcare  orient 

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The State of Patient Experience 2019: Reflections and Four Considerations for Action

Posted By Jason A. Wolf, PhD, CPXP, Tuesday, September 10, 2019

Nine years ago this month in the Patient Experience Blog from The Beryl Institute, we introduced the definition of patient experience.

The sum of all interactions, shaped by an organization’s culture,
that influence patient perceptions across the continuum of care.

Those words remain true to this day and essential to all we have done to address the healthcare experience. As I offered then, “We will use this definition as a guide for how we build resources for our members. It will also serve as the standard for how we support and advocate for the creation of a positive patient experience across all healthcare organizations.”

This commitment and all it represents has guided the moments, months and years since that time; a time filled by the contributions, sharing and collaboration of thousands of people around the world, from across the healthcare spectrum and on both sides of the care experience, who have come together to elevate the human experience in healthcare.

This generosity of spirit has served as the fuel for the effort to do just what we aspired to do in 2010: to support and advocate for a positive experience for all across healthcare. It also serves now as the foundation for the continued exploration of what drives excellence in this work. The pursuit of exceptional experiences for all in healthcare – that is, ensuring safe, quality, reliable, service-oriented, cost effective, accessible, equitable and ultimately human care – now has taken its place at the strategic heart of healthcare itself.

This was reinforced in our latest exploration of the state of patient experience. In the fifth iteration of this study, The State of Patient Experience 2019: A Call to Action for the Future of Human Experience, we have seen trends revealed and opportunities elevated. While this piece is not intended to recap every finding (you can read about those in the full research report) it is important that we come back to where we started nine years ago in introducing the definition of patient experience itself.

Much of what we see today is rooted in the very ideas shared in September 2010 when we offered that a critical intention of the definition of patient experience was, “that we first must acknowledge that there is some "thing” called the patient experience we need to both recognize and address.” This “thing” as we knew then is even more essential to what healthcare is ultimately about. Experience is not a small part of healthcare, but rather it is woven into the very fabric of what healthcare is and continues to become. The results found in this year’s study underline that point.

So, in our intention to move to a future of healthcare grounded in experience, we are called to recognize and act on a few fundamentals. Many have been central to our focus at the Institute from the very beginning. Some we have discovered from our community as we have worked together to improve the patient experience and elevate the human experience in healthcare. With this I offer four essential considerations for action:

  1. Patient experience is not something healthcare does, it is who healthcare is. It is when experience is simply seen as a thing to do, a box to check in a complex healthcare world, that its possibility is immediately weakened. Experience happens regardless of plan or process. It is who a healthcare organization is and how it is perceived by others. It is incumbent on all in healthcare to build organizations that realize that every action, every encounter and every interaction create an experience for all involved.
  2. Patient experience is driven by all we do and, therefore, every effort must be approached with an integrated view of how it will impact the overall experience we provide. This is the essence of the experience framework itself. It is in understanding that all the elements it includes, the eight strategic lenses, while often operated distinctly in healthcare, must be seen as one integrated set of actions in ensuring an aligned and effective effort to drive experience and the outcomes we look to achieve.
  3. To succeed externally, we must focus internally. The idea that culture matters or that how we treat those who work in an organization will impact the experience of those it serves is not new.  The state of patient experience data from 2015 to today reveal a rapidly growing awareness of communication and employee engagement as the primary path to experience success. If organizations are not willing to work on themselves first, they will never ultimately achieve the experience success they seek.
  4. A commitment to experience will not (and must not) ever end. One of the greatest issues raised by healthcare organizations is that of sustaining success with their experience efforts. This raises an opportunity for all to consider. Experience excellence is not simply something to be achieved. That idea presents a false consideration as it suggests experience has been accomplished and your efforts done. But the need to ensure the best in experience never truly ends. It is about a relentless pursuit of excellence, about consistent delivery of intent and an unwavering commitment to the human experience at the heart of healthcare that will lead to the outcomes we all aspire to achieve.

These considerations offer a clear and solid footing on which organizations can build as they strive to ensure the best experience for all they engage. I have long shared that if we do not set the proper foundation for our organizations in healthcare, all the strategies, processes and tactics live on unstable ground at best, and therefore outcomes – and more so sustained outcomes – are at risk from the start. Yet, what the State of Patient Experience 2019 has revealed and has reinforced in what we found in both our exploration of Consumer Perspectives on Patient Experience and Influence Factors on Patient Experience last year, is that healthcare is moving toward a more comprehensive view of what experience is and recognizing the breadth of efforts aligned to realizing experience success.

From those insights and the reflections of our participants in this year’s study, it is safe to say patient experience is perhaps at the most exciting moment in its arc of life. From its elevation as a concept in definition nine years ago, through the shared journey of so many in the time since, experience as a concept and a movement finds itself at the start of a new era. The healthcare experience will now be driven by what consumers of care seek and will be grounded in an accessibility of knowledge by those consumers that is already shifting the fundamental power dynamics. If we only continue to address experience as something that happens when care is delivered, we too will fall short of what is needed and may very well miss where the market is going. This is where the work of the experience community must continue to evolve.

In understanding what healthcare encounters will look like now and into the future, the ideas and elements that influence those experiences will be vital to consumer choice, system viability and the health of our communities and populations served. Yet in the end so much of it will come back down to the simple ideas where we started nine years ago, that experience is truly the sum of all interactions that occur in healthcare, and those interactions are shaped by the culture of the organizations that offer them.

The future of patient experience is inspiring. The elevation of the human experience unquestionable. Now we must focus on nourishing our strong roots and feeding our big visions. That is what those who seek care every day will be looking for and those truly committed to what healthcare can be will expect to deliver every day.


Click here to download your complimentary copy of The State of Patient Experience 2019: A Call to Action for the Future of Human Experience.

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My Rearview Mirror: Reflections from a Former Patient Advocate

Posted By Tiffany Christensen, CPXP, Thursday, August 15, 2019
Updated: Tuesday, August 20, 2019

I became a patient advocate for a major medical center after my second double lung transplant (first for cystic fibrosis and second due to chronic rejection) and quickly learned that I was quite naïve about the job I had just accepted. In the three years I worked with CMS Guidelines to resolve complaints and grievances, I went home many nights crying, gritted my teeth all night long and woke up every Monday with a “new plan” to make this job into what I had hoped it would be. I wanted to help people, I wanted to be what the title said I was; “advocate.” Instead, I felt like my days were spent getting yelled at about things I could not really fix while emotionally fighting to stay above water in a sea of conflict. 

In the past month, The Beryl Institute has dropped a new podcast featuring four patient advocates and a White Paper exploring the role and all of its many sides. Both of these resources brought up a lot of memories for me and I took some time to reflect on what I experienced nine years ago. What I found was a hearty serving of regret. The crying, the teeth grinding and all of the other manifestations of my stress did not have to be so intense; perhaps they did not have to exist at all. My biggest regret? Not being able to manage my own thoughts and recognize that the patients were not stressing me out but, rather, I was stressing myself out. Perhaps a few examples would be best to illustrate what I mean.

What happened:

She knocked on my office door and I opened it to find an agitated and slightly frantic woman who began talking immediately, making it impossible for me to even invite her in. We stood in the doorway as she told me that her husband was being moved out of the ICU to the step-down unit after a heart transplant and she did not want him to move because the ICU was a much nicer environment than the main hospital.

What I thought:

“Well, of course the ICU is a nicer facility…it’s brand new and the step-down unit is in a building built in the 1980’s! Doesn’t she understand that staying in the ICU means her husband is sicker and moving to step-down means he’s getting well? That’s a good thing! Doesn’t she see that if her husband stays in ICU when he doesn’t need it, he’s keeping someone who is very sick from being in the bed they need? She should better understand the system and she should know that keeping her husband in ICU is just not an option.”

Looking Back:

Reflecting back on this interaction and so many others, I regret thinking this way. Not only because I was very far away from “meeting people where they are” but because these thoughts actually caused me stress. If I am being honest, I had thoughts like these about most of my interactions during the day. If we pile these thoughts on top of each other we have a day filled with frustration and a sense of always swimming upstream. I now know that there is a way to adjust my thinking so that I no longer cause myself stress AND I am more effective in these types of interactions.

Often, I carry a belief or judgement with me that I am not even fully aware of. In the example above, one of those beliefs might be, “Patients and families need to understand the system.” In this case, this would mean understanding that patients in ICU need to be a certain level of acuity to be in the ICU. When I believe the thought that this woman in my doorway should know this already, I feel frustrated with her assertion her husband should stay in the ICU. Internally, my chest clenches and I feel a little hot. I am impatient as she talks and am ready with my response of why “this is a good thing” and, before she is done speaking, I interrupt her. She does not feel heard and now the rapport is breaking down and I walk away frustrated that I have to talk with someone who is unreasonable. 

It didn’t need to be this way. The problem was not her request. The problem was my belief that she should understand the system. It’s my internal, unconscious belief that caused me to be irritated, not her. It was my internal, unconscious belief that made me impatient and took our conversation in a negative direction when it could have been one of support and encouragement. We could have ended in a place of celebration because her husband was leaving the ICU. 

So, why am I now looking in my rearview mirror and thinking I could have done things differently? Because now I have some tools to help me identify my stressful thoughts and turn them around. There are many ways to do this but, in this example, I want to use “The Work of Byron Katie” to see how this interaction might have played out differently.

Patient’s wife: “My husband is being moved out of the ICU after his heart transplant. I do not want him to move because the ICU is a much nicer environment than the main hospital!”

My internal thought/reaction: This woman doesn’t understand how healthcare works—of course her husband can’t stay in ICU! Other people need those beds and leaving the ICU means he is getting better so she should be happy about that!

I could pick multiple thoughts to inspect here: “she should be happy,” “she should understand how healthcare works” and “other people need those beds more than him” are all reactions that would benefit from exploring so we’ll just pick “she should be happy” and do a modified version of “The Work”:


“She should be happy”: Is that true?

Yes! Her husband is getting better!


“She should be happy”: Can I really know that that’s true?

Well, no, maybe there are too many other things/worries going on for her to be happy about this


How do I react, how do I behave, when I think this thought “she should be happy”?

I am frustrated with her for not being happy! I speak in short sentences and think about other people who have it worse, who are not getting better. I try to hurry her up so we can wrap up the conversation because I want to get on to helping others who are having a harder time than her husband.


Who would I be in that moment if I was incapable of thinking the thought “she should be happy”?

I would just be a person who is listening. I might be happy for her husband, even if she’s not able to see yet that leaving ICU is a good thing. I would be interested in her perspective and I would want to know more about why she prefers the ICU over the main hospital. Her concerns would be most important to me in that moment.


Can you see any non-stressful reason to keep the thought, “she should be happy”?

No. My irritation doesn’t serve anyone and, the truth is, whether she is happy or not is none of my business.


In healthcare, it is very easy to get into a cloud of irritation. It is such a stressful place to work that sometimes finding flaws in those we serve or those we work beside becomes a habit and we don’t even realize it. Sometimes, we work to be “less judgmental” in order to be a better person but we fail to notice that these kinds of thoughts hurt us first and those we interact with second. For me, realizing that I am in charge of my own stress just by noticing and inspecting my own thoughts is such a relief. The world isn’t happening TO me, I am responsible for how I see it.

I regret that I did not have these tools when I was a patient advocate. It’s my hope that sharing this might help someone who is currently working in healthcare see that there is a way out of this kind of internal stressor and give it a try. As you go about your day, notice your thoughts: 

“Patients should be nice to the people who are trying to help them”

“My boss should understand how much stress I am feeling and not give me more work”

“My colleagues should apologize when they are late”

As you notice these thoughts, remember to ask yourself the questions when you have a moment:

  1. Is it true?
  2. Can I really know that it’s true?
  3. How do I react, how do I behave, when I think this thought?
  4. Who would I be in that moment if I was incapable of thinking the thought?
  5. Can you see any non-stressful reason to keep the thought?

Thank you to all of the patient advocates who are able to remain caring and grounded in a very challenging role. Thank you to everyone who works in healthcare and is able to be understanding and forgiving towards patients, families, staff and clinicians. Whether or not you choose to use this model of personal inquiry, I hope you are able to find peace within yourself during even the most frustrating or chaotic moments in your professional life. Patients matter and those who serve them matter too. Care for your own heart and it will then naturally care for patients.


Tiffany Christensen, CPXP
Vice President, Experience Innovation
The Beryl Institute

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Doing a Happy Dance for Fewer Emails

Posted By Stacy Palmer, Tuesday, July 16, 2019
Updated: Tuesday, July 16, 2019

We send a lot of emails.  Those on our mailing list will likely agree. 


To be transparent, we’ve struggled with balancing our communications over the years. We have so much great information to share from the generous contributions of our members, and we’ve worked hard to ensure no one misses something that might support their patient experience efforts. But, at times our members have shared that the frequency of emails can be overwhelming. 


Earlier this year we brought on a new marketing manager. Emily is a polished communicator with great energy and fresh perspective. Within a few weeks she came to our team with a bold idea, “Let’s only send ONE email per week.” At first we gasped, as it seemed such a departure from our typical approach. But the more we listened to Emily’s reasoning, the more excited we became.


She reinforced the opportunity to make things easier for busy healthcare professionals, to consolidate our content and to create a publication that our community could anticipate arriving in their inbox on the same day at the same time each week. She believed there could be calm and rhythm in the predictability of a newsletter received in a concentrated format. 


In healthcare, we emphasize the need to listen to those we serve. Recognizing the opportunity to heed those words and put them into action at the Institute, we looked to our community for feedback.  First, we introduced the weekly email idea to our boards and councils. With their incredibly positive response, we then conducted four virtual focus groups. (Note: if you haven’t signed up to participate on our Virtual Focus Groups, I encourage you to do so!) 


The focus groups were unanimously in favor of the transition. In fact, two different members on two separate focus groups exclaimed they were doing a ‘happy dance’ at their desks as Emily shared the idea. They appreciated our understanding of their professional challenges, the intention to streamline content and the opportunity to contribute feedback to the process.


So, today, in an effort to consolidate and improve our communications, we are excited to introduce PX Weekly…your Patient Experience newsletter.


You will still receive all the resources and information you’ve come to expect from the Institute, just in a consolidated, weekly publication. While that means emails will be longer, we’ve designed PX Weekly to be consistent and clean with simple icons to help you quickly find your favorite features such as event calendars, podcasts, learning bites or blogs.


There will be occasions in which you receive additional emails from the Institute, but we will limit those to special announcements such as new issues of Patient Experience Journal, new white paper releases and event-specific communications for Patient Experience Conference or PX Pop-ups.  


Take a look at the first issue. We would love to hear your thoughts. We welcome any suggestions on how we can improve the newsletter to best support your efforts to positively impact the healthcare experience for patients, families and those providing care. 


We’re working hard to support your needs and hope this change will help keep you engaged, informed and better prepared to do the important work you do. (And maybe even inspired to do a little happy dance!)



Stacy Palmer, CPXP

Senior Vice President and COO

The Beryl Institute


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A Gift Not a Burden

Posted By Deanna Frings, MS Ed, CPXP, Wednesday, June 5, 2019

Memorial Day has just past and my thoughts keep going back to the long weekend spending much of it with family. It was raining most of the day and so I wasn’t able to put out our American flag as I typically do. I missed this simple ritual because as I’m placing the flag in its holder on the front of the house, I’m reflecting on the purpose for this holiday, connecting to the gratitude I feel (the sadness too) for those that have lost their lives in service to our country. While it’s a somber moment, I embrace the heaviness. It’s the least I can do.

That evening my husband and I ended our day watching the movie Saving Private Ryan. For those that don’t know the story, it takes place during the invasion of Normandy in WWII. Captain John Miller (Tom Hanks) has orders to lead his team behind enemy lines to find Private James Ryan, whose three brothers have been killed in combat. Experiencing the brutal realties of war, as they search for Private Ryan, each solider set out on a personal journey and discovers their own strength to triumph over an uncertain future with honor, decency and courage. Near the end of the movie, Captain John Miller is fatally injured. His final words to Private Ryan are, “Earn this.”

Some might think as I did, that this is a huge burden to lay on someone. My husband however, shared that maybe it’s a gift rather than a burden. To quote him exactly, “A gift even more valuable than his life being saved because it gives his life a purpose, to make their sacrifice worth something.”

What are the lessons we can apply in our own lives? If we use Memorial Day not as a single day to honor or remember the fallen, but as a day to remind ourselves of our duty to honor them every day by our actions, we make the country stronger. Can we use these same lessons to make our healthcare systems stronger?

At the Institute, our purpose is Changing healthcare by advancing an unwavering commitment to the human experience. We do this with and alongside you, the patient experience community. Whether it’s through our On the Road experiences, collaborating with you on White Papers, gathering at our PX Pop Ups, engaging in conversations during our PX Body of Knowledge classes or hosting our monthly webinars, we see you doing it with honor. The many actions you take every day are making the experiences of those you serve better and our health systems stronger.

Having a clearly defined purpose can be a powerful guide to action and I don’t think we have to make it too difficult or overly complex. As leaders in healthcare, I also encourage you to find opportunities to share your own personal journey with those that depend on you. Share what patient experience means to you, why you think it’s important and what you believe your team does every day that positively impacts the experiences of others. These simple actions when done with courage, strength and humility honor your teams and opens the door for them to connect to their purpose and make greater meaning of their day to day actions.

Those that work in healthcare often witness the courage with which patients and families face the fear and the uncertainly that comes with a personal healthcare event or serious diagnosis such as cancer. This alone is a great reminder of the purpose for the work that we do in striving to make the experience more comforting, easier to navigate and to embrace the heaviness and fatigue that can come with this type of work. I hope you see it as a privilege to share their burden and fears with care, comfort and compassion.

Our purpose lives on because of you. It will be through our collective voice and the actions we take together that we celebrate this gift that is given to us. The gift of striving to make healthcare more accessible and the human experience better and doing it with honor and gratitude. It’s the least we can do.


Deanna Frings, MS Ed, CPXP
Vice President, Learning and Professional Development
The Beryl Institute

Tags:  encouragement  honor  humility  leaders  memorial day  purpose  sacrifice 

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Introducing the Experience Ecosystem: Reinforcing community, collaboration and the integrated nature of healthcare experience.

Posted By Jason A. Wolf, PhD, CPXP, Tuesday, May 7, 2019

On our journey to grow the experience movement and The Beryl Institute community, we have built a vibrant and dynamic network of committed professionals and practitioners, innovators and researchers, patients and family members, caregivers and partners from around the world. This network, through its commitment to “share wildly and ‘steal’ willingly”, first shared in acknowledging the experience era in which we now find ourselves, helped shape an Experience Framework introduced by the Institute last year (Figure 1). The Framework is comprised of eight strategic lenses that represent the broad and integrated perspective needed to ensure a comprehensive focus on experience. Aligning efforts on these lenses is essential to ensuring the ultimate achievement of experience excellence.


Figure 1. The Beryl Institute Experience Framework

The Experience Framework, grounded in research from the Institute and the experiences of our community, offers a means to better codify, digest and access the information and resources that will support the community on our shared experience journey. It provides a structure through which we can individually, organizationally and collectively understand where we are on our experience journey, identify the opportunities we have and then connect to the resources and solutions that will help us continue on the road to experience excellence.

In our commitment to observe, learn, and adapt and to not just support the continuous improvement of the experience conversation, but also to elevate innovation, support sharing and ensure ongoing value for our community, we realized the Framework was only the core of the conversation. What we realized was the Framework was a means for identifying and connecting the vast collection of resources, organizations and solutions that comprise the broad efforts to positively impact the patient experience and the human experience in healthcare.

This recognition ultimately helped us to identify the Experience Ecosystem, which represents the comprehensive collection and interconnected system of resources and assets committed to experience excellence. The Ecosystem addressed a critical opportunity for our community and the movement by ensuring ease of access, expanded awareness and speed to action in tackling experience efforts by connecting people to the information and tools that could support their success. In developing the ecosystem three principal levels were identified and established:

  1. RESOURCES. This level is comprised of the resources offered by and through The Beryl Institute. The full extent of content, resources, research and tools available via the Institute community is now aligned with each segment of the Experience Framework for easy identification, access and application.
  2. ASSOCIATED ORGANIZATIONS. This level is comprised of the organizations that provide insights and resources beyond the Institute’s boundaries and/or complement our efforts. Providing a clear link to this vast network of organizations and underlining their connection to experience both reinforces the opportunity in alignment and the importance of connection and collaboration in this work.
  3. SOLUTIONS PROVIDERS. This level is comprised of product and solutions providers – those that have invested in being part of The Beryl Institute’s Patient Experience Marketplace – who have solutions and offerings that can support you in your experience efforts.

All Resources, Associated Organizations and Solutions Providers are now segmented by and aligned to at least two of the eight strategic lenses of the Experience Framework with which they best connect. This identification, curation and linking to this growing collection of content and knowledge is central to our purpose at the Institute to serve as a center for collaboration, connection and shared knowledge. Each strategic lens has its own landing page linking you directly to the information available under each of the eight lenses of the Framework. Ultimately, the opportunity with the Experience Ecosystem is to serve as a bridge from discovery to solution, need to action, opportunity to outcome. And this will happen in some new and exciting ways.

Within the Experience Ecosystem you will have the means to identify where you are excelling or have opportunities to address in your experience efforts. To complement the launch of the Ecosystem, we have introduced the Experience Assessment; a quick assessment tool through which you can individually or organizationally identify how you are performing in each of the eight strategic lenses. The Assessment is built on global research conducted via the Institute identifying the issues and actions of greatest importance to consumers in healthcare and those actions that high performing healthcare organizations have deemed essential to experience success. In aligning the data from consumer voices and the insights from healthcare organizations, the Assessment was built to evaluate the current efforts of an organization, provide insights for reflection and quickly uncover opportunities for action.

While the assessment can be taken individually by anyone as a single point of data, we encourage you to consider an organizational evaluation (currently available to organizational members of the Institute). The results report you receive provides a breadth of information from your overall Human Experience Index (HXI) score to individual scores on each strategic lens as you identify strengths and opportunities. On your score report, you will also find a link to the landing pages noted above leading you to more resources for each strategic lens.

In the end, the potential of the Experience Assessment is two-fold. Not only does it help with individual improvement efforts, but as the database of responses grows, we will have the ability to provide both insights and benchmarking comparisons to how the general market is doing. It will also help identify the broader opportunities we have as a community to focus our efforts on experience improvement, support shared opportunities for learning and identify those organizations that can help one another with the challenges they continue to face.

The Experience Assessment is built on our value at the Institute that there is not one right model for everyone, not one best solution for all to choose, and yes, not one organization that can say it will solve all your experience answers. This underlines the unique power of being part of the Institute family. As an independent, global community of collective voices with a commitment to experience excellence and to one another, we can ensure you find the best resources for your needs in a safe, helpful and impactful way.

The ultimate goal of this effort is to provide the means to support connection and ensure that what can sometimes feel like a disparate and disconnected range of information is now a thoughtful, codified and focused resource that supports and reinforces the ultimate purpose we live at the Institute every day: To change healthcare by ensuring an unwavering commitment to the Human Experience.

This purpose highlights our shared commitment as a community and reinforces the independent nature of the Institute itself. Our opportunity remains to objectively provide access and connection to the breadth of resources available and being sought by patients and family members, clinicians and caregivers alike in organizations and systems around the world. If we can bridge identified needs to the resources needed, if we can elevate and share strengths in a way that we all win, then we have truly done what calls us together in the experience community. In the end the Assessment and Ecosystem shortens your distance to discovery, builds a bridge to supporting resources, and quickens your pace to outcomes.

We believe introducing the Ecosystem does a few critical things. It helps ensure The Beryl Institute’s site is easier to navigate. It elevates and expands our reach and opportunity for excellence by connecting people to Associated Organizations and Solutions Providers that bring value to the conversation. In doing so it reinforces our philosophy at The Beryl Institute that through collaboration and cooperation, connection and purpose, we can and will ultimately elevate the experience conversation together.

The Experience Ecosystem, Framework and Assessment provides a means to help us get from now to the tomorrow we know we can achieve, and it is a tomorrow we WILL achieve together. We invite you to join us in the journey, take the assessment, apply the Framework, contribute your knowledge to the Ecosystem and we will ensure that healthcare is the place in which experience is not the outlier, but truly the heart of all we do.


Jason A. Wolf, PhD, CPXP
President & CEO
The Beryl Institute

Tags:  associated organizations  caregiver  ecosystem  experience framework  resources  strategic lenses 

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Staring at Walls: Who Are We Designing For?

Posted By Tiffany Christensen, CPXP, Tuesday, April 9, 2019

As funny as it may sound, the topic of “environment” within the Field of Patient Experience is somewhat controversial. Some professionals in this industry feel environment is the primary variable in patient experience while others are frustrated that it’s even part of the conversation at all. The 2018 Consumer Perspectives on Patient Experience 2018 study from The Beryl Institute shows that patients and families rank listening and communication as the key ingredients to a good experience while the age of the facility and parking are low on the list of importance. So how does environment fit into the puzzle of providing a good patient experience?


I went to see a friend of mine in ICU days after she’d had an unexpected brain bleed and hours of brain surgery. She had just come off the ventilator so this visit fell during a critical and tense time. During my visit, my friend began to vomit and appeared to be having difficulty clearing from her mouth and throat. I attempted to get help but, when I poked my head out the door, the nurses’ station seemed to be miles away and there were no clinicians in site. I went back into her room and attempted to get her on her side so she wouldn’t choke and fumbled around for the call bell. After a few minutes, a nurse came in and my friend was given the care she needed.

For days and weeks after that visit, that moment haunted me. What I remember most was the profound sense of being ALONE in there with a friend who was very, very sick. The ICU itself was beautiful and very large. So, large, however, it felt unsafe to have sick patients down long hallways far from any central point. Clinicians helping each other had to be far away from the patient they were caring for, essentially leaving patients unattended.

It strikes me that this ICU was an area of pride for this hospital; extremely high tech, modern, and, did I mention…large? But, that describes an environment that appeals to healthy people. From a clinical perspective, the mark was missed because those for whom the building was designed needed their clinician nearby, something this design failed to prioritize. It made me wish that I could ask the architects: “Who are you designing this for?”


For patients being cared for over time, there are often stages of recovery. In my life as a CF/Transplant patient, my hospital visits have usually had the same progression:

  1. Arrive, sick, tired and with the sole goal of getting into bed to rest
  2. Begin feeling better, get more engaged in my care plans and ask about discharge
  3. Feel better, get more and more irritated with everything in the hospital and anxiously await discharge
  4. Almost time to go home, consider writing a letter with everything I am noticing could be improved and wait, like a dog at the front door, for the next clinician to come by and give me news
  5. Go home, feel grateful for my care and recovery, forget all about the “improvement letter” and work on building strength to get back into my life

It may come as no surprise that, during steps 1 and 2, the environment around me doesn’t hit my radar (Unless it appears dirty. In that case, I worry about catching something new while there.). During steps 3 and 4, however, my environment impacts my state of mind. Staring at blank walls or signs that say “Call Don’t Fall” do little to help me distract myself from being enclosed and antsy. Soothing colors, wall art I can dive into with my eyes and options for natural light can bring some comfort. There is actually science around this but it’s not a science we use often in healthcare. (For one great example of this, explore the work of Danish artist, Poul Gernes, who believed that colors could have a stimulating effect on hospital patients and help reduce pain and suffering.)

During a recent stay in a hospital, I took a photo (see adjacent picture) of my primary visual focus during the time I was in-patient. This sliver of a window facing the hallway was the one part of the room with life and hope; watching people bustle by and wondering if this would be the next person to knock on my door. This window is most of what I remember from my hospital stay. This is what I would call “the lived experience” of a healthcare environment. 


I got a call early on a Monday morning that my mother was at our local ED after suffering a stroke. My 3 siblings, 2 brothers-in-law and my father all descended on the ED to sit with her through the testing and admission process. Well, perhaps I should say “stand with her.” Like many EDs, there was little space for the family beside her bed, even if we went in 2 at a time. That was alright for my siblings and I but my father is in in his mid-eighties, has trouble walking and was distressed over his wife’s sudden change in health status. In some ways, I worried more that there was nowhere for him to sit than I worried about my mom at that point. 

Watching him, and others, struggle with long walks from A to B (the walk from the ED to the in-patient unit actually required a car ride for him) and, once in a room, he seemed to receive little consideration as an elderly family member, made me wonder how often we consider family when designing spaces.

I have seen beautiful hospital lobbies with piano players and comfortable seating. I have seen hallways with compelling art pieces lining the walls. I have seen fountains and gardens on the grounds of healthcare facilities that take your breath away. These spaces are wonderful but are used quite infrequently in comparison to the space at the bedside, gurney-side or chair-side of a loved one seeking and getting care. I can’t help but wonder what might happen if we invested more in the spaces that most impact the patients and families rather than we often do on the common spaces? What if we focused on designing an environment that:

  • Was always built for safety before aesthetics
  • Supported the staff and clinicians in delivering efficient care without wasted steps, etc.
  • Enabled the shortest path from A to B
  • Was soothing and pleasing to the eye
  • Had room for family and clinicians so that all felt comfortable and valued at the bedside

Perhaps the “controversy” about how much emphasis should be placed on environment is less about how MUCH it matters but more about WHAT matters in supporting the human experience of healthcare. Considering these elements and working to understand the true lived experience of those really using the healthcare spaces, would surely make “environment” a key driver in experience.


Tiffany Christensen, CPXP
Vice President, Experience Innovation
The Beryl Institute

Tags:  environment  ICU  patient experience  safety  sanity  space 

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