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To Care is Human: 3 Considerations for the Future of Patient Experience

Posted By Jason Wolf, Wednesday, December 5, 2018
Updated: Wednesday, December 5, 2018

This has been an exciting year for the patient experience movement in which an unwavering commitment to human experience has been elevated and expanded globally. In our efforts at the Institute we have had the opportunity to engage the voices of healthcare consumers on their views of experience and what drives their decisions, we introduced the Experience Framework to reinforce the integrated nature of the human experience in healthcare and now just last week released our latest study on the influence factors on patient experience.

This is significant in that in linking these efforts together we begin to see for the first time in practice and evidence that there is alignment around what we can and should do to ensure experience excellence. This work lays out a pathway that while not surprising has been sometimes difficult to ensure a commitment to in a healthcare system driven by transactions, checklists and processes that overlook the very essence of healthcare itself – the human caring at its heart.

I shared a story to open Patient Experience Conference 2018 about how my son Sam taught me a valuable lesson in the power of human connection and how simple and brave we must be to ensure these connections occur. He showed me sometimes it just takes commitment, the willingness to reach out and acknowledge another human being in front of you for who they are, not what they have or what they do. This too is what consumers told us they wanted, and it is what we discovered in the findings of the Influence Factors Study as well.

For the Influence Factors Study, over 1400 respondents identified the factors of greatest importance to patient experience. In addition, almost 300 high performing healthcare units (as defined by achieving and sustaining high percentage of scores in the top box of 9-10 in the overall rating question on the CAHPS survey) representing 175 organizations provided input as well.

The study revealed that for both respondent groups how patients and family were treated and how they were communicated with had the greatest influence on experience. This was followed closely by the teamwork and engagement of care teams and core clinical indicators such as responsible management of pain and care coordination. Interestingly enough what was shared here, that is that experience is driven by 1) how we treat people we serve, (2) how we treat each other and (3) how we provide the quality people expect, perhaps provides the triangulation of factors that sums up the potential of and opportunity for an elevated commitment to the human experience in healthcare overall.

This discovery reinforces that at the end of the day our opportunity to care for one another as human beings is the essence of our work in healthcare. This was supported in the alignment of the influence factor responses with the voices in the study, Consumer Perspectives on Patient Experience released this summer, which found that that top-rated items of importance to consumers were, in order, ‘listen to you’, ‘communicate clearly in a way you can understand’ and ‘treat you with courtesy and respect’. The most significant realization in this finding in comparison to what were identified as the top influence factors was that not only were the top items nearly identical, in essence effective communication and respectful treatment, but also that these items scored significantly higher response percentages in both studies. This had them stand out clearly as the top items in both surveys and coming from two very distinct respondent groups.

What this means is that what people are asking for from healthcare, it is evident healthcare organizations know and high performers provide. So, then what has been in our way of meeting those expectations and needs? I offer it has been healthcare’s commitment to process at the expense of people and transactions at the expense of interactions that has undercut its very capacity to achieve this ultimate goal.

This is not offered to diminish the complexity of healthcare we face today, but rather to call us to ask if we are the reason for the very complexity that gets in our way. If we were to focus on these simple things, to build processes, programs, technologies and innovations to support and sustain this focus on the humanity in healthcare, would we see something very different in how we look to lead healthcare globally. That is our opportunity and the story I hope you will find of interest in our latest paper: To Care Is Human: The Factors Influencing Human Experience in Healthcare Today.

With this we are called in healthcare to come back to ground with three considerations that can help us all lead the experience effort forward. These include:

  1. Patient experience must be seen with an integrated focus that ties together the many facets impacting how human beings on both sides of the care equation experience healthcare. It must be operationalized with this broad and inclusive perspective.
  2. Experience excellence, at its heart, is about the relational interactions we have in healthcare. It is grounded in the kind of organizations we build to sustain quality, safe and effective healthcare for all engaged. We must move beyond simple transactions and find comfort in the human complexities that are at healthcare’s core.
  3. To care is human and above all else that must be a rallying cry for what healthcare can and must be. Yes, medicine is a complex science, but healthcare is not just about medicine. When we mix that science with the art that healthcare ultimately represents, we get a symphony comprised of the greatest experts, but one that only works when all those expert parts play together. And if we do that, the outcome will be truly magnificent.

The Dalai Lama is quoted as saying, “The human capacity to care for others isn’t something trivial or something to be taken for granted. Rather, it is something we should cherish.” I would add it is something we must acknowledge will require hard work, unwavering commitment, a willingness to try and fail and a focused commitment to excellence.

The things healthcare has shown it knows to be true and the things consumers are asking for consistently come down to something so essential I could be blamed for saying it too much – that in healthcare we are human beings caring for human beings. So, whether I am walking the halls of a VA facility or waiting in an essential hospital’s emergency room, seeking new research innovations from an academic medical center or being cared for in my rural healthcare center, or standing on any continent in any health system, in any healthcare setting across the continuum around the world for that matter, this universal truth remains.

It then is up to us to consider how we balance the science that has driven healthcare with the art that is what will enable it to ultimately succeed.  We can no longer say that all people want is for us to make them better. That has been healthcare’s driving outcome, but for the patients and families we serve, it has been a fundamental expectation that we do so. Where the real difference and ultimate distinction lies is in HOW we make them better, in the acknowledgement that in caring for the human in front of us and those who serve around us we are realizing the true potential healthcare has to offer.

Yes, to care is human, the evidence bears out its impact and value. And in giving ourselves the permission to hold that idea as central to all we do in healthcare we can and will reframe a system with a potential for care, wellness and healing we have only dreamed could be possible. Experience is not something else we must or should do, it is all one does in healthcare, it is time we acknowledge this and move forward with this new sense of possibility. What will be your first step?


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

Tags:  amenities  cleanliness  Clinical  defining patient experience  employee engagement  feedback  Human Experience  improving patient experience  Leadership  patient and family  Patient Experience  policy  quality  safety  service excellence  signage 

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Experience Innovation: Connecting Motive to People and People to Action

Posted By Tiffany Christensen, Tuesday, November 13, 2018
Updated: Tuesday, November 13, 2018

As the VP of Experience Innovation at The Beryl Institute, it seems quite logical (and necessary) for me to have a clear understanding of how to define innovation in the Field of Patient Experience. Since I have just celebrated my one-year anniversary at The Beryl Institute, I thought this might be the right time to share my perspective on what we mean when we say “Experience Innovation.” 

At its core, innovation requires creating something new or changing something that already exists so that it becomes new/improved. By this framing, we can safely say innovation permeates experience efforts across all aspects of the Experience Field. Perhaps more important than defining Experience Innovation, however, is determining the motive and method for innovation. 

IDENTIFYING MOTIVES BY UNDERSTANDING WHO WILL BE IMPACTED

Healthcare is competitive. Even in the Field of Patient Experience, we see organizations and individuals striving for recognition and advancement. At times, the motive for innovation might be driven more by a desire to stand out. In some cases, innovations are designed for the sake of being innovative. For these and other reasons, we must closely examine if the motive for innovation is directly tied to being helpful to a PERSON or GROUP of people. Innovations without a clear connection to the people potentially served, at the very least, run the risk of wasting effort/resources or, in the worst case scenario, creating harmful innovations. 

The first step in examining an innovation’s motive involves becoming clear about who will be impacted by the innovation. This requires an in-depth understanding of the experiences of the “end-users” (to borrow a Human Centered Design term). In healthcare, the “end user” is often a patient but it is certainly not limited to patients and families.  

Once the “end-user(s)” are clearly defined, it is important to ask a few basic questions:

  1. Do we know the problem we are trying to solve is a) really a problem and b) is a priority for those impacted?
  2. Have we gathered sufficient data from those we plan to help to a) understand their experiences and b) ask them if our innovation would potentially make their experience better?

After these questions have been answered we can then begin to walk through ow the innovation is directly tied to being helpful to a PERSON or GROUP of people. One possible way of doing this is by pulling in the Model for Improvement. While this approach is a widely recognized step-by-step way of improving safety and quality in healthcare, for some reason, this model is applied to experience improvement far less often. Because we have a large and diverse toolbox filled with potential tactics for change, we want to be sure we are not using an “innovation for innovation sake” approach but, rather, building an innovative strategy to help people by addressing a specifically identified need. Using something like the Model for Improvement can help guide the discovery of the “why” before the “how”. 

KNOWING THE “WHY” BEFORE CONSIDERING THE “HOW”

For organizations working to find strategies that enable them to hear the voice of their patients and families, finding a structure to do so is innovative and met with enthusiasm. 

A Patient and Family Advisory Council (PFAC) is a well-known, widely accepted strategy with low risk to the organization. For these and other reasons, PFACs are often the first choice for partnering with the community. Despite the popularity and comfortability, in some cases, organizations are surprised to find the PFAC’s administrative lift is too heavy or the community itself is not interested in engaging with their local healthcare organization in that way. Such a discovery may be followed by a revisioning of the goals for the PFAC and, in some cases, the choice is made to use an entirely different partnership strategy. In either case, the time spent running a PFAC without clear aim was potentially wasteful and frustrating. 

In instances like these, it was recognized far down the road that there was not a clear vision for the “why” but, rather, only a focus on “how” to build and implement the strategy.

Rather than starting out by choosing an innovative strategy (like building a PFAC), we can begin by getting clear about the desired improvement to experience. Moving forward, it is important to know a few basic things:

  1. What are we trying to accomplish with this innovation? How will it help people?
  2.  How will we know we have helped people?
  3.  What strategy will we choose to improve the experience? (Included in this might be “how will we learn from the Experience Community about all of the potential solutions we have to choose from?”)

Once you are clear about the people who you plan to help and the way their experience will be better through this innovation, you can decide if the motive for the innovation is a healthy one.

So, how do I define Experience Innovation? Amazingly, even after a year of thinking about it, the complete definition is still coming into focus. The more time I spend at The Beryl Institute, the more I am excited by the nuances of both language and operationalization required to describe it. My hope is to share my personal definition of Experience Innovation at my 2-year anniversary with The Beryl Institute! 

For now, what I know for sure, is how to define what constitutes the spine of Experience Innovation. Before we can innovate in any meaningful way, we must, like vertebrae, connect motive to people and people to action. I visualize this as “the Backbone of Experience Innovation.” When healthy, this is what makes innovation strong, enabling it to move nimbly forward. I define this backbone as being: 

Thoughts, actions and designs driven by a deep understanding of the lived experiences in healthcare that result in improvements created to address the most urgent needs. 

 

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

Tags:  Advocacy  healthcare  improving patient experience  patient and family  Patient Experience  perspective 

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The Smell of Love: An Olfactory PX

Posted By Tiffany Christensen, CPXP, Monday, October 8, 2018

It's been an important realization for me to see that the way in which I look at the patient experience is dependent on my orientation to it at the time. Most of the time, I look at it through my professional eyes, using the Experience Framework and the Eight Lenses of how to operationalize improvement.

When I am actually experiencing the need for medical care, my orientation shifts. Wearing the skin of a patient, the primary focus becomes:

  1. Physical sensations (pain, SOB, cold, etc)
  2. Emotional experience (worry, fear, elation, etc)
  3. Relational (engagement w/care team, co-design of plan, etc).

When I went into my ENT’s office a few years ago my priority was definitely based in the physical experience. I was having chronic headaches and every morning it was taking an hour for the headache to subside enough for me to begin my day. As a cystic fibrosis patient, I was unusual in that I had never had sinus surgery, so it seemed like a good and natural next step.

I liked my surgeon a lot. When we spoke, I felt like he really cared about my outcome and my quality of life. He did a good job of preparing me for the surgery itself. I went into the procedure confident in his ability and comfortable with our relationship.

When I first noticed that I couldn't smell anything after surgery, my surgeon assured me that my sense of smell might return. I was not aware that losing my sense of smell was a possible result of sinus surgery but I also wasn't very worried about it. Who really needs a sense of smell anyway?

It's been two years since I have been able to smell anything. My life has been more dramatically affected by my lack of a sense of smell that I could have ever imagined. My sense of smell, as it turns out, is directly related to my sense of safety, decency and love.

First, there is the safety element of it. There have been more times than I'd like to count where something was burning in the oven and I had no idea. If a friend hadn't been around during those times I can only imagine that it could have started a fire or at the very least filled my kitchen with smoke. It makes me very uneasy knowing that there may be things happening around me that are generating a smell as a warning sign that I am not able to heed.

In this culture, bad smells are considered indecent. As a person who cannot smell, I find myself in situations in which I am fraught with paranoia; worried that I may be unknowingly violating this decency. What if, when my friend stops by to visit, my trash smells? What if the dog smell in my car is overpowering? What if, God forbid, I smell? There's most certainly a layer of anxiety in my personal interactions that was never there before. (On the flip side, I will have to add, not being able to smell things like smelly trash cans is one of the perks of this issue!)

I really had to mourn the loss of my sense of smell when I fell in love. As it turns out, one of the most powerful senses that we use when we're falling in love is our sense of smell. Smell plays a huge role in the romance of falling in love. Smell is part of what builds a unique bond between two specific human beings. Smell is what you carry with you when you're missing the person that you love. The loss of smell during this important time in my life was incredibly sad. I now know that there's a direct line between my olfactory nerve and my heart.

I can easily understand why a conversation about the surgical side effect of losing a sense of smell would not be priority during my pre-surgical visits. When working with a CF/transplant patient, I'm sure there are much more pressing clinical and safety considerations. When we orient ourselves to the patient experience by way of a clinician perspective, the lived experience may get missed.

When we orient ourselves to the patient experience through the actual physical experience of being that person, however, it's easy to see that talking about the potential side effect of losing a sense of smell is absolutely something that needs to be part of the conversation. One might argue, it's even a potential reason to not move forward with an elective surgical option. While losing my ability to smell doesn’t prevent me from living a good life, it all adds up to a change in my life’s quality.

Would I have done anything differently had I known I would lose my sense of smell? I honestly can't answer that question. My perception of that overall surgical experience is, admittedly, now quite clouded from this outcome. I can’t help but feel as though my person-ness was not taken into consideration in the way that I hoped and believed that it was during the surgical consult process.

As we continue to explore and unpack the Experience Framework, it’s my hope that we will also begin to routinely ask ourselves to check our orientation to experience. When we hold the 8 Lenses up to the light we can ask ourselves: how does the picture change if we look at it through the eyes of a patient? A family member? A clinician? A leader? If we begin to see the Framework at 3-dimensional, so too will our efforts become 3-dimensional. I believe it is important for experience professionals to become more cognizant of the fact that there are different orientations to Experience Improvement and priorities will shift depending on that orientation.

And, if nothing else, I hope this blog reminds you to enjoy the smells of love all around you!  

 

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

Tags:  decency  experience  love  perspective  safety  smell  surgeon 

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The Practice of Experience: A Relentless Pursuit of the Truth

Posted By Tifffany Christensen, Wednesday, September 5, 2018

As a CF/lung transplant patient turned Patient/Family Advisor (PFA), I have been on the frontlines of the evolution of Patient Experience strategies since 2005. I fell in love with PFACs and have been thrilled to see the ways in which we partner with patients and families grow more sophisticated over time. Today, we have patients and families working directly in clinical quality improvement, sitting at the board level and rounding on patients actively receiving care. It’s both inspiring to see the changes and frustrating to see how far we have to go to achieve genuine partnerships across the continuum of care.

After working as a patient advocate, I became a specialist in Patient and Family Engagement (PFE) “best practices.” Working with healthcare organizations to improve bedside engagement and community engagement proved challenging for multiple reasons. I hunkered down on the best practices, sought out additional strategies and remained steadfast in the belief that the right strategy would improve engagement and, ultimately, experience.

One day, I was on an oncology unit trying to determine how well the clinicians communicated with their patients.  I was rounding from room to room, asking patients questions. To me, the questions were both simple and very important to my understanding of the patient experience:

  • “When your doctor came in this morning, did you understand everything he told you?”
  • "After morning rounds, were you left with any questions that didn’t get answered?”
  • “When you call for a nurse, how quickly do they typically come to your room?” 

These were simple questions directed at what we care about in improving experience: clear/respectful communication and a timely response to needs. I thought I was doing a great job with my questions but the answers I kept getting were not what I expected, wanted or needed. Instead of telling me about the communication and timeliness of responding to call bells, patients were telling me about the pain in their side that was worrisome. Spouses told me long stories about getting the patient to the ED before being admitted. Universally, my questions were not being answered at all, no matter how many times I asked them or how I was able to rephrase. I wasn’t getting what I came for, but I was seeing what I had become.

In healthcare, there is a need to focus on improvement and standardization. I began to wonder, “Is it possible that I have ‘systematized’ my work in Experience to such a degree that it has become a series of strategies rather than an exploration of the ACTUAL experience?” The answer, for me, was ‘yes.’ My next question; “Am I working on strategies without a clear understanding of what matters most to those living the actual experience?” Again, the answer, for me, was ‘yes.’ I had become so deeply invested in “moving the needle” around improving the patient experience that I was no longer looking at the experience at all. Or, at the very least, I was only allowing myself to see a small sliver of it. It was an embarrassing and deeply important realization. This was a reminder that patients are living the experience of illness and injury—not the operationalizing of PFE best practices—and this internal focus is immediate and unrelenting. For me, this was the beginning of a new way of seeing “the experience of Experience.”

Today, I use Human-Centered Design and Experience Based Co-Design strategies to ensure I am able to uncover the “lived experience” of those providing and receiving medical care. In doing so, I am humbled to have the chance to witness the pain points caused by systems, cultures and perceptions. I am able to quiet my own agenda so those living in the ACTUAL experience have the opportunity to reveal what matters most. I have learned that change happens when an experience can be seen with the 360 degree view: patient, family, professional AND objective observer. Working in this way means I am no longer trying to “push the river,” but, rather, riding its natural flow long enough to gain true insights, understand the priorities and identify the Experience Aim. 

“Ethnographic research” or, what we often call “shadowing,” is not revolutionary in itself. What was revolutionary for me was what shadowing taught me about how much I had lost sight of caring about and capturing actual experiences. As this work evolves, so too does our toolbox of ways to improve. What I know now is that, in the face of so many exciting tactics, we must not allow ourselves to forget about the value of eyes and ears on the frontlines of care. The only way to true partnership (and sustainable improvement) is through a relentless pursuit of the truth using a variety of strategies.

Experience is not only an outcome.

Experience is a practice of returning over and over again to the source (patient, families, clinicians and staff) in order to understand how healthcare is being received and delivered.

Only then can we design meaningful improvements.

 

Tiffany Christensen
Vice President, Experience Innovation
The Beryl Institute

 

Tags:  design  improvement  partnership  staff  strategy  transplant 

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Introducing a Framework for Experience in Healthcare

Posted By Jason A. Wolf, PhD, CPXP, Wednesday, August 22, 2018
Updated: Wednesday, August 22, 2018

From the Roots of Community

In just a few weeks, The Beryl Institute will reach its eighth anniversary as a membership community and a growing global community of practice. On our journey we have been dedicated to building a network of committed professionals, practitioners, innovators, patients and family members and partners. That network, through its commitment to sharing wildly, has helped shape a framework for what represents the human experience in healthcare and clarify eight strategic lenses through which organizations can engage all voices in ensuing the best in experience for all.

This growing body of knowledge and collective understanding established through research and experience and the content it has produced called for a means to better codify, digest and access the information that will support everyone on this shared experience journey. The idea was a simple one, to establish a framework through which we could individually, organizationally and collectively understand where we are, identify the opportunities we have and then connect to the resources and solutions that will help us continue on the road to experience excellence.

Through conversations with a broad range of community members over the last year, this idea evolved from an experience landscape that could be used to define the work, to an experience framework, represented by an integrated set of lenses that influence experience. It offers an actionable means to engage deeper in experience improvement and excellence. 

Why an Experience Framework

An experience framework helps us in three critical ways. The first, it provides clarity in the strategic areas of focus – the strategic lenses – through which any experience endeavor should be framed. If we ascribe to the view of experience as the integration of all we do from quality, safety and service to the range of factors that influence the healthcare experience, then a means to identify these ideas and a structure to frame them helps us in expanding our strategic view of experience and leads to more comprehensive action overall. 

The second, it provides a means to identify where you are excelling or may have opportunities to address. By engaging in experience efforts through a set of strategic lenses you can both understand the areas in which action has led to outcomes and identify areas in which further work is needed. This framing also helps, as noted above, in ensuring a comprehensive set of actions focused on the experience effort overall.

The third reflects a practical application of the framework, as it offers a means by which knowledge, resources and solutions can be aligned. You will see that all content now available via The Beryl Institute aligns with one or more of the eight lenses (and is searchable based on these lenses as well). You will also find our events, such as Patient Experience Conference, will evolve into active learning programs centered around these lenses and we will be working with our vendor partners to align their solutions to the lenses they address as well. 

We invite and encourage others to consider this framework as a means to identify and align content and knowledge and share broadly as a result. Through this common framework we can create more efficient connection of needs to knowledge, strategies to resources and opportunities to solutions and expand our collective global dialogue through a common structure for focus and action.

The Experience Framework

With that recognized opportunity and an understanding of the roots and motivation for this endeavor I’d like to introduce you to the eight strategic lenses of the experience framework. In framing this introduction, it is important to stress that through the community input that shaped the framework we underline that all voices are critical and matter in the experience conversation. In addition, this framework reaches well beyond the clinical experience of patients to the full extent of the human experience in healthcare. The framework as such represents the range of perspectives and honors the breadth of those perspectives in its considerations while having some intentionality in helping to align and support the broader strategic and operational items that impact experience endeavors. It also recognizes that no two individual experiences can or will ever be the same and so this is not intended as a one size fits all solution, but rather as introduced, it is a strategic framework to enable that level of individualization to be even more effective. In having a means to align efforts at a macro level, we are well served to drive specific efforts and address specific needs to the level we must in any effective healthcare endeavor. 

The framework (Figure 1) is built on eight strategic lenses all of which address some aspect of what impacts and influences experience. Each of the eight lenses is also accompanied by a statement of “why”, rather than a definition. Our intention was not to create a static model of commonly accepted definitions, but rather to introduce eight active lenses and the considerations for why they require our focus in any experience effort. The eight lenses and their why statements follow: 

  • Culture & Leadership: The foundation of any successful experience effort is set on who an organization is, its purpose and values, and how it is led.
  • Infrastructure  & Governance: Effective experience efforts require both the right structures and processes by which to operate and communicate and the formal guidance in place to ensure sustained strategic focus.
  • Patient, Family & Community Engagement: Central to any experience effort are the voices of, contributions from and partnerships with those receiving care and the community served.
  • Staff  &  Provider  Engagement: Caring for those delivering and supporting the delivery of care and reaffirming a connection to meaning and purpose is fundamental to the successful realization of a positive experience.
  • Environment & Hospitality: The space in which a healthcare experience is delivered and the practices implemented to ensure a positive, comfortable and compassionate encounter must be part of every effort.
  • Innovation & Technology:  As a focus on experience expands, it requires new ways of thinking and doing and the technologies and tools to ensure efficiencies, expand capacities and extend boundaries of care.
  • Policy & Measurement:  Experience is driven and influenced by external factors and systemic and financial realities and requires accepted and understood metrics to effectively measure outcomes and drive action.
  • Quality & Clinical Excellence: Experience encompasses all an individual encounters and the expectations they have for safe, quality, reliable, and effective care focused on positively impacting health and well-being.

 

                              Figure 1. The Beryl Institute Experience Framework

 

A Move to Action

With the introduction of the experience framework, I want to reinforce the active nature of this work. We already have research efforts underway to further validate the framework and its application in certain care settings as well as will soon be releasing a report and follow-up research on influence factors of experience related to the strategic lenses.

The release of this framework is not simply a call for action and a hope for a response, but rather this is a move to action in itself. When we align as a community around what is fundamental to experience success and support one another in both what is needed to succeed and in helping others to understand what this work truly encompasses, then we can truly call ourselves a movement. The experience journey we have been on as a community has led us to this point where we can stand together in providing a formal frame to understand our opportunities and guide our actions. It is now up to each of us to determine how we will apply these ideas to support our own efforts, to positively impact those we care for and the communities we serve and how we can all continue to contribute to this global conversation on experience that is fundamentally changing healthcare for the better. Thank you to you all for your partnership and collaboration on this journey. 

 

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

Tags:  engagement  experience efforts  framework  lens  strategic 

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When Work Has Meaning

Posted By Deanna Frings, Tuesday, July 10, 2018
Updated: Friday, July 6, 2018

The title of this blog is not original to me but was a headline on the cover of the July-August 2018 issue of Harvard Business Review (HBR) referencing an article, Creating A Purpose-Driven Organization. It seems everywhere I turn, there is another book, article or referenced research on the neuroscience of purpose as a driving force that gives our lives meaning. And let me be clear, I love that there is currently an abundance of discussion on purpose and meaning. 

 

I have worked in healthcare my entire career from being on the front line as a respiratory therapist, leading teams in multiple leadership capacities to my current role as Vice President of Learning and Professional Development of The Beryl Institute. From my experience, conversations on meaning and purpose are not uncommon in the field of healthcare. I don’t know, maybe it’s because those of us who work in healthcare can easily connect that what we do really matters? We save lives. But how is this knowledge being lived out in our day to day practice as leaders in healthcare. Are we creating cultures that facilitate a discovery of purpose for ourselves and our employees? 

 

Organizations are focused on employee engagement and acknowledge its critical role in their experience efforts as reported in our, State of Patient Experience 2017: A Return to Purpose. And, it’s not surprising given the 2017 Gallup State of American Workplace report, that only 33% of employees are engaged in their work and workplace and only 21% of employees strongly agree their performance is managed in a way that motivates them to do outstanding work. 

These startling figures are not a new phenomenon. Previous Gallup Reports have shown much of the same. So, while we acknowledge the importance of an engaged workforce, the data suggests we continue to struggle, despite all the focus on improving it. 

I often speak on the critical role of leaders in achieving experience excellence and I would suggest that leadership is the critical link in transforming organizational cultures and creating engaged environments where individuals can reach their full potential. During these speaking engagements and workshops, I love taking people through a journey of discovery of purpose and meaning and I have witnessed the immediate and powerful impact it has. I hear a higher level of excitement in their voices, a clarity in vision and a drive in their commitment as they share their stories with each other. 

The conversation continues as we take the critical next step and determine actions we, as leaders, can take to not only share our purpose but invite employees to do the same. It’s one way to connect people to purpose. Simply stated in the HBR article, leaders most important role is to connect people to purpose.

Acting on a higher purpose can often motivate us to learn and develop our skills so we can excel in our performance contributing to what’s meaningful to us. It’s one reason I’m excited about Patient Experience 101(PX 101), a new educational resource releasing next week from The Beryl Institute. PX 101 is a comprehensive community-inspired and developed resource to build patient experience knowledge and skill for all employees across an organization by taking individuals through a discovery of purpose. It’s one of several new opportunities we’re launching this year in an effort to support global patient experience efforts based on the needs of our community. 

PX 101 offers the tools and activities you need to engage in deeper and authentic conversations on what patient experience is, what it means to your employees and how they positively impact experience excellence. It invites them to share their own accounts of how they make a positive difference resulting in a stronger sense of purpose and meaning to the work they do every day. 

 

When we find meaning and purpose in our work, the sky’s the limit to how high we can soar and how much we can contribute to our individual and organization’s success.  

As leaders in healthcare striving for excellence in experience, how do you connect people to purpose?


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

Tags:  choice  compassion  culture  employee engagement  healthcare  improving patient experience  leadership  Patient Experience  personal experience  perspective  purpose 

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Radical Support After Adverse Events

Posted By Tiffany Christensen, CPXP, Thursday, June 7, 2018

Recently, I had the honor of speaking at Yale New Haven Health’s 2018 Inaugural Quality, Safety and Experience Conference. One of my favorite parts about presenting at conferences is the opportunity to attend and learn from the other presenters. This event was no different and it was a great day.

One of the most powerful sessions of the day involved two physicians discussing their experiences of harm and error. The focus of the conversation was not clinical and did not dwell on the details of the case—in fact, the patients discussed were clinically fine after an adverse event. Additionally, there was even some gray area about whether or not the physicians involved could have done anything differently to avoid the adverse event. This was not a conversation about clinical safety but, rather, emotional safety among colleagues.

Despite there being significant differences between the clinical elements of their experiences, the two physicians onstage shared many similarities in their experiences after the adverse event. They both considered leaving medicine; one physician confessed she wondered if she should make a career change to home renovation. Both struggled to sleep at night and both replayed the event over and over in their mind, seeking an answer to what could have been done differently. Perhaps most important, both physicians are haunted by the event to this day even though many years have gone by.

What I carried away from both of the stories shared that day was the deep sense of isolation both physicians experienced. When sharing their grief and trauma with collogues, they found they were met with responses that had good intentions but fell flat. “You did the best you could,” and “But the patient is alright, isn’t she?” didn’t sooth the deep, unrelenting self-doubt that had manifested within these dedicated doctors. The experience had not only caused them to question their worth as professionals but their worth as human beings. It seemed they had no safe place to turn. These two physicians made it clear that when mistakes happen the primary need for support goes to the patient and family. That does not mean, however, that support for the provider is not also needed.

Listening to these heart-wrenching stories, my mind went to an article I had read years ago. The article, “How the Babemba Tribe Forgives,” tells the story of a tribe in South Africa. In this community, when a person makes a mistake or does something irresponsible, everyone in the community drops what they are doing and circles around. For hours and sometimes days, the members of the tribe shower this individual with details of their good deeds, positive traits and strengths. Once they are satisfied that they have shared all of the good stories about the individual, the circle breaks and a celebration begins. I see this approach as “radical support” and is far from the standard way that most healthcare professionals receive support after a traumatic experience.

We live in a culture that often expects perfection of our healthcare professionals and, when a mistake is made, we don’t always have tools or skills to effectively support the person as they process and grieve. I can’t help but wonder, if the colleagues of these physicians had been given tools in order to react and provide support more effectively, might the physician wondering if she should move into home renovation see things differently? If, instead of replying with statements that invalidated the physician’s deep sense of insecurity, what would have happened if the response was to validate all of the physician’s strengths and good qualities as a person and a professional? What if the root of pain the professional is experiencing comes from an unconscious need for forgiveness and we offered that to them?

Assuming the “radical support” approach of the Babemba Tribe is philosophically intriguing, it may be challenging to imagine how it may translate into current systems and processes. For some teams, supporting a team member who is struggling with an adverse event may be a more informal conversation among leaders, staff and providers behind closed doors. Other organizations may benefit from a more formal approach that builds a new program or, ideally, integrates into an existing framework.

One potential framework that many organizations already use is Schwartz Rounds. Looking at The Beryl Institute White Paper, Schwartz Rounds: Supporting the Emotional Needs of Staff: The Impact of Schwartz Rounds on Caregiver and Patient Experience, it strikes me that both the spirit and the format would easily lend itself to a few adjustments in order to include “radical support.” A few highlights from this whitepaper quickly illustrate why one might connect the two:

  • The Schwartz Rounds program, now taking place in more than 425 healthcare organizations throughout the U.S., Canada, Australia, New Zealand and more than 150 sites throughout the U.K. and Ireland, offers healthcare providers a regularly scheduled time during their fast-paced work lives to openly and honestly discuss the social and emotional issues they face in caring for patients and families.
  • One of the primary goals of Schwartz Rounds Decreased is to reduce feelings of stress and isolation while fostering more openness to giving and receiving support.
  • One Schwartz Rounds participant articulated, “The ability to find a safe venue for expressing our unrest was, to me, the most attractive feature of the Rounds.” Another participant stated, “The emotions we feel, the stress we feel, does need to be ventilated someplace…”

The Beryl Institute has an unwavering commitment to the human experience in healthcare and, it is evident, humans working in this challenging field need more avenues to hear how much they are valued. Perhaps the Babemba Tribe approach is one worth adapting to the complex world of healthcare; whether through Schwartz Rounds or another framework already hardwired into the organization. No matter what, we must find ways to address isolation and provide better support to those facing questions of their own worth after an adverse event.

 

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

Tags:  emotional safety  employee engagement  human experience  patient experience community  professional support 

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More than a Hashtag: We are #PXTogether

Posted By Stacy Palmer, Thursday, May 3, 2018
Updated: Thursday, May 3, 2018

Last month over 1,100 participants from around the world gathered in Chicago for the largest Patient Experience Conference to date. It was an incredible week offering opportunities for sharing and connection with our community. We learned together, cried together, laughed together and even danced together. 

This year’s opening video and message focused around the idea of #PXTogether. You may have even seen photos on social media of people proudly wearing t-shirts with that hashtag. But what does it really mean and why is #PXTogether so significant in this movement? 

Being part of The Beryl Institute team for the past seven years, I’ve had the opportunity to watch this field evolve through the power of community. I remember celebrating the first official member of the Institute on September 14, 2010, and we’ve continued to celebrate each time our now more than 14,000 members made that decision to join the patient experience movement. We celebrate because membership shows they share a commitment to this work and see value in accessing content and resources to improve the experiences of their patients, families and teams. But we also celebrate because their involvement means our community can learn from them as well. Each new thought, idea, process or question shared expands the library of resources and offers new insights and opportunity to others. That is the power of #PXTogether.

So, how can we ensure it’s more than a hashtag? I challenge you with a few suggestions to reinforce your commitment to this work and to the patient experience community.

  • Share your experiences. As we continue to support the global patient experience movement and in the spirit of #PXTogether, the Institute is expanding efforts to gather and build a library of case studies on the value and impact of patient experience from settings across the continuum of care and from locations around the world. We’re looking for case studies that identify critical opportunities or address specific problems, are focused on practical and replicable steps and provide some measure of outcome and/or impact as a result. Submit a case study so other community members can learn from your efforts.  
  • Recognize the successes of your team and/or those who inspire youAt the Institute, we understand the effort it takes to change cultures, implement new strategies and build true partnerships with patients and families. In order to recognize those efforts, we will be honoring and celebrating innovation among advisors, healthcare professionals and teams through our new PX Innovation Awards program. Consider nominating yourself, your team, organization, Patient/Family Advisor or others you see doing incredible work to further the movement.
  • Celebrate healthcare staff impacting patient experience everyday. Last week was the fifth annual PX Week. Inspired by members of the Institute community, PX Week provides a focused time for organizations to celebrate accomplishments, reenergize efforts and honor the people who impact patient experience from nurses and physicians, to support staff and executive professionals, to patients, families and communities served. The official PX Week always starts on the fourth Monday of April, but if you missed it this year, we encourage you to find a week that works with your organization’s calendar and priorities. Celebrating PX Week, whenever you choose to do it, reinforces to your staff that patient experience is a priority and their efforts are appreciated. The Institute has created a list of resources to assist you with planning a recognition program with suggestions for events you can implement and offers a list of audiences you should remember during your celebration.
  • Spend time with those who share your passion.The true spirit of #PXTogether can perhaps be seen best when those committed to improving patient experience gather to network, share and inspire one another. Save the dates and plan to attend future Patient Experience Conferences, and, even before then, join us at one or more of our new PX Pop-up events. Dates and locations will be announced soon for these regional lunch meetings hosted by member organizations.

Representing the idea of connection and sharing that has been essential to the Institute’s growth, the power of community remains strong and #PXTogether reinforces the great opportunities still ahead.

As this year’s opening conference video shared: 
Together, we are growing a global movement. We are impacting countess lives. We are ensuring an unwavering commitment to the human experience. #PXTogether

Stacy Palmer, CPXP
Senior Vice President
The Beryl Institute

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Opposing Natures: Honoring the Properties of Water

Posted By Tiffany Christensen, Wednesday, April 4, 2018
Updated: Tuesday, April 3, 2018

Patient activation is a behavioral concept… It is defined as 'an individual's knowledge, skill, and confidence for managing their health and health care'.
(Hibbard et al 2005).

We know from all of the literature on patient activation that there is a way to both understand and measure a patients’ readiness to manage their health and their healthcare. We also know that there are techniques, such as motivational interviewing, that can assist in moving a patient from lower activation to a higher activation. In so doing, patients and families gain knowledge skills and confidence. As a person working in the field of patient experience, I find activation work to be both inspiring and essential in operationalizing engagement. As a patient, I have experienced activation is a moving target.

Recently, I was reacquainted with my personal activation scale when I found myself feeling puny shortly before a big trip to Thailand. I had never been to Thailand, I was meeting my best friend there and I was using all of my airline miles to have the trip of a lifetime. It goes without saying that I really wanted to go so when I began feeling sick my first thought was “Noooooo! I can’t let this stop me from going!” Like a good CF/Lung Transplant patient, I called my team and set up an appointment to be seen with the hope that I would get the “ok” from my team to go on my big trip. I arrived with my personal SBAR form all filled out, questions at the ready and feeling very high on the activation scale.

The flu swab was negative, WBC was normal, chest X-Ray looked good and I was not spiking fevers. After a great conversation with my transplant medicine doctor, we decided it would be okay to go on the trip as long as my symptoms did not get worse over the next few days. That was the news I hoped to hear!

A few days later, I was on my way to Thailand via a very long series of stops: Raleigh to JFK to Moscow to China to Thailand. Confident I had a simple virus, I boarded my first plane feeling very comfortable with traveling the long distance. By the time I got to JFK, things began to change and by the time I was ready to board the plane to Moscow, I knew I was too sick to travel. After making the tough decision to turn around and getting my flight home arranged, I began my descent into illness.

In the interest of the reader, I want to begin by saying I was fine and I am fine. Eventually, it was determined through a bronchoscopy that I did have the flu. Just the flu. Especially this season, few people seemed to be able to avoid this virus and, just by how common it is, it seems silly to say that it brought me to my knees; especially in light of my past medical history. But it did.

Fever, fatigue, coughing…the normal flu stuff. At some point in the illness process I lost my voice entirely which was far more debilitating than I would have imagined it to be. As a CF/ Lung Transplant patient, I was hyper-focused on my symptoms and my internal life was one of balancing logic (“this is just the flu”) with diligence (“you can’t let this get away from you”). I had faith in my team and hoped each day that I would feel better but, day after day, I felt worse and worse. Worry began to creep in and clouded my mind. My once clear, organized approach to dealing with this illness challenge began to slip away. My level of activation seemed to be melting away along with my sense of well-being.

It was approximately one week after my initial symptoms that I had a night of restless sleep peppered with visions of ventilators. It was as if I could feel the life draining out of my body and I thought to myself, “Oh, I can see how people die from the flu.” I couldn’t help but wonder if I was experiencing anxiety or a premonition. My canceled trip to Thailand was no longer something I gave a second thought—my goal had shifted from wanting to go on that trip to wanting to make it through this alive.

The following morning, I carried the weight of my ventilator dreams with me as I went to have a bronchoscopy. At the hospital, I felt what has become a very common dichotomy for me: my very personal (often unspoken) illness experience butting up against the day-to-day work of those caring for me.

Because of my history working in a hospital, I both recognize and respect the “why and how” of daily operations. During the years I worked as a patient advocate in an academic medical center, my days were dictated by structure. The structure of the CMS policies I was required to follow, the structure of prioritizing the calls, letters and pages I received each day and the structure of daily work flow for the clinical providers surrounding me. Checklists, protocols and routines were everywhere. Assuming the role of sick patient, however, I was reminded that the experience of being a patient is often the antithesis of a structured, day-to-day norm. In fact, showing up for healthcare is quite opposite from a “normal” day. Likewise, being activated wasn’t something I had achieved and could check off of a to-list; it was something that I had to work to maintain.

The walk from the car to the front door was difficult; I was too weak to walk without holding on to my friend. After checking in, I had to get labs, CT and go to clinic. All of these were in very different parts of the hospital and the walk to each area seemed to be miles and miles. In each waiting room, I longed to lie down but there were only hard, upright chairs. I wore a mask and, since I lost my voice, nobody could hear me or see my mouth move. Person after person seemed both surprised and shocked to discover I was unable to communicate verbally. To all of the people I presented to, my case was not remarkable nor was it dire. Objectively, they were correct. That didn’t change the fact that I was still weighed down by my night of ICU visions and getting from “A” to “B” seemed to take all of the strength I could muster. It seems strange to me now that all of those emotional twists and turns had gone largely undetected by those around me; both my medical team and my family.

After the bronchoscopy, I was given strong antibiotics and slowly began to recover. My healing was as palpable as my descent into illness. I could feel my body changing every day and, some days, I was filled with a sense of euphoria because of my improving health. The tides had shifted and my internal life was one of hope and gratitude. Increasing physical strength buoyed my ability manage my life again. My challenging internal journey was winding down and I was returning to my “activated” self.  My sites were now set on going back to work and rescheduling that trip to Thailand.

If we want to "engage" patients, we must never lose sight of the fact that we are functioning in two different worlds: one that demands predictable outcomes and one that, by its own nature, can never be truly be made submissive to our will. As many times as I have lived through illness and healing, I am always amazed at how quickly I forget the reality of what it is to experience it. To try and operationalize the patient experience is like trying to contain water. It can be done, certainly, but to dishonor the unpredictable nature of illness/healing is like trying to deny the properties of water.

As we continue to hammer out ways to be better partners in the road of illness and healing, it’s natural for people on both sides of the bed to feel frustration. It’s also imperative that we keep in mind that this frustration does not result from one person being right or one person being wrong. Both are simply behaving exactly as the nature of their respective experiences dictate: the healthcare professional is functioning from logic, structure and science and the patient is immersed in the ever-changing tides of an illness/healing dynamic.

Activation levels are not a constant, no matter who the patient happens to be or how extensive their medical history. Knowledge, skills and confidence rise and fall like water lapping against the shore. If we begin all of our interactions with that awareness, we can put aside some intrinsic, (often) unconscious frustrations that derail us from partnership and effective communication. It is then we can truly meet people where they are and come together as a team.

 

Tiffany Christensen
Vice President, Experience Innovation
The Beryl Institute

Tags:  communication  flu  healthcare team  partnership  patient engagement  personal experience  recovery  story  team  together  transplant 

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Increasing the Value of The Beryl Institute Membership

Posted By Denise R. Weathers, Thursday, March 8, 2018
Updated: Thursday, March 8, 2018

For years, The Beryl Institute has offered the community a growing library of resources to support you in leading a positive patient experience effort for your organization. Over the past year, the Institute has experienced some major accomplishments highlighted in our 2017 Year In Review. As we continue the commitment to improving the human experience by offering value-added resources and services, the need for our members become ever so important. The question has become – how can The Beryl Institute best serve its members and the patient experience community?

Through our Annual Member Experience Survey distributed in December 2017, you helped us address this question by providing your much-deserved feedback. To highlight a few observations, we asked what you thought of the services that are being offered by the Institute. Similar to previous survey results, the top six most-valued and accessed member benefits are Publications, such as White Papers and Research Reports, Webinars, E- Newsletters (PX Monthly and PX Newslink), Learning Bites, PX Connect, the latest member benefit and the PX Conference.

Although the above-mentioned resources were rated as the most-valued resources, the one word that was consistent throughout the survey feedback and placed an even wider smile on our faces was “Community.” Relationships are considered by many to be the most important and satisfying aspect of life, and your partnership with The Beryl Institute provides you with a diverse global community of physicians, nurses, patient experience leaders, patient and family advisors, consultants, etc., in various healthcare settings, coming together to support one common goal…to improve the patient and human experience in healthcare. Community matters in patient experience and we must ensure it does for the power of the collection of voices in our movement and in the work, it calls us to do every day.

Community speaks to the heart of who we are and to the resources and opportunities we develop for you to engage in for learning, the collection and dissemination of ideas and the connection among peers such as your ability to connect in the recent addition of the online member community, PX Connect, and by attending the 2018 PX Conference, coming up next month April 16-18 at the Hyatt Regency Chicago.

The Power of community has also been elevated with the recent emergence of the PX Policy Forum and the newly formed Nurse Executive Council. To further increase the value of your membership, the Institute has or is taking steps to improve your member experience by providing:

 

Enhanced offerings for professional development and learning exploring how the Institute can elevate the partner organizations and speakers who present at its professional development learning areas such as webinars, PX Conference, Regional Roundtables and PX Grand Rounds; engaging and leveraging discussions in the online patient experience member community, PX Connect, to develop untapped content and resources; and, organizing content collaboration targets for specific areas we recognize may have some gaps such as Ambulatory Care, Physician Office Setting and Long-Term Care, to name a few.

 

 Increased member benefit awareness with enhanced communications highlighting targeted member benefits such as: Career Center, expanded volunteer opportunities and PX Connect, and include Patient Experience Continuing Education (PXE) credit offerings through most of the professional development and learning programs, pending approval.

 

Innovation, research and global presence by adding an Experience Innovation position to expand the Institute’s global landscape of groundbreaking advancements in the PX evolution.


It is our commitment to be that organization…that patient experience community that identifies and address your needs more effectively and one that provides an optimal suite of patient experience resources, products and services at the most affordable investment and value.

The Beryl Institute staff are here to serve you. We hope the continued focus on improving the resources, products and services display our commitment and our drive to showcase and support you and your organization on your patient experience journey.

Do you have ideas on how we could continue to increase the value of The Beryl Institute membership? Email me at denise.weathers@theberylinstitute.org with your ideas and suggestions.

 

Denise R. Weathers
Vice President, Membership
The Beryl Institute

Tags:  commitment  Community  community of practice  member benefit  member survey  member value  px connect 

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