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You are not alone in addressing the patient experience! Expanding your capacity and impact is your choice.

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, May 3, 2011
Updated: Tuesday, May 3, 2011
This April, leaders from across North America joined together to engage in a dialogue on the critical importance of the patient experience in our healthcare systems. The gathering at The Beryl Institute Patient Experience Conference 2011 was headlined by top healthcare executives from such places as UCLA and Henry Ford Health Systems and speakers from healthcare organizations across the continent. While the content was unparalleled and the learning well received, what emerged as the most profoundly important takeaway was the connections made and the network of peers formed.

In reading post conference evaluations one comment seemed so personal and touching it cased me to pause for a moment. The words on the page were simple:

"I'm not the only person struggling with how to make the patient experience better.”

In reading this statement I realized that while we can talk about the patient experience in a collective way, it is truly an individualized experience in each organization and facility.  According to The Beryl Institute’s recent benchmarking study, patient experience was deemed a priority by almost 800 healthcare executives, yet they lacked definition and a clear path forward. Beneath the data what I saw was 660 healthcare organizations that have taken it upon themselves to, in their own way, tackle this issue.

For the amount of time we each work to address patient experience in our own facility, many individuals have done the same. They have tried new ideas, and created others, failed terribly and succeeded wildly. What lies beneath these efforts is an even greater opportunity for shared learning and connection. It is the chance for those of us in healthcare to collectively see improvements in the experience of our patients, their families and in the communities we serve.

No…you are not alone!  But you must be willing to take the step to connect with and engage others. While the Patient Experience Conference was a microcosm of how this can be done, it is creating your own network of peers where the connections created, energy unleashed and shared passion realized at events like the conference can be experienced all year round. This was poignantly observed by an attendee who said, "Everyone in attendance wants to see a shift for the better within the industry, this is not one of those conferences where everyone is trying to prove their own magnificence, rather everyone is trying to come together and make a significant difference in Healthcare as an industry.”  This is the opportunity we have and the difference we can make in coming together each and every day.

I believe that most (if not all) of us chose to take on addressing patient experience for more than simple competitive advantage. It is and continues to be a much higher calling.  One in which the collective energies of many will far outweigh the attempts of one. The connections and resources you gain from choosing to reach out to others will help you realize even greater success.

Therefore, I would assert that being alone in this work is also a choice, one that may serve ultimately as a roadblock to progress.  In the end, you are alone in addressing the patient experience, only if you choose to be.  I challenge you to find others with which to take this journey. That may be the most important choice you make in your journey to improve the patient experience.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Tags:  improving patient experience  networking  Patient Experience  service excellence 

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Do we need “rules” to do what is “right”? And are ACOs and Value-Based Purchasing reasons to now take action?

Posted By Jason A. Wolf Ph.D. CPXP, Monday, April 4, 2011
Updated: Monday, April 4, 2011

We have all heard the quote "what gets measured, gets done”. What this reveals is how leaders have been conditioned to act, yet this has not always led us to our desired results.

This quote also touches the very issues facing patient experience. For years we have discussed patient-centered care, domains have been identified that define patient-centeredness, and patient satisfaction measurement is now not only an accepted practice, but also a growing and profitable industry. These standards and measures have helped remind us who our customers are and provided data on which to act. Yet, even with this information, while some have tackled this important issue, many have not.

Now with the emergence of new policy measures such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey in the U.S. and the Excellent Care for All Act in Ontario, Canada, as well as efforts in other locations around the globe, a patient’s experience is now a variable in not just ratings, but also a component of individual and/or organization compensation formulas. Even more so, these scores are being publically reported in an attempt to provide transparency (or is it to truly capitalize on the competitive nature of the healthcare business – see my blog from November 2010)

Even with the advent of the HCAHPS survey, when we conducted a survey of The Beryl Institute’s membership last summer (almost 4 years since the launch of HCAHPS), just over 50% of the respondents had a comprehensive patient experience strategy. So can we say what gets measured, gets done?

But perhaps now, specifically in the U.S., the stakes and implications have been raised with the introduction of the proposed rules on both the measurement and payment process for Accountable Care Organizations (ACO) and Value-Based Purchasing (VBP). The headline of these rules in relationship to patient experience is simple - perform well on the standard metrics, specifically HCAHPS, and you will reap the "benefit” of maintaining reimbursement dollars (VBP) or of obtaining payments resulting from the new shared savings arrangement (ACO). Simply stated, patient experience is now a measure that equates to dollars lost or gained.

This leaves me with the question, why the frenzy now when we have always been in the business of delivering care to patients? Has health care become something we simply do to people for revenue? I am not saying we do not need effective financial performance, as this is critical to sustaining services. What is disconcerting is that it seems we have carefully crafted our processes and practices, structures and systems to accommodate us – meaning the deliverers versus the recipients of our services.

Perhaps it has been a harmless oversight on our part, though I have heard many healthcare leaders emphatically say, "We are not in the hospitality industry”. With that I can agree. People do not usually choose to spend their hard-earned dollars with us, but rather circumstances, some dire, bring them to our doors. I do suggest instead that we are in the service business. We always have been and always will. Care is not the privilege of a few (though with the current systemic issues it could be perceived and even experienced as such by some) -care is a service we provide- be it in our medical practices, long-term care facilities, outpatient centers or hospitals.

I am not advocating for or against the measures or processes put in place, rather I am holding up a mirror to ask why it has taken these policies and programs to truly see action and activity on improving patient experience. What has been our motivation to act now? Perhaps more importantly what slowly had us move away from service to process, from relationships to transactions, from patient to diagnosis?

During my recent On the Road visit with the UCLA Health System, both CEO, Dr. David Feinberg and CMO, Dr. Tom Rosenthal said a key to their success was helping their staff uncover and rediscover the passion that brought them to healthcare in the first place – the care and service of others. My hope is that while we may now be motivated by measures to get things done, this is not the fundamental reason we respond to this expanded commitment to the patient experience. Let’s use this as an opportunity to exceed expectations and provide quality care, not because it is in the rules (or being measured), but because we know it is fundamentally the right thing to do.

What are your thoughts on the implications of these new rules around Accountable Care Organizations and Value-Based Purchasing? And how can continue to do what is right for our patients regardless of what we may be required to do?

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Related Body of Knowledge courses: Metrics and Measurement.

Tags:  accountable care organizations  HCAHPS  Patient Experience  service excellence  value-based purchasing 

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Find Your Magic Moments in Creating an Unparalleled Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, March 1, 2011
Updated: Tuesday, March 1, 2011

Last week, I had the opportunity to spend time with our friends at the Disney Institute and visit Walt Disney World. My experience raised some issues for me that often come up in conversations I hear in our healthcare environment. From my first days in healthcare I heard the comments, "We are not a hotel so that won’t work here,” or "we are not in hospitality so we can’t do that here.” I must admit I have too become a creature of our own environment and have slowly been pulled into what I have come to call the "we are unique” zone.

As someone that has worked with numerous hospitals of all shapes, sizes and locales, I have heard time and again the rally cry that healthcare is a unique environment. While I do not think any of us inside (or even outside) of healthcare would ever challenge that statement, I believe we need to consider two things. One, that every industry is unique in its own right and therefore has its own opportunities and challenges, and two, that we all have an opportunity to learn from those other experiences. While we may not adopt others’ ideas directly, we can find new ways of addressing our own issues by broadening our perspectives.

My "ah-ha” emerged from a jumble of hand-scribbled notes about how wonderfully Disney operated based on a culture committed to service. This was mixed in with a simultaneous questioning of how these points would translate into any of the healthcare environments we serve -- from hospitals, to medical practices, to surgery centers and beyond. My question came from the observation that people choose to show up at the Magic Kingdom, to spend their hard-earned dollars, to have what for some is an experience of a lifetime. For these guests the wow often hits with the anticipation of the visit before even setting foot on the property. So, I reasoned, of course these people will be satisfied, even overjoyed with their experience…and asked…so what more is there to do? The fact is that Disney (named for the sake of my experience here, but I have also seen this in certain hotels, airlines, small businesses and elsewhere) could let people thrive purely on that excitement and anticipation, yet they choose to provide quality service by exceeding guests’ expectations every day.

Here is my point. An organization that represents a magical experience doesn’t leave service to chance (or magic). They are purposeful in their actions to ensure they provide what their guests desire. So what are the implications for healthcare? For as much good as we do every day and for every life we touch (and often save), people don’t lay in bed "too excited to sleep” prior to a hospital visit. They may be awake, but it is due to the anticipation, fear, nervousness and anxiety that accompany any health issue. In this way, we are unique. But where we cannot be unique is in our commitment to exceed our guests’ expectations. If an organization that people choose to visit recognizes the need that service takes effort, we in healthcare must recognize it takes just a little bit more. We must be committed and focused on efforts that ensure unparalleled experiences for our own guests (our patients, their families and support groups) and we must be a little more intentional every day through every encounter to ensure these people are wowed.

In the chaotic environment of healthcare, we can always find excuses for what will distract us, or what takes precedent strategically, clinically or financially. The one thing we cannot find excuses for is our commitment to creating magical moments in every encounter. It is even ok to acknowledge that in healthcare we are in fact unique. We have to do just that little bit more for each individual we touch to alleviate their pain or anxiety and ensure they are on a path to healing. And we need to do so knowing that we delivered (and they received) not just quality care, but an unparalleled experience.

We are working to collect and share your stories and invite you to comment on what you are doing in your organization to create magical moments. What you share here is a true gift for others and we thank you in advance for your contributions.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Tags:  magic  Patient Experience  service excellence 

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Service Excellence: Team Sport or Improve Troupe? Both!

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, February 1, 2011
Updated: Tuesday, February 1, 2011

En route to my most recent On the Road visit to Rush University Medical Center, I was privy to an exemplary service "moment.” My flight from Washington to Chicago should have been a simple 2-hour trip, but winter weather took hold and turned that short trip into an almost endless journey. It was a situation that for most would be stressful, frustrating and all too often one in which the customer is left "in the dark." Rather, what occurred on this trip was an incredible orchestration of service that had what could have been a plane full of angry travelers leave with an appreciation for the care and attention they received.

I emphasize the word "moment” because too often service is viewed as a single encounter at one point in time. Rather, I suggest effective service is an integrated effort and a connection of experiences over time. In healthcare, I do not think any of us would suggest the valet at our front door, the person in admissions, the nurse on rounds, or the discharge manager represents the totality of the service experience in our facility. It is the work that these individuals do in concert with one another (whether consciously or not) that shapes the perceptions of a patient’s, family’s and support network’s overall experience.

While on my flight, I thought of the core elements of service excellence often suggested including ensuring the "right people” are hired and providing them with the "right words.” Selecting for fit is often easier to say than do and takes a significant commitment and patience in the hiring process. Scripting, while also a practice that generates positive results, still faces resistance and often raises the concern of removing the passion from the healthcare process. What stood out to me on the flight was that while these service keys may have been used, they represent fundamentally individual activities. The right individual or the right words only work in one-on-one encounters, yet as suggested above, our healthcare journeys are built on countless interactions.

What I experienced on that plane was a coordinated team effort, including consistent communication on our status from the flight deck and engagement by flight attendants who went above and beyond in reassuring concerned travelers about connections, while providing comfort with either beverages or blankets. It included the actions of the gate agent (when we needed to land in an alternative airport to refuel) who greeted us, kept us informed, and provided thoughtful options for travellers with specific needs. More importantly they were communicating with each other, across roles, in addressing the specific needs of the situation. The group of individuals interacted as a team, covering all aspects of our service needs at every moment of the experience. There were plenty of individual "moments of service,” but it was the synchronized actions of the group as a whole that led to service success.

Clearly this was not a typical situation for which these specific individuals could rehearse. What they had to do was improvise, not just as individuals, but rather through a coordinated effort that helped them best address the situation at hand. Unlike the story shared during my visit to Rush of the rental car shuttle driver who recited her complete script even though there was only one individual on the bus, they adjusted what they did to the situation. In service encounters, where no two individuals or experiences are exactly the same, improvisation becomes a critical team skill.

Service delivery, especially in our healthcare environment, cannot be over-structured. We need to create a team consciousness that helps our people realize they each play a part in the service picture and that every action they take is part of the overall patient encounter. We also need to challenge them to respond in the moment to what is needed.

While understanding the parameters of what is acceptable, we need to ensure these individuals have the ability to "dance in the moment” and share the passion for care that draws so many of us to this work. As we ask our patients to both take on the wholeness of their experience, while accepting the need for flexibility along their care journey, we too must recognize that service is a team sport, requiring agility and the need to improvise in order to ensure the greatest of patient experiences. Our flight "team” did just that, turning a "moment” into a service experience to be remembered.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Related Body of Knowledge courses: Organizational Effectiveness.

Tags:  patient experience  service excellence  team 

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When Focusing on the Patient Experience, Every Day Provides the Opportunity for “New Year’s” Resolutions

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, January 4, 2011
Updated: Tuesday, January 4, 2011

I wish you a Happy New Year, both personally and from The Beryl Institute. The idea of the New Year has been around for millennia and has always symbolized a time of both reflection and foresight. It represents an opportunity to review past events and to plan for new actions.

The recognition of January 1 as the start of the new year (for many, but not all cultures) was solidified when Julius Caesar reset the calendar year to start on January 1. It was associated with the mythical King Janus, who represented beginnings and served as the guardian of doors and entrances. I found this metaphor of great relevance as we think about the patient experience and how important beginnings are. The patient experience is not simply represented by the doors and entrances of our healthcare facilities. We must think more broadly to the initial interactions that patients have with our organization. Whether it is on the phone searching for a physician, making that first appointment, or pulling up to be greeted by a parking valet, these are all critical beginnings in the patient experience process. These actions set the tone and frame the perspective of how a patient, their family and support network experience your facility.

In addition, Janus is traditionally depicted with two distinct faces – one looking towards the future and one into the past. I believe this is symbolic of the work we take on every day in healthcare. We engage in moments of care that have both strong histories and hopeful outlooks. Our patients’ stories are not simply single encounters in time, but rather they are grounded in the experiences that carried these individuals to our doors. And while rooted in the past, these stories are also focused on a future of healing and replenished health.

In looking towards 2011, we personally will look back at what we accomplished and plan ahead for what we want to achieve. I would suggest we also need to be aware that our patients are managing this in a much more vital way. As we create our patient experience resolutions for the year to come, one important consideration is to make an effort to understand the past for each of our patients. In doing so, we create a connection and present a level of understanding and compassion that can establish a foundation for a greater overall experience. We must also challenge ourselves to look forward and help our patients exceed expectations for what they hope to achieve through our care and what they aspire to be doing once they leave us.

At The Beryl Institute we are purposeful in our definition of the patient experience as "the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care". This includes all that comes before and after the clinical encounter. In this same way, as each of us considers our resolutions every year, we do not spend the time just thinking about New Year’s Day itself. The day is simply a doorway that transitions us from one point in time to the next.

When we realize that for most patients their stay affords this same experience – a chance to reflect on the past and an opportunity to plan for the future – new possibilities emerge. This happens, not just on January 1st, but each and every day. In healthcare, we have the opportunity to create resolutions with every encounter and more importantly to support the resolutions of our patients every day of the year. It is our job to look both forward and back, to help people cross that threshold of healing, and to ensure that the experience we provide is one that allows for dreams of a bright future ahead.

So what will your resolution be as you focus on the patient experience in 2011? How will you support the resolutions of others at every interaction? It could be the most important thing you do in caring for others this year! Here is to a fulfilling and rich year ahead.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Tags:  Continuum of Care  Patient Experience  Resolutions 

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Tis the season! Storytelling: A Key to a Positive and Lasting Experience

Posted By Jason A. Wolf Ph.D. CPXP, Monday, December 6, 2010
Updated: Monday, December 6, 2010

Maya Angelou, celebrated poet, novelist and educator, is attributed with saying "There is no greater burden than carrying an untold story.” I would suggest that in healthcare (and in particular as we focus on improving the patient experience), storytelling must become central to what we do. It not only influences how staff translates ideas into actions, but it also creates a means by which patients, families and the community can engage with your facility.

In my recent On the Road visit to Memorial Medical Center, it became evident to me that storytelling was central to the hospital’s ability to translate the patient experience message to staff. Rather than lists of "must dos” or required actions, it was the stories that people most often remembered. In fact, one nurse manager suggested that it was the sharing of stories that gave power and life to the concepts being taught. Storytelling has become a central part of their orientation program and a foundational element in their effort to a greater patient experience.

Stories have been shown to have much greater impact than PowerPoint presentations, speeches or even well designed advertisements or promotions. More so, they have a lasting effect well beyond those efforts. Stories help people relate to a situation as if it was their own and help them to engage in ways that facts and figures do not.

Jay Conger, senior research scientist from University of Southern California, suggests some tips to storytelling in an organizational setting, that I believe make storytelling a powerful tool in your patient experience efforts. They include:

1.Keep it short: people tend to retain a story around 2 minutes in length.

2.Focus on 2-3 characters: this provides an opportunity to relate to the individuals involved.

3.Keep it simple: a story should be built around a single message that is clear and understandable.

4.Tell it in the present tense:this allows people to experience as if they are part of the story itself.

5.Build in visual images: people store and retain these images and give a story lasting qualities.

6.Repeat or reinforce a key phrase or concept: this ensures people are clear about the message you are conveying.

A story that I recently heard regarding the patient experience follows this model. This story serves as a great way to convey expected behaviors in a patient room without having to simply list required actions. A nurse enters a patient’s room and finds a spill on the floor near the bed. The nurse excuses herself and makes a quick call to housekeeping to have the spill cleaned. When housekeeping arrives the nurse points out the spill and asks the individual to mop it up. The housekeeper responds that it is just a few drops and that the nurse should have been capable to wipe this up herself. The nurse then argues in fact it was not a drop, but a spill, and therefore it was a housekeeping issue to deal with. As the two continue to argue, the patient grabs the pitcher of water on her bedside table, pours it all on the floor and asks them both, "it is big enough now?” Clearly the expected behaviors and the influence on a potential patient experience were conveyed very effectively through this simple, but powerful story.

There are also stories that reinforce the impact of positive behaviors. One such example was about a high school student who volunteers after school at his local hospital delivering meal trays. One evening the student volunteer was on his dinner delivery rounds. As trained, the student checked the hospital bracelet of the patient before leaving the dinner tray. As he looked up from the bed, he saw that the IV bag had a different name on the label. He immediately notified the nurses who were able to quickly make the appropriate correction. While this patient was not in any significant danger in this specific situation, it reinforces the importance of following protocol and how every individual plays a critical role in the overall experience of patients. By telling a story, we effectively convey this critical message and the lesson has a lasting impact.

At this time of year when stories are so prevalent - stories of joy, of hope and of thanks - there is no better time to identify and frame the stories that represent your facility or healthcare organization. What are the stories you tell about your patient experience efforts (or what stories should you tell)? I encourage you to share your story with us and hope to continue to collect them as we enter the new year. I invite you to attach your story below as a comment to this blog.

I wish you the most joyous of holiday seasons. Here is to a year ahead full of positive stories!

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute


Related Body of Knowledge courses: Communication.

Tags:  patient experience  storytelling 

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Execution: The Key to a Greater Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, November 2, 2010
Updated: Tuesday, November 2, 2010
I have always been struck by an interesting paradox in healthcare, the drive of competition and the need for collaboration. I have seen the competitive drive of healthcare facilities in the same market as they strive for higher volumes, physician loyalty, expanded service lines, and growing market presence.  At the same time, with the increased focus on improving quality and service, healthcare facilities are driven to collaborate on such ideas as proven practices in combating hospital acquired infections, strategies for noise reduction on the nursing floors, or faster throughput in the Emergency Department.

My observation is that healthcare facilities seem more than willing to share ideas outside their market or at a national level rather than collaborate on ideas that may be of direct value to the communities they serve. While this broad sharing is of value, and I encourage it, it has local consequences as well. It can lead to a shrinking of the local knowledge base and require facilities to look beyond their markets for innovative ideas.

My challenge with this is that as the healthcare industry struggles overall to ensure the best patient experience for everyone, the important practices that drive a successful experience, including quality and service, should not be used as the competitive wedge between healthcare organizations. Sharing proven practices, processes and knowledge that can be used to improve the patient experience, is an obligation to the community you serve. It does not detract from your competitive edge, but rather allows you to emerge as an expert and a contributor to the overall health of your market.

Improving the patient experience is about the basic common sense fundamentals we know and believe in when choosing to take on healthcare as a profession. The "whats” of addressing the patient experience (knowledge, processes, practices) should be our universal in providing the best care for patients. The "how” you choose to get it done is where you can and should distinguish your competitive edge. It is in the execution of your plan and your organization’s commitment to engage in driving the critical components of an effective program where the patient experience is truly realized. It is not simply in WHAT you do…but HOW you choose to do it.

In the book Execution: The Discipline of Getting Things Done, Larry Bossidy & Ram Charan are explicit in defining execution as "a systematic process of rigorously discussing ‘whats’ and ‘hows’, tenaciously following through, and ensuring accountability.” Execution is your competitive edge in effectively improving the patient experience. I challenge you to use this as your measuring stick. How well do you execute on the fundamentals of an unparalleled patient experience? What are you willing to commit to to ensure your processes are most successful?

I challenge you to share your practices on improving the patient experience broadly and then compete on how well you can execute on those plans. If we are willing to focus on execution, we will find greater potential for improvement. Rather than being caught in a battle over whose process is better, our patients will be buoyed by a rising tide of execution that will ultimately ensure the best experience for the patients we all serve.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

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A Simple Idea with Significant Possibility

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, October 5, 2010
Updated: Tuesday, October 5, 2010

Recently, a colleague was doing some work in a hospital system and came across the picture you see here. I was immediately intrigued by how this simple act of personal initiative represented such a significant opportunity and potential impact for this facility.

With the most recent public reporting of HCAHPS scores this September (representing data from January – December 2009), the national average "top box” score on the question "what number would you use to rate this hospital?” was only 66%. This means that less than 7 in 10 of your patients rated your facility a 9 or 10. This may not seem to be an issue until you get beneath these numbers. The 2005 National Hospital Service Performance Study by JD Powers and Associates determined that individuals giving a perfect score of 10 in satisfaction measures had an 80% chance of returning to the same facility. From there the opportunity quickly diminishes. For those rating hospitals a 6-7 in satisfaction, only 37% percent say they will return to the same facility again.

In considering these numbers in the context of this picture, I believe there are some choices hospitals and other healthcare organizations can make to begin to develop patient and family engagement and ultimately build a loyalty to their facilities. The simplest, yet potentially most important step is listening to your patients.

We must acknowledge that managing patient experience is not something we simply DO to patients. If we are to be truly successful, we must build our patient experience strategies and efforts WITH patients. By involving patients in creating unparalleled experiences, we ensure they begin to develop a sense of ownership, are more highly engaged and ultimately better connected with a facility. Patients are and should be active participants in their experience, not simply subjects to it.

The picture above is just one example of how a patient directly engaged herself to improve the facility in which she was staying. It represents a clear expectation about how the patient wanted to be cared for. I am sure the hospital had similar signage for its staff, perhaps even in this patient’s very room, but she wanted to emphasize one aspect of the care experience that was critical to her. We have all heard of or experienced similar situations regarding surgical patients marking their own limbs for surgery…”this leg,” or "not this leg.” These are just some of the many examples of patients seeking to improve communication and compliance with their wishes.

My advice to healthcare leadership and staff looking to elevate the patient experience is to start asking patients how they would like to be involved in their care process. I know many facilities today have established patient and family councils, community focus groups and other resources. Yet, while important, these processes deal with macro issues that often take time to influence or change.

If you are looking for a way to act now, it will happen at the individual level, at every point of personal interaction with your patients. Take the time to ask, "Is there something I haven’t covered that you’d like to discuss? Is there anything we can do to make you feel more comfortable about the care plan we’ve developed? What can we do to ensure you have the best experience while you are with us?” or any of many other questions that align with your organization’s experience goals. Some patients may surprise you by putting up a sign. And it is those types of signs we’d better pay attention to if we want to see our scores improve and our customers return. Perhaps it is nothing simpler than that.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Related Body of Knowledge courses: Patient & Family Centeredness.

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Defining Patient Experience

Posted By Jason A. Wolf, Ph.D., Tuesday, September 7, 2010
Updated: Tuesday, September 7, 2010

Does a definition really matter? Especially when it comes to something as dynamic and complex as the patient experience? As an organization committed to improving the patient experience we felt it was important to tackle this question head on.


I would assert a definition does matter for a number of reasons. It is through definition that we create a standard by which to understand, act and measure. If your organization is on the path to improve the patient experience, you should know what it is you are out to change.


Equally important is the recent discovery that there is a performance impact to having a clear definition of experience. A 2008 study by Aveus, a global strategy and operational change consultancy, discovered companies that have a definition for customer experience and use this definition in everyday decision-making are more likely to exceed profit and revenue goals. The study showed:


  • While individual definitions of customer experience vary by organization, there is a clear performance difference between those who have an organization-wide definition and those who do not;
  • 26 percent of companies with a definition for customer experience report exceeding profit targets, compared to only 14 percent of those without definitions;
  • Organizations with the greatest use of customer experience in daily decision-making report the strongest operating results with 67 percent meeting or exceeding revenue targets and 65 percent meeting or exceeding profit targets.



The bottom line, customer experience is a path to improved profitability, not a distraction from it AND it is a clear and shared definition that is a critical key to successful outcomes. I would suggest that focusing on the patient experience in healthcare has the same potential value.


Therefore, I believe a definition can have a significant impact on what you do within your organization as you work to improve the patient experience. To support you, The Beryl Institute decided it was important to help define this somewhat amorphous term – patient experience. Our hope is that this definition will create a shared understanding and common framework that will support your organization’s efforts in building a plan of action around the patient experience.


To accomplish the task of defining patient experience, a work group of your peers - patient experience champions and leaders from a number of hospitals and healthcare systems - came together over a series of virtual meetings to brain storm, research and collectively craft a definition. The definition is purposefully designed to be value neutral, suggesting that we first must acknowledge that there is some "thing” called the patient experience we need to both recognize and address. The result of the team’s efforts was powerful, broad, and yet concise.


The Beryl Institute defines the patient experience as:

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


At the Institute, 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. How will you use the definition in your organization? And what value might it bring to your efforts?

So to our original question, does a definition matter? I maintain that it does. There is much more than you may believe riding on it.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Related Body of Knowledge courses: History.

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Can You Create a Formula for Improving Patient Experience?

Posted By Jason A. Wolf, Ph.D., Wednesday, August 4, 2010
Updated: Wednesday, August 4, 2010

As part of its ongoing commitment to providing an exceptional patient and family service, Community Health Network (CHN) in Indianapolis, decided to turn to its employees for input on how it can continue to improve this aspect of its mission. As part of a recent survey to staff members at one of the system’s hospitals, CHN asked about potential barriers to improving patient experience. This generated great energy among the staff with more than 300 staff members offering over 800 distinct responses regarding possible influences on the patient experience in their facility.

From those responses ten top barriers were identified, including:

  1. Poor personal communication skills
  2. Lack of time to spend with patients and families due to conflicting organizational priorities
  3. Managers and Administration not making Patient Experience a priority
  4. Lack of staffing
  5. Equipment and supply issues that both interrupt the ability to provide care and frustrate the patient
  6. Attitudes and mood of the staff that affect ability to relate to patient
  7. Ineffective systems and processes
  8. Interdepartmental communication breakdowns
  9. Excessive "all staff” emails cut into patient care time
  10. Breakdown in teamwork

    One of the significant "ah-has” from the survey is that while many of the barriers are not surprising, they are clearly items that can (and should) be addressed and improved. While some are operational issues, such as staffing or equipment that may require longer decision cycles, the others get to the core of how staff at all levels engage with patients and one another. These provide potential opportunities for more immediate impact.

    Hospitals that want to pursue improvements in patient experience can learn from CHN’s process. Take the important first step to identify organizational changes that can be made quickly. They can also learn from the list itself, in recognizing it may be some of the very fundamental aspects of organizational life that impede our ability to best meet patients needs. In CHN’s case, how can communication skills be improved, interdepartmental communications reinforced or stronger teamwork developed?

    Let me be clear, in sharing these examples I am not suggesting the solution is simply training. Rather, success is realized through an unwavering commitment to make fundamental changes in your organization. These are not cumbersome and large shifts taking great time, effort or resources. They are focused and purposeful improvements that will go a long way to change the experience for patients and their families, as well as your employees.

    This week The Beryl Institute releases the first in our expanded series of white papers on improving the patient experience. The paper provides insights from three individuals who are leading efforts to transform how their organizations address the patient experience, one of which is CHN. For all three organizations, the patient experience starts well before the patients enter the physical hospital building at their first contact with the hospital - be it online, on the phone, or in the parking lot. This reinforces the idea that first impressions are just the start of creating truly lasting impressions. Through their stories, each individual helps us see is that it is often a commitment to identifying opportunities and then taking steps to address the fundamentals that can have a significant impact.

    The healthcare marketplace is increasingly focused on what it will take to improve the patient experience. The trick is determining what steps matter, where we can make positive change quickly and what actions may require more time and resources. Right now, having a top patient experience score translates into local market bragging rights. Soon it will equate to bigger reimbursements from CMS. So can we create a formula for improving the patient experience? Remember, as the experience at CHN shows, improving the patient experience is an individual journey for each organization; one that requires clear priorities, unwavering commitment and a bias for action. Perhaps the real question is can you afford not to?

    Jason A. Wolf, Ph.D.
    Executive Director
    The Beryl Institute

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