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The Beryl Institute Patient Experience Blog
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You are the Patient Experience: A Reflection

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, April 2, 2013
Updated: Tuesday, April 2, 2013

In just two weeks, hundreds of healthcare leaders, resource providers, patients and family members from around the world will gather together at Patient Experience Conference 2013. This annual gathering continues to amaze me, for while I get to take part in the organization and preparation with an incredible team of planners and volunteers, what happens during these days together is still, in many ways, a surprise.

Why is that, you ask? It comes down to a simple philosophy we work hard to ensure permeates our community at The Beryl Institute each and every day. With as many resources as we continue to provide – from papers, to case studies, On the Road visits to research – and our commitment to be the global community of practice and premier thought leader on improving the patient experience, we fundamentally believe the greatest power in our community is the connection and sharing with one another. That is what makes the annual gathering of patient experience leaders so powerful; it is grounded in the learning from and connection with one another and provides a new level of support for what many can feel at times may be a very lonely and challenging adventure.

No one person, organization, provider or vendor "owns” the patient experience and they should not claim to; rather it is ALL of the people who live it, struggle with it, work to improve and yes experience it every day, who do. It is you who truly are keepers of this movement. You are the patient experience. I see our job to create the space for this to happen, provide the information from which you can learn and fundamentally encourage the connections that will help all of us ultimately improve.

In my March Patient Experience Blog, Why Community Matters in Improving Patient Experience, I suggested, "…to provide a true experience, you must think well beyond the physical nature of your facilities or practices to recognize that experience resides in the network of people that surround and are connected to your organization, both near and far.” I would suggest that in the call to action to address the patient experience we remember this fundamental point. This is what also has me encourage people to get engaged, be part of the community, contribute and learn from one another. It is why at the Institute we have launched our Voices of the Patient Experience series to start this year from the perspective of executives, the front line, healthcare students and patients and family members and why we are ensuring patients and family members can participate in Conference 2013 (#patientsincluded).

I also share these thoughts with a new perspective on this passion, from that of a patient and family member myself. Personal experience has led me to spend time (and as someone committed to patient experience, observe the experience) in an emergency department and primary care setting, and has blessed me with the chance to encounter the preparation and expectation setting that happens with both physician and hospital in anticipating the arrival of your first child. These personal encounters have reminded me that each and every one of us committed to this work are also (or will be) that patient or family member.

I share all of this to reiterate my central point, if we are committed to improving patient experience, to ensuring all voices are heard, to providing the best in quality, safety and service, then the opportunity we have and must take advantage of is to tackle this not alone, but as a true global community. Whether in person at Patient Experience Conference, on a call or via an electronic network, the impact that we can have is only heightened through our connections. I encourage your engagement and I urge your sharing. This is an effort worth every moment we spend. I most look forward to all that will still emerge as a surprise!

Jason A. Wolf, Ph.D.
President
The Beryl Institute

Tags:  community of practice  global healthcare  healthcare  improving patient experience  Leadership  networking  patient  Patient Experience  Patient Experience Conference  team  thought leadership  voice 

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Why Community Matters in Improving Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Wednesday, March 6, 2013

They say when someone mentions a Red Beetle – the automobile version from Volkswagen or "bug” – you go from not seeing them at all to seeing them everywhere you look. In a similar fashion my recent conversations on the patient experience have raised this sense of "everywhere” awareness to the idea of community. From as recently as our March 5 webinar on patient engagement to the final interviews I just conducted for our pending paper on the Voices of Patients & Families on Patient Experience, there is a recognition that while patient experience is built on the foundation of countless personal interactions, when pulled together it is a true community issue and, I would suggest, opportunity.

The idea of community aligns strongly with the definition of patient experience that asserts patient experience crosses the entire continuum of care. I need to reinforce from the perspective we hold at the Institute this is not just the continuum within the four walls of the clinical experience, but from the very first encounters someone has with your organization to the stories they share well after their departure or discharge. Where are these stories told and where do they live beyond the boundaries of what you can control? In your communities, in the voices of people that have either had encounters with your organization or who have heard the stories, true or embellished, about what happened within your walls.

This means to provide a true experience, you must think well beyond the physical nature of your facilities or practices to recognize the experience resides in the network of people that surround and are connected to your organization, both near and far. This is at its heart, the essence of experience. As defined, experience is all that is perceived, understood and remembered. Those perceptions and memories and the stories through which they are shared are not collected at your doors, but rather they flourish in the sunlight and in the air of the streets, towns, and cities around you. The experience you provide is a community story and one you must be willing to acknowledge and address.

But I want to suggest another angle on community as well that is as equally important in all I have seen. That accomplishing the greatest in experience is a true community effort. It is not just something that can happen at admissions or discharge, or in your top performing units or departments. It must happen across the organization or system. More so I strongly believe the essence of patient experience thrives in much bigger ideas of community, which is why we have worked so hard in creating a true community of practice in The Beryl Institute itself.

I continue to be amazed by the generosity of spirit and sharing that has been afforded by the safe framework of our community. The realization that in healthcare if we are to be about the patient experience, holding our cards close to our chest or believing our "secret” process is our competitive advantage, is counter to what we are all trying to achieve. As much as I admire systems and organizations big and small for what they accomplish, I can tell you from my travels and encounters around the world, there is no one secret to success. What I have seen as the greatest resource comes back to the idea of that red beetle – community. It is in our willingness to share ideas and practice, to be open to exposing where we may have been challenged and celebrate and disseminate that which drove success, through which we can all impact patient experience.

This is not just a lesson for those in the delivery of care, but for those that support it; the resource providers and vendors, from survey companies to technology tools. It is their willingness to collaborate and share in community through which even greater things can happen. While their distinctions may be in variations of a theme in process and clearly more on level of service and the personalities involved, the reality is that they too play a part in this critical community conversation. From leadership to the frontline, from the future to patients and families themselves, it is the spirit of community and through the action of community that we can ensure the greatest in patient experience for all the patients, families and yes the very communities we serve.

As we approach Patient Experience Conference 2013, and we bring our virtual global community together physically for a few days this April, we hope that we are all reminded that it is through our connections that we have the opportunity for greatest impact. It is in our collective efforts and shared learning that we have the clearest path to success. My hope, and my vigorous invitation, is to join us, join this community and our efforts at The Beryl Institute as member or guest; as caregiver, physician, administrator, resource provider, patient or family member and to be in conversation on what we can accomplish as a community, together. The greatest of opportunities will emerge when we find our collective voice and there is so much yet to learn from one another.

Jason A. Wolf, Ph.D.
President
The Beryl Institute

Related Body of Knowledge courses: Coaching and Developing Others.

Tags:  accountability  choice  community  community of practice  culture  defining patient experience  healthcare  improving patient experience  Interaction  Leadership  Patient Experience  Patient Experience Conference  patient stories  recognition  storytelling  voice 

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Why did you get into healthcare in the first place?

Posted By Stacy Palmer, Thursday, February 21, 2013

I can name a dozen places in our blogs, publications and case studies at the Institute that reference the idea of "reconnecting people to why they got into healthcare in the first place.” I love the notion. It inspires people to think about that moment in time when they realized that serving others during their times of need was important to them.

A few weeks ago I had the chance to connect with Kourtney Govro, Founder and CEO of Sphere3. Her story is simple yet powerful. She’s a busy mom of four whose career path changed when her son, Noah, at only six weeks old was hospitalized for respiratory syncytial virus. One afternoon little Noah vomited. Based on her experience of waiting over 30 minutes after pressing the nurse call button for someone to respond to the situation, Kourtney founded a company that helps hospitals track call light response times and offers consulting services to help those hospitals improve results. As a mom, I applaud her for experiencing a frustrating situation and doing something to help improve the processes that caused it.

For some it was a personal illness that led them to healthcare. I’m inspired by the story Tiffany Christensen shared in her keynote at last year’s Patient Experience Conference. Born with cystic fibrosis and recipient of two life-saving double lung transplants, Tiffany grew up in hospitals. She developed strategies and coping mechanisms but found the healthcare maze difficult to navigate. She decided to share the lessons learned along her journey and is now a patient advocate and delivers inspirational workshops to the healthcare community.

Others consider it a calling – not necessarily prompted by a particular event but maybe inspired by a family of healthcare workers or an innate nature to help people. I asked a recent nursing school graduate why she chose healthcare and her response was simple yet thoughtful. She said she loves to help people and if she can make a difference in someone's day, or ease their pain in some way, she’s happy.

Everyone has their own reason for venturing into this space. It’s in remembering those reasons – even when shifts are long, processes are overwhelming and frustrations are high – that we can pause and reconnect with that energy and passion to make a difference.

So, why did you get into healthcare in the first place? We know our members and guests are passionate, committed people, so I’m confident many of you have inspirational stories about your journey into healthcare. We invite you to share yours in this brief form. It may even be featured in an upcoming video or publication from The Beryl Institute.


Stacy Palmer
Vice President, Strategy and Member Experience
The Beryl Institute

Related Body of Knowledge courses: Employee Engagement.

Tags:  choice  Field of Patient Experience  global healthcare  healthcare  patient engagement  Patient Experience  storytelling  Tiffany Christensen 

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The Importance of Voice in Improving Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, February 5, 2013
Updated: Thursday, February 7, 2013

As The Beryl Institute has grown from a small group of committed individuals to a true global community, I have learned something very important. There is tremendous power in giving voice to ideas. Voice is not just the spoken word, but also the expression of opinion and thought, of creativity and passion, through multiple avenues. It is this essence of giving voice that rests at the core of excellence in patient experience itself.

My hope is that the Institute has reinforced that very fact. More than just a membership association or a research organization, the Institute’s strength in supporting those working to improve the patient experience has been in giving voice to the over 15,000 members and guests that engage in our community of practice. It was members and guests that provided input on the largest patient experience benchmarking study to date, it was members and guests who over 400 strong have contributed to creating the Patient Experience Body of Knowledge, it was members and guests who came together to author the definition of patient experience.

Why is this important? Because we have been built by and for our members in the way I have seen the most successful organizations address the patient experience itself. Those organizations have created the means to engage the range of voices they encompass. Those successful facilities and practices, systems and centers have made a commitment to intentionally listen and actively engage the voices of their community. They did this by:

  • Creating the opportunity for the voice of patients and families to be heard, not just in formal advisory roles, but also in common interactions. Those organizations that have incorporated patients and families as critical partners in the care experience excel at ensuring the best in service, quality and safety.
  • Providing the means for the voice of staff to be heard, not just through engagement surveys, but also as active contributors to an environment of continuous improvement. The ability to speak-up, offer ideas and even challenge the status quo without fear of repercussion has led to great improvements and important changes in the delivery of care.
  • Offering the chance for the voice of the community to be heard, more than just asking for contributions to foundations or causes. The engagement of community through strong presence and focused outreach shapes the nature of a healthcare organization, be it a rural community health center or a major urban hospital. In healthcare we hold a unique place in the communities we serve and play a role no other service provider can.

The importance of voice plays a central role in improving patient experience in healthcare settings around the world. In fact, in our most recent paper, Voices from the C-Suite: Perspectives on the Patient Experience, the executives we interviewed consistently talked about the importance of engaging the voice of patients, family and staff.

In no small part then is the importance of continuing to ensure the power of voice is included in all we do at the Institute. We have opened the year with a series of papers, including the Voices from the C-Suite mentioned above, that provide the opportunity for voices to be shared. This will be followed by Voices in Practice and ultimately Voices of Patients and Family, as we look to reinforce this simple, but significant tool and the lessons it offers in impacting patient experience.

Perhaps more importantly, we commit to ensuring the voice of the patient experience is heard. It is in our collective expression and sharing in which each individual and the organization they represent can learn and grow. It is ultimately in expressing our voice that we give the greatest gift to one another, it is in inviting that voice that we show the greatest of respect.

Improving the patient experience is not just an act, it is a critical dialogue; one that we must foster and encourage. Its impact is greatest when all voices are heard. Our commitment is to provide the space for that to continue. My question now is how will you use your voice to impact the patient experience and how will you engage the voices of others? This is one conversation we must never let end.

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

Related Body of Knowledge courses: Patient & Family Centeredness.

Tags:  culture  defining patient experience  employee engagement  healthcare  improving patient experience  Interaction  patient engagement  Patient Experience  service excellence  voice 

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The Power of Expectations: A Thought for the New Year

Posted By Jason A. Wolf Ph.D. CPXP, Wednesday, January 2, 2013
Updated: Wednesday, January 2, 2013

Expectations are powerful. They influence what we see, how we act, and the way we react. They stir emotions and create real feelings from joy to anger, surprise to sadness. The reality of expectations is that they present an intriguing paradox in how they can and do influence the situations in which we find ourselves. Expectations are an individual and even very personal experience, yet at the same time they can be set by organizations, businesses and other people outside of one’s self. This makes expectation potentially the most valuable and perhaps most precarious tool in the discussion of consumer experience and in healthcare, the patient experience.

The example of how personal expectations can modify the perception of reality has long been part of the healthcare world. As Chris Berdik notes in his new book, Mind over Mind, the power of expectations lies at the center of the placebo effect. Berdik makes a compelling case that what we expect from the world changes how we experience it. He notes that research into placebos is expanding to examine everything that affects a patient's expectations for treatment, including how caregivers talk and act and even the impact of the wealth of online information now available – and how those expectations can help or hinder healing. I believe the same is true as we look at the overall healthcare experience. Patients and families come with personal expectations and more often with ones that healthcare organizations worked to create. It is these very expectations that impact how individuals experience an organization and ultimately rate its performance overall.

I can share a non-healthcare example of this from just this past week. My wife and I had the chance to take a few days away for the holidays at a small inn near our home. We had heard great things about the service and quality of the experience and were excited by some of the extra amenities they offered. When we arrived we discovered our room was the only one missing the special amenities they touted in their promotions, and while the service was impeccable, this missed expectation had already impacted our experience. The hotel did all they could to accommodate and provide service recovery for our experience. To an extent they even exceeded what we would have anticipated in response, but it was the missed expectation that still lingered for us as guests.

Now imagine in the healthcare setting where our patients and families come with their own set of anticipations and clear expectations. Most do not choose to visit, but rather are dealing with illness or other issues that may be cause for great concern and even fear. They come with expectations of how they will be treated, but even more significantly they come to your doors with the expectations your organization has set through the stories shared and the messages disseminated via advertising or other means.

I saw an example of this at a recent hospital I visited. They were so proud of their new facilities, including new amenities, private rooms, etc. The advertisements and billboards they produced promoted the newness of the hospital. Yet, they still also had an older wing, where the rooms were dated, semi-private and lacked the sparkle and shine of the newer rooms. While the patient experience of the facility was not designed to be about the physical nature of the buildings, but rather the encounter people have with staff, they set the expectations publically that the facility itself was at the heart of their overall experience. In essence, they set expectations they could not always fulfill…and it set up the potential for disappointment before they even had the chance to make an impact.

The lesson here is simple, yet significant and one I think is critical to looking at the year ahead. For as much as we can control our efforts in healthcare, we must work to set the best and most realistic expectations we can for our patients and families. This is not what I have heard some describe as lowering expectations to outperform, but rather it is about setting the right expectations for what you want to deliver in your own organization and ensuring the means – both in resources and process – to deliver on it.

In maintaining a focus on providing a positive patient experience, consider starting the year by identifying the expectations you hope to deliver, ensuring your leadership and staff are aware of these touted expectations and establish a process to check your performance to these expectations at every point in the care experience. While you cannot dictate every expectation people bring with them to your doors, healthcare organizations can shape their own story in a way that ensures expectations are realized and the patient experience is one that will always be remembered. Wishing you fulfilled and exceeded expectations for the year ahead!

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

Tags:  choice  expectations  improving patient experience  patient  Patient Experience  service excellence 

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Patient Experience: A Global Opportunity and a Local Solution

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, December 4, 2012
Updated: Tuesday, December 4, 2012

Last week we held the second call of the new Global Patient Experience Network supported by The Beryl Institute. The call included Institute members from eight countries and spread across 18 time zones. Despite our differences in location, time of day, native language or accent, when the conversation started, we discovered that the concepts at the core of improving patient experience are fundamentally the same. Providing the best in experience for patients, families and the communities (and countries) we serve is an unwavering focus for people across healthcare systems and functions around the world.

As I listened to the conversation and we dug deeper in identifying what posed the greatest challenges and offered significant opportunities for improving patient experience, I was struck by the recognition (and even relief) that participants showed in how similar their issues were. One participant offered, "It’s comforting to know we are all contending with the same challenges and questions moving forward,” with a second individual noting, "It is amazing that at the end of the day we are all working towards the same end and facing the same issues.” This realization drew agreement and raised the excitement of the group in understanding that even with great distances between us, there are great similarities and therefore possibilities.

The group identified the same top issues central to patient experience efforts that I have seen in my travels. They included:
  • The importance of organization culture and our ability to manage change in today’s healthcare environment
  • The understanding and effective implementation of patient (and team) interaction processes from patient, physician and staff engagement and involvement to service recovery, post care follow-up and building consumer loyalty
  • The implications of measuring our patient experience efforts to gauge perception and understand the impact of each effort
  • The value of the structure of patient experience practice itself, ensuring a clear focus, supportive leadership, aligned roles and right structures to deliver on the best experience possible

While these are not the extent of the issues faced in addressing patient experience, it was evident that among peers separated by great distance, they still had closely knit similarities. This was especially significant for our team at the Institute as we have always approached our work from the belief that while systems may operate differently and policies might be distinct, the very fundamentals that drive a positive patient experience – the power of interactions, the importance of culture, the reality that perceptions matter and the realization that experience covers the continuum of care – as framed by the definition of patient experience, continues to hold true.

With this great commonality and the excitement generated in the discussion, it was also evident that our members recognized that patient experience is a local, dare I say personal effort. Each and every individual that plays a role along the care continuum has some level of responsibility. It is based on the sum of all interactions, as we suggest, that a patient and their family members gauge their own experience. Therefore in building a patient experience effort, it requires an understanding of your own organization, the people that comprise it, and the community (and demographics) that you serve. Patient experience success is not driven by a one model fits all solution, it is and forever should be something that meets the need of your organization and your patients whether in San Diego or Sydney, New York or New Delhi. Ultimately, patient experience is a global issue, but it is and will continue to be up to each of us locally to bring these grand ideas, the critical practices, and the day-to-day needs to life in every encounter. There is a great opportunity we have been given to move beyond policy to true cause, beyond process to effective practice and beyond "have tos” to "always dos”, that will impact the lives of patients and families globally. I have always suggested it is a choice…I maintain that and hope it is part of all our resolutions for positive and healthy New Year!

In reflecting on the launch of the Global Network and other Institute efforts in 2012, it is clear that this has been an amazing year for our growing global community, with now over 11,000 members and guests in 28 countries focused on improving the patient experience. We have all committed to something noble and important, the best possible experience and the health and well being for our fellow man. And we have been given a great opportunity, to turn a global need into something each and every one of us can impact directly. Happy Holidays to you all and I look forward to continuing to learn and grow together in the year ahead.

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

Related Body of Knowledge courses: History.

Tags:  choice  culture  employee engagement  global defining patient experience  global healthcare  healthcare  improving patient experience  Interaction  patient engagement  Patient Experience  perception  service recovery 

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All Voices Matter in Improving Patient Experience - A Reflection on Election Day

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, November 6, 2012
Updated: Tuesday, November 6, 2012

In some of my most recent blogsand in current publications from The Beryl Institute we have expanded the dialogue on the importance and power of voice in driving towards a positive patient experience. It is only fitting to take pause of this, as today - November 6, 2012 - in the United States represents one of the most powerful examples of the expression of voice to be found. In electing a President, citizens of the U.S. of all backgrounds and beliefs have the opportunity to be heard. The intention is that every voice regardless of how young or old, soft or loud, rich or poor has value in a broader dialogue about the greater good and direction of the country.

As I travel to healthcare organizations and engage with patients and families, caregivers and leaders, one thing stands out. It is the great alignment these individuals have in desiring and working to ensure the best care outcomes and overall experience possible. The recognition in this expanding dialogue on experience is not one of cynicism or even submission to simple performance on surveys, but one driven on the same passion and commitment to the wellbeing of our fellow human beings as those that vote to support the best in what they believe.

The common denominator in these ideas is the most critical component of all we do in healthcare, in our world of human beings caring for human beings. The power is that of voice and the voice of all, be it spoken, written, sung or signed. Healthcare organizations around the world bring people together at the most critical times of our lives – from the joys of birth, to the tears of a last breath – and this is not something any of us do alone. It takes the hearts, minds and yes, voices of many to make it work. It is the voices of patients and families in expressing their needs, but also sharing their fears and pains. It is the voices of caregivers who contribute to the best processes of care and support for one another. It is the voices of physicians who bring great insight and education along with the powerful ability to heal. It is the voices of staff that in basements, back rooms, and labs sew together the web through which the paths of care are supported. It is the voices of leaders who set visions and inspire and hold the space for all voices to truly make a difference in how we care for one another.

I had someone suggest to me once that if we allow room for all these voices, we give in to chaos at the cost of processes of care; that the input from all corners of a healthcare experience, be it acute or pediatric, ambulatory or practice-based, cause a murkiness that only leads to confusion. My response was simple, and my experiences have proven it to be true more and more each day. The chaos only exists if we fail to listen. When we get beneath what some may perceive to be noise, we realize there is a great commitment to the idea that every one is working towards the health and well being of those in care. By bringing together a symphony of voices we not only engage people, but we also expand the potential of what we can accomplish.

There is no magic formula or process for the gathering of voices. The methods and processes are rather clear, be they surveys, focus groups, advisory councils or committees for patients, staff, physicians and leadership. More important is the fact that we choose to acknowledge that all of these individuals have a voice to share and it may be in the most unsuspecting moment that the most impactful idea emerges. Perhaps in the end it is simple, that improving the patient experience is nothing more than a critical dialogue that must be fostered, nurtured and supported in ensuring that we listen and understand that each and every voice matters.

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

Related Body of Knowledge courses: Communication.

Tags:  accountability  choice  culture  improving patient experience  Interactions  patient engagement  Patient Experience  service excellence  voice 

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7 Steps to Accountability: A Key Ingredient in Improving Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, October 2, 2012
Updated: Monday, October 1, 2012

As I continue to visit healthcare organizations and engage with leaders globally there are clear emerging trends at the heart of effective efforts to address the patient and family experience. In my recent series of blogs I suggest we must recognize the implications of patient perceptions as a focus of our patient experience efforts. I support this by reinforcing that culture is a critical choice for organizations to consider in terms of how they look to shape those perceptions. In fact we cannot overlook the centrality of culture to the very definition of patient experience overall. I add that it is on a strong cultural foundation that we can then ensure a sense of engagement for our staff and patients.

The missing piece in this important dialogue is that of building a foundation of accountability in our healthcare organizations. It has been identified as a top issue for healthcare leaders during my On the Road visits and at our Regional Roundtable gatherings. In looking at all the suggested paths and plans to accountability some general themes emerge.

Building a basis for accountability in organizations requires a number of committed actions. Without these organizations run the risk of falling short on their defined patient experience objectives. They include:

1. Establish focused standards/expectations – Determine and clearly define what you expect in behaviors and actions as you create a culture of accountability.

2. Set clear consequences for inaction and rewards and recognition for action – Be willing to reinforce expectations consistently and use as opportunities for learning.

3. Provide learning opportunities to understand and see expectations in action – Ensure staff at all levels are clear on expected behaviors and consequences.

4. Communicate expectations, reinforcing what and why consistently and continuously– Keep expectations top of mind and be clear that these are part of who you are as an organization in every encounter.

5. Observe and evaluate staff at all levels providing feedback and/or coaching as needed – Turn actual encounters, good or bad, into learning moments and opportunities to ensure people are clear on expected behaviors and actions.

6. Execute on consequences immediately and thoughtfully – Respond rapidly when people miss the mark (or when people excel) to ensure people are aware of the importance of your expectations.

7. Revisit expectations often to ensure they meet the needs and objectives of the organization – Remember standard and expectations are dynamic and change with your organization’s needs. They must stay in tune with who you are as an organization (your values) and where you intend to go (your vision).

Accountability has been tossed around more and more in conversations today in healthcare organizations as something that leaders want to see more of. The reality is that accountability is not just something you simply expect and it just miraculously appears, it is something you must intentionally create expectations for and reinforce. As with patient experience itself, accountability needs a plan in order to ensure effective execution.

I often speak of patient experience efforts as a choice; one that requires rigorous work. This is overcoming something I call the performance paradox, which helps us recognize that many things we see as simple, clear and understandable are not always easy, trouble-free and painless to do. Yet I would suggest we have no other choice. As a positive patient experience is something we owe to our patients and their families in our healthcare settings, creating and sustaining a culture of accountability is something we actually owe to our staff in supporting their ability to create unparalleled experience.

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

Related Body of Knowledge courses: Coaching and Developing Others.

Tags:  accountability  choice  culture  defining patient experience  employee engagement  HCAHPS  improving patient experience  patient  patient engagement  Patient Experience  perception  Regional Roundtable  service excellence 

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7 Steps to Accountability: A Key Ingredient in Improving Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, October 2, 2012
Updated: Monday, October 1, 2012

As I continue to visit healthcare organizations and engage with leaders globally there are clear emerging trends at the heart of effective efforts to address the patient and family experience. In my recent series of blogs I suggest we must recognize the implications of patient perceptions as a focus of our patient experience efforts. I support this by reinforcing that culture is a critical choice for organizations to consider in terms of how they look to shape those perceptions. In fact we cannot overlook the centrality of culture to the very definition of patient experience overall. I add that it is on a strong cultural foundation that we can then ensure a sense of engagement for our staff and patients.

The missing piece in this important dialogue is that of building a foundation of accountability in our healthcare organizations. It has been identified as a top issue for healthcare leaders during my On the Road visits and at our Regional Roundtable gatherings. In looking at all the suggested paths and plans to accountability some general themes emerge.

Building a basis for accountability in organizations requires a number of committed actions. Without these organizations run the risk of falling short on their defined patient experience objectives. They include:

  1. Establish focused standards/expectations – Determine and clearly define what you expect in behaviors and actions as you create a culture of accountability.
  2. Set clear consequences for inaction and rewards and recognition for action – Be willing to reinforce expectations consistently and use as opportunities for learning.
  3. Provide learning opportunities to understand and see expectations in action – Ensure staff at all levels are clear on expected behaviors and consequences.
  4. Communicate expectations, reinforcing what and why consistently and continuously – Keep expectations top of mind and be clear that these are part of who you are as an organization in every encounter.
  5. Observe and evaluate staff at all levels providing feedback and/or coaching as needed – Turn actual encounters, good or bad, into learning moments and opportunities to ensure people are clear on expected behaviors and actions.
  6. Execute on consequences immediately and thoughtfully – Respond rapidly when people miss the mark (or when people excel) to ensure people are aware of the importance of your expectations.
  7. Revisit expectations often to ensure they meet the needs and objectives of the organization – Remember standard/expectations are dynamic and change with your organization’s needs. They must stay in tune with who you are as an organization (your values) and where you intend to go (your vision).

Accountability has been tossed around more and more in conversations today in healthcare organizations as something that leaders want to see more of. The reality is that accountability is not just something you simply expect and it just miraculously appears, it is something you must intentionally create expectations for and reinforce. As with patient experience itself, accountability needs a plan in order to ensure effective execution.

I often speak of patient experience efforts as a choice; one that requires rigorous work. This is overcoming something I call the performance paradox, which helps us recognize that many things we see as simple, clear and understandable are not always easy, trouble-free and painless to do. Yet I would suggest we have no other choice. As a positive patient experience is something we owe to our patients and their families in our healthcare settings, creating and sustaining a culture of accountability is something we actually owe to our staff in supporting their ability to create unparalleled experience.

Jason A. Wolf, Ph.D.

Tags:  accountability  choice  culture  defining patient experience  employee engagement  HCAHPS  improving patient experience  patient  patient engagement  Patient Experience  perception  Regional Roundtable  service excellence 

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Organizational Culture: A Critical Choice at the Heart of an Exceptional Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Monday, September 3, 2012
Updated: Saturday, September 1, 2012

The Beryl Institute defines patient experience as the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care. While healthcare organizations may not be able to directly control the perceptions of patients and families, the opportunity to influence these perceptions is grounded in their very culture. I suggest that culture is fundamentally based on the choices an organization makes.

When I first explored the characteristics of high performing organizations in healthcare, "seven simple truths” emerged that were tied to positive outcomes. They represented committed choices of action in the organizations studied. These truths included:

  • Visionary leadership
  • Consistent and effective communication
  • Selecting for fit and ongoing development of staff
  • Agile and open culture
  • Central focus on service
  • Constant recognition and broad community outreach
  • Solid physician/clinical relationships

It was this combination of efforts that helped organizations drive exceptional outcomes in experience, engagement, quality and the bottom-line. These characteristics have continued to emerge during my exploration of what is driving patient experience success in healthcare organizations around the world.

As recently as my last two On the Road visits, with St. David’s Healthcare and Scripps Health, the central role of culture in patient experience efforts was reinforced. In the St. David’s system, at the core of the process for reinforcing system-wide values and focus on exceptional experience are three questions. They ask daily how staff will define, live and manage the culture. The recognition at St. David’s is that the experience tactics you implement are only as effective as the foundation of culture on which they are built.

This was also the case at Scripps Health, where they recognized the very nature of the organization has a significant impact on overall experience. Vic Buzachero, Scripps Health’s Corporate Senior Vice President for Innovation, Human Resources and Performance Management shared, "It is important that we build a culture that drives consistency in our effort. We must have the infrastructure to show the genuine nature of our organization, reinforce our focus on the patient and shape the balance of systems, processes and behaviors that will help us realize our goals.”

This is not just a U.S.-based phenomenon. My visit to the NHS in the United Kingdom reinforced the importance of culture to experience. They created an opportunity for patients, family and community members to interact directly with senior leadership and initiated processes that improved communication and understanding of patient’s needs. They also focused on creating happy and engaged staff to ensure happy patients.

This idea is reinforced by recent research conducted by Britt Berrett and Paul Spiegelman. They suggest in any business, and especially healthcare, you can’t take care of customers if you don’t take care of employees. The realization, as we saw exemplified in the cases above, is that to ensure the best experience and focus on patients and families, there must also be an intentional focus and effort to create employee engagement and loyalty. Again, this is driven by the culture of an organization. (They offer a complimentary survey in which you can gauge your own organization’s culture of engagement).

Through all our explorations at The Beryl Institute into what drives the best in experience there has always been an element of those simple organizational truths above, all which represent a commitment to creating a culture of service. Simply putting tactics in place has you run the risk of turning your patient experience efforts into the latest flavor of the month activity. Patients and their families and, yes, your colleagues and employees deserve much more. To truly drive an exceptional patient experience, you can only influence perceptions through the choices you make. One of the most critical of those being the type of organizational culture you choose to create.

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

Related Body of Knowledge courses: Organizational Effectiveness.

Tags:  bottom line  CIQ  culture  defining patient experience  Employee EN  improving patient experience  Leadership  Patient Experience  Scripps Health  St. David's Healthcare 

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