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How Will You Inspire the Patient Experience Movement? Four Considerations for 2014

Posted By Jason A. Wolf, Ph.D., Tuesday, January 14, 2014

I am inspired. The New Year has arrived with great energy at The Beryl Institute. We start 2014 as a global community of practice of over 20,000 professionals, focused without hesitation on ensuring the best in experience for patients, families and one another in healthcare.

I am inspired by the continued commitments expressed for this work: by The Beryl Institute’s Patient Experience Scholars who met recently to share their research and reinforce their willingness to encourage and support others; by the members of the Global Patient & Family Advisory Council who want to influence how patients and family members are heard and engaged in making a profound difference in healthcare; by the many contributing to the development of the Patient Experience Body of Knowledge courses soon to be available to the community; and by many more.

I am inspired by how in the first two weeks of a new year, such commitment and intent can emerge, built on all that has come before and focused with purpose on the great opportunities ahead. As I reflect on this idea, a question emerged and perhaps a challenge for each of us to consider:

How will you inspire the patient experience movement in the year ahead?

I pose this question with the hope that actions and considerations from the smallest moments of unparalleled kindness to the largest strategic triumphs all find room to take root and grow. Inspiration comes in all shapes and sizes, but in this diversity it has strong commonalities – it causes us to feel a sense of something special and powerful. It provides a boundless energy to influence, lead, change and make a difference. This is an exciting prospect in seeing that each of us can choose to have an impact. And while no two actions will be exactly alike, I do want to offer a few thoughts on how you can continue to frame your patient experience efforts to inspire yourself and others.

As we return to the definition of patient experience, I continue to experience its relevance time-and-time again in the application of these words to central actions associated with excellence. In reviewing its words – the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions, across the continuum of care – I again see clear directions on moving your own experience efforts forward. They include:

1. Reinforce strategic focus. Patient experience has proven itself to be a relevant part of the healthcare conversation. It has surpassed the challenges of being dubbed a fad; it too has shown it has stronger legs than just serving as a policy framework. Experience is a central strategic pillar to organizational performance and success. Patient Experience in its broadest sense should be a clear and transparent component of every healthcare organization’s strategy.

2. Clarify and map your critical interactions. Experience doesn’t happen on billboards or in espoused actions, it happens at the most personal moments, at those points of engagement between one individual and another. The ultimate tool in patient experience improvement is your self, your heart, your hands and arms, your minds, your compassion and your common sense. We have a huge opportunity to map the interactions that occur on the patient path to ensure we consider the most effective way to respond at every touch point.

3. Model desired behaviors. Simply put, if interactions drive experience, then the behaviors that comprise them are the conduits that direct these interactions in one way or another. Organizational culture is shaped by behaviors, they represent the people, presence and purpose of an organization overall and no slogan, policy or program will trump the power of individual behavior. We must model, observe, coach and improve constantly to impact experience outcomes.

4. Expand your listening. As we ended 2013 exploring the Voices of Measurement, we learned that the power of data is only as valid as what we choose to do with it. Collection or reporting data for the sake of data misses the opportunity for learning and relevant action. To capitalize on the value of the voices that surround us in healthcare we must expand our listening. Experience is measured first in the direct voices of healthcare consumers, who remain our most significant mirror into our own efforts, but it is also found in the voices of our peers and colleagues. We are only capable of achieving our strategy through our people. They are much more than pawns to direct, but rather living resources accountable for ensuring excellence.

Perhaps these ideas will help spark your own thoughts on how you will choose to inspire the patient experience movement. Regardless of which direction you go, I hope you recognize the power that exists in your own personal choice and the ability to impact the experience of the person that is coming next. The year ahead can and should be about a great many things both personally and professionally. My hope is that you find you can and will be an inspiration in your efforts. This cause is too great for your efforts to be anything less. Now the question remains, what will you do? I look forward to your updates with great anticipation.

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

Tags:  accountability  Advocacy  body of knowledge  choice  community of practice  consumer advocacy  Continuum of Care  culture  defining patient experience  employee engagement  Field of Patient Experience  global defining patient experience  global healthcare  HCAHPS  healthcare  improving patient experience  Interaction  Interactions  patient  patient engagement  Patient Experience  service excellence  thought leadership  voice 

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Reflecting on The Patient Experience Movement: The Power of Voices and Collaboration

Posted By Jason A. Wolf Ph.D. CPXP, Wednesday, December 18, 2013
Updated: Tuesday, December 17, 2013

Patient Experience - Voices in CollaborationAs we stand at the end of each year, we tend to look back at all that led us to this moment and anticipate all that lies ahead. I stand here now with all of you that comprise our patient experience community, who live and breathe in your every action this patient experience movement, and can say without hesitation that together we have accomplished great things and together there are even more powerful moments to come.

 

This year has exemplified our core values at The Beryl Institute – the importance of community and the integral role of collaboration. We have worked to reinforce the true power of engaging all voices in the patient experience conversation. This gathering of voices has seen our patient experience community grow from 11,000 to 20,000 members and guests this year alone, representing over 45 countries. This gathering of voices has led to a year in which the foundational ideas of this movement have been reinforced and solidified. In our commitment to expand access to the greatest breadth and depth of individuals across healthcare we recently expanded our membership framework to provide access to all associates in any healthcare facility. These Institutional memberships enable staff at all levels, in all roles, across the range of healthcare organizations to engage, to learn and to lead in their own environments.

 

In expanding the conversation on voice itself, this year has been shaped by the Voices of Patient Experience series in which we heard from the C-Suite, front-line practice, students across healthcare disciplines, physicians, patients and families and those measuring the impact of our patient experience efforts. This collection of voices served to complement the many others that contributed to learning and sharing of ideas via webinars and case studies, Patient Experience Conference presentations and On the Road visits. Hundreds of you added your thoughts to the conversation via these and other outlets. This open sense of sharing, of giving, of collaboration has allowed the patient experience movement to thrive.

 

The voices series also raised a significant awareness for the community; to be an organization truly committed to patient experience, we had to move beyond the talk about what we do "to” patients and families, and reinforce an unwavering commitment to do "with”. This partnership in care underlines the very intent of the Institute to provide a place to learn from one another, and it was clear that included the voices of patients and families themselves. This led us to establish the Global Patient & Family Advisory Council, comprised of leading patient and family thinkers, writers, speakers and activists. It also had us collaborate with IHI at the 2013 National Forum to support the "Patient is In” Booth in which patients and family members could share input and ideas with forum participants. These voices remind us of the boundless value of this partnership in patient experience improvement.

 

The expansion of voices also led to the 2ndState of Patient Experience Study, the largest conducted to date on patient experience efforts, and revealed some interesting trends in the both the focus, intent and awareness of patient experience efforts. Yet, while the movement continues to push on, less than 50% of U.S. hospitals have yet to formally define patient experience for themselves. We still have great opportunities to educate and learn from one another.

 

This awareness made it only natural that we expand our efforts overall on the professional development of patient experience champions, furthering the work on the Patient Experience Body of Knowledge with domain outlines and the anticipated release of the domain courses in 2014. As a community you reinforced your desire and the greater need to shape this work in ways that will allow each and every one of us to grow stronger. The year ahead brings even more exciting work on this front.

 

In a recent Hospital Impact blog I mentioned my great excitement about the growth of the patient experience family overall, from new sister organizations to research entities focusing on this area, to critical gatherings in numerous places in support of this important discussion. We will continue to support and reinforce the value of all these efforts and maintain that in collaboration we all win in this movement. We remain committed to serving as a hub and connector of the many voices focused on this effort and keep our arms open for the opportunities for further collaboration.

 

This very idea led to us to begin conversations with and engage in a formal collaboration with the Society for Healthcare Consumer Advocacy (SHCA) and its 40 years of incredible history and commitment to patient voice, rights and advocacy. A strong and storied organization whose roots can be found at the very start of the patient experience movement, SHCA felt they found a home for their future with The Beryl Institute, but I would say while the container is the Institute, the home is the community of peers, of leaders and teachers, of resource providers and caregivers, of patients and families who make up this growing professional home for so many. The integration with SHCA and the purposeful collaboration with a growing number of organizations committed to this cause help reinforce the power that collaboration itself brings to this conversation.

 

I would be remiss if I did not add a personal note to this reflection on the year, that as I stood on stage to close Patient Experience Conference 2013 and received the call that I needed to rush home for the delivery of my son, I shifted abruptly from champion and advocate for a movement to a family member surround by a healthcare system still admittedly learning itself. My eyes were opened, not only by the magic of the birth of a child, but of a family member watching your loved ones cared for, your new child handled, complications managed and tense moments relieved. We must not forget we are all patients and family members and need to continue our work as such.

 

The work you do may at times seem like small gestures, part of your standard process or even done automatically as a seasoned veteran, but to a patient or family member you are providing an incredible gesture of service, of quality, of safety – of experience. In every moment we have the choice to create the experience for our patients and their families. And every moment each of you as members of this community, of this movement, have that choice as well…to engage, to learn, to contribute, and to encourage the involvement of others.

 

You see this is your community, it is built on the power of your voices, it is driven by the collaboration we find with one another and it is from that place that we look to the new year knowing that the greatest opportunities still lie ahead. Thank you for your contributions, support and leadership. May you have a healthy and happy holiday and be ready with great excitement for all the New Year will bring.

 

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

Related Body of Knowledge courses: Communication.

Tags:  Advocacy  body of knowledge  community of practice  consumer advocacy  defining patient experience  Field of Patient Experience  improving patient experience  partnership  Patient Experience  thought leadership  voice 

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The Patient Experience Must Be Owned By All: Welcoming the Society of Healthcare Consumer Advocacy

Posted By Jason A. Wolf, Ph.D., Friday, November 22, 2013
Updated: Friday, November 22, 2013

In The Beryl Institute’s recent research report – The State of Patient Experience in American Hospitals 2013 – I noted in conclusion that the state of patient experience is growing stronger every day because of the many voices committed to this work. I too reinforced my belief that a patient experience movement is afoot, one that requires continuous and focused efforts and one that should be grounded in and built upon collaboration and alignment versus competition or the desire to stake a claim.

This idea rests at the very core of the global community of practice we have built at The Beryl Institute. We do not claim to own the patient experience, but rather to be a place where people can gather together to share what is best in what they are working to accomplish. Our philosophy has been and will remain that through collaboration not just great, but greater things can happen. 

It is in this very spirit of collaboration that I am excited to share the bridging of two great organizations to expand the alignment and dialogue on patient experience improvement. We have been in discussion with and will soon be welcoming the Society for Healthcare Consumer Advocacy (SHCA) into The Beryl Institute community. After an incredible 40 year history and supportive home with the American Hospital Association (AHA), our three organizations – The Beryl Institute, SCHA and AHA – saw great potential in supporting the next 40 years and beyond for SHCA within the Institute (You can read a letter from all of SHCA’s Past Board Presidents here). As of January 1, 2014, our communities will align to continue to expand the patient experience conversation and in doing so model the power of coming together in this critical dialogue.

More details will soon be available around this exciting next step in the history of focus on patient advocacy and more broadly patient experience improvement, but suffice it to say, the commitment to engaging all voices and growing those engaged in this important work is top of mind for us all. I am excited and proud to welcome the SHCA community to The Beryl Institute family as their new professional home and in doing so reiterate the very critical message I share here. That it is in coming together, not attempts at market distinction, in which the greatest outcomes are possible. 

I have watched in recent years as patient experience has moved from an emerging term to an active conversation at the center of policy and now financial focus. I have also seen a great game of ownership being played out. Much like one might have experienced during the gold rush, claiming their small bit of mountain stream to pan for hours, days or more in search of that one bright speck, many organizations – some well established, and some quite new – have all worked on positioning for their piece of the pie.

While I am a true believer in free enterprise and recognize the great potential for market savvy in this new world of healthcare, I also believe we have something bigger we are attempting to do in working towards patient experience excellence. It is in the bringing together of disparate thoughts or competing ideas, be they those of resource providers of similar services or healthcare organizations occupying the same market, in which the greatest outcomes can be realized. You see no one organization owns the patient experience, yet we in healthcare must all take ownership of it.

For this reason we have worked to bring the many voices together, for as I asserted above, this is where the strength of our work and its impact rests. This idea has been realized in the Institute’s Regional Roundtables where market "competitors” join together in sharing thoughts and crafting shared plans focused on improvement. It has been realized at Patient Experience Conference where numerous resource providers join in and engage in support of a true, independent community dialogue. It is seen in the willingness of some of the largest players in experience measurement to come together to share ideas between the covers of our soon to be released paper on the Voices of Measurement.

If we are to make the greatest differences in the lives of our patients, families, peers and community we must be open to the idea that above all else through collaboration and coordinated effort profound possibility exists for improvement and sustained impact. And while by my very words, I cannot claim The Beryl Institute is the only place this can or will be done, I do hope and in fact commit that we will continue to stand for the bringing together of all ideas, of every voice and of each hope in each and everything we do. As a community of practice it is our calling, at The Beryl Institute it is our cause and we are so very excited to see (and hopefully be a catalyst in) the patient experience family continuing to grow.

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

Tags:  Advocacy  AHA  body of knowledge  choice  community of practice  consumer advocacy  Continuum of Care  Field of Patient Experience  global healthcare  healthcare  Interactions  Leadership  patient advocac  Patient Experience  Patient Experience Conference  perception  SHCA  thought leadership  voice 

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A Patient Experience Lesson from the Latest U.S. Congressional Showdown

Posted By Jason A. Wolf, Ph.D., Tuesday, October 1, 2013
Updated: Tuesday, October 1, 2013

While I don't wade into the political spectrum often in these discussions, in light of the news of the day, I am hard pressed not to at least share a reflection on what is taking place in Washington, D.C., its impact on the U.S. Healthcare system, and the broader economic implications it is presumed to have. I do not intend to advocate for one position or another here, but rather share a core reflection on the lesson I see for patient experience professionals in the current state of affairs.

For those of us in healthcare (and in reality for all of those that are not), this week signifies a historic time with some of the first steps underway in the implementation of the Affordable Care Act, also referred to as Obamacare. Regardless of the actions (or inactions) on Capitol Hill, and whether you are in support of or against it, the healthcare law will move forward for now. I do not intend to break down the law and examine its detailed impact on the patient experience here. Rather, I hope to share a simple but significant realization about the entire U.S. Healthcare system revealed in this debate.

Recent polls conducted separately by both Fox News and CNBC found that when asked, Americans often distinguish between the Affordable Care Act (ACA) and Obamacare. Much of this distinction is driven from the very mouths of congressional and other political leaders. In fact in exploring people's opinions on the programs under these two naming conventions there was a variance in the value, interest and support for each of these programs. The challenge (or perhaps surprise) in this discovery is that in fact these two programs are exactly the same thing - the ACA is Obamacare and vice versa.

The reality is in healthcare we have many words that raise this same challenge in our delivery system, driven by providers, supported by payors and serving patients and families. The example above, of divergent opinions on, in essence, the same idea, driven by language, expert opinion or pure rhetoric, is one of the best I have seen reinforcing with clear data the power of language and more importantly perception.

The concept of perception - the way you think about or understand someone or something – is a central part of the patient experience itself. Defining patient experience as the sum of all interactions, shaped by an organization’s culture, that influence patient (and family) perceptions across the continuum of care makes explicit that perception is both the result of experience and also the lens through which people make choices now and into the future around their care.

For the reported confusion created in the language around two names for the same healthcare law – ACA or Obamacare – there are limitless levels of confusion created in the language of our healthcare system itself, from diagnosis to medications, acronyms to systemic issues. In the simplest of terms we all too often and in many cases unintentionally create confusions for the healthcare community, our patients and their families in the terminology and language we choose to use. I recently sat on a panel at DePaul University on the future of healthcare in the U.S. and this very issue emerged – that in creating true accessibility we have to not only have the proper processes and checklists in place, but also the right, and perhaps more importantly, the clearest language possible.

I am not suggesting the healthcare system is facing the same levels of dysfunction as the U.S. Congress, but I do believe there is a great opportunity for clarity in making the healthcare experience easier and better for all receiving care. Finding language that works for patients and families, as well as for those working in the system, will only serve to better engage and inform patients and families and support the invaluable nature of their role as partners in the healthcare process.

This could perhaps be one of the first and most important steps in driving patient experience success. There is power in language, in its application and perception…the US congress taught us that again this week in a way I don't think we cared to learn. But in this chaos I see a silver lining, an important lesson for all of us either entrusted with and/or committed to the best in patient experience. Manage perceptions with clarity and honesty in each and every healthcare encounter. It may not change the system overnight, but it will have a positive and powerful ripple effect that will be very hard to diminish.

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

Tags:  ACA  Continuum of Care  defining patient experience  healthcare  improving patient experience  Leadership  Patient Experience 

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The Conversation on Patient Experience Improvement Continues: A Reflection on Three Years

Posted By Jason A. Wolf, Ph.D., Friday, September 13, 2013
Updated: Friday, September 13, 2013

Most people would suggest that change doesn’t happen overnight, and while I believe change does take time, it does not need to take a lot of time. In fact, change, like most things in life, requires nothing more complicated than a simple choice. It is this same idea – the power of choice - that I use to frame all my discussions on patient experience improvement.

I share this idea of choice and change on the week that The Beryl Institute itself turns three years old. As we have seen the patient experience movement grow and flourish, it too has been a journey of change and choice. From the very first member signing on in September 2010, to the now over 18,000 members and guests from 45 countries around the world, The Beryl Institute community has made big choices and as a result driven big change.


Over the course of the last few years I have written about engagement, involvement and community and I am excited to say that the state of The Beryl Institute community is strong. We have seen a growing use of the definition of patient experience. We have also experienced almost a doubling in organizations having a formal definition of patient experience (something we stress as critical) as revealed in the 2013 State of Patient Experiencestudy and represented in the recent powerful infographic of the findings. We have also been inspired by the growing "#IMPX” movement with increasing numbers of organizations creating compelling videos of their teams reinforcing the message – "I am the Patient Experience!

At the Institute, we have also worked hard to ensure all voices are engaged in the conversation on patient experience improvement. We have authored an extensive series of publicationsto be a resource to all those working to impact the patient experience – from the C-Suite to the front lines from students to patient and family members. This effort has been expanded by the launch of the first of its kind Global Patient and Family Advisory Council to ensure this critical perspective is central to all we do. It has been supported by not only our virtual community connections, but also the consistently growing annual Patient Experience Conferenceproviding practitioners the space to reconnect and reenergize every year.

In shaping the knowledge and information base for patient experience improvement, we have led the effort to create a comprehensive body of knowledge focused on developing patient experience leadership now and into the future and guided by the input of over 400 healthcare leaders around the world. We have also awarded over 25 patient experience grants to support direct research projects on patient experience improvement where it is taking place – on the front lines. Most recently we have announced the launch of The Patient Experience Journal, a multidisciplinary, peer-reviewed publication designed to share ideas and research, and reinforce key concepts that impact the experience of patients and families across healthcare settings.

The full historyof the Institute is rich, but more importantly it exemplifies the very power of choice and of community I mention above. It was the choices of so many that made these offerings and resources possible. It will be the continued contributions of community members that will maintain this growth and drive the patient experience movement forward. These choices have led to great change and our hope is to continue to support this growth by providing a gathering place for ideas, a dynamic space for interaction and a vibrant hub for continued dialogue on patient experience improvement. We have arrived at this point with the guidance, leadership and support of so many around the globe…for this we are forever grateful. We now humbly go forth knowing there is much more work left to do. Happy Anniversary to you, this passionate and engaged community. We celebrate how far we have come together and look forward to continuing this journey with you!

 

Related Body of Knowledge courses: History.

Tags:  choice  culture  HCAHPS  healthcare  improving patient experience  Leadership  patient  Patient Experience  service excellence 

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Involvement is the Path to Patient Experience Excellence

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, August 6, 2013
Updated: Tuesday, August 6, 2013

The words of the day in healthcare of late, especially in light of the policy undertones influencing the system in the U.S., are around engagement and activation, especially of patients, but also focused on staff, physicians and community. Studies show that activated patients are more apt to have greater patient experiences (When Seeing the Same Physician, Highly Activated Patients Have Better Care Experiences Than Less Activated Patients, Health Affairs, July 2013 32(7):1295–1305) and the e-patient revolution is well underway as exemplified by such organizations as the Society for Participatory Medicine.Papers espouse the power of staff engagement as the means to better experience (The Role of Organization Culture in a Positive Patient Experience, The Beryl Institute, 2012) and community engagement is reflected by growing involvement in strategic efforts such as what I experienced at the William Osler Health System in Brampton, Ontario, Canada.

While these ideas are external efforts that influence specific organizational strategies and associated actions, I was struck with the recognition this too is what we have worked to model via The Beryl Institute ourselves. As a global community of practice, we have been clear in declaring a mission to create a dynamic space for members to convene, engage and contribute to elevating, expanding and enriching the global dialogue on improving the patient experience.

In just the last two weeks we held the very first call for our Global Patient and Family Advisory Council (GPFAC), an incredible group of patients and family members committed to serving in ensuring patient and family voice is part of the patient experience movement. Their generosity of spirit and commitment to this cause left me inspired and excited for all we still have to do in our efforts to improve experience. We also met with our Patient Experience Advisory Board for their quarterly call to review our direction and strategy as an Institute and ensure we are meeting the needs of those on the front lines addressing the patient experience every day. In that conversation I was moved by the excitement and commitment to the movement we all support. It is through the generosity and spirit of these two groups, and also the continued contributions of members and guests via On the Road visits, sharing case studies, and through a record number of Patient Experience Conference speaking submissions, as just a few examples, that the sense of involvement was palpable.

Involvement, you could argue is a play on all these words: engaged, activated or even participatory. I do not want to play the semantics game, but for sake of discussion, one can be engaged or even "activated” without a true bias for action, they can simply serve as states of "being”, not doing. Perhaps this is why the Gallup Organization uses the term "actively engaged” to reinforce their measures of a highly engaged workforce. Participation, more so, suggests action, as it requires the individual to be doing something. Involvement continues to expand that reason, from one of a state of being to one of acting. In fact one definition of involvement I saw encompassed these very terms (parenthetical comments are my own): to engage (an action) as a participant (an active contributor).

The takeaway for me here is simple, as we have seen in countless organizational visits, cases and presentations, as we have uncovered in research efforts and benchmarking studies and perhaps most importantly what we have experienced in our very organization is that not only does involvement matter, it has significant influence on what can be achieved, how it is achieved and how quickly it can be achieved. An unassuming word on its own, involvement, may provide a profoundly important key to success in a healthcare world now intently focused on the improvement of the experience of all, patients, family members, community and caregivers. I believe that involvement is a fundamental component of any path to patient experience success. The question that now remains is how involved are you in your efforts and how willing are you to involve others in your success? I also strongly invite you to get involved in the patient experience movement and The Beryl Institute. We all still have significant and exciting work ahead!

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

Related Body of Knowledge courses: Coaching and Developing Others.

Tags:  community of practice  culture  employee engagement  healthcare  improving patient experience  patient  Patient Experience  Patient Experience Conference  service excellence  thought leadership 

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Patient Experience and the Freedom of Choice

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

In writing a blog for a US-based, global organization on the week of July 4th, I am hard pressed not to think about the concepts of independence, of freedom and of what those concepts provide for. To be independent, to be of free will, is something most, if not all, aspire to. It is ingrained in our human nature, for at its base is an idea so simple, yet at times so complex – the power of choice. For me this concept of choice is the essence of patient experience itself.

When I talk to people about the strategies and tactics of patient expedience improvement, I start with the simple recognition that what we do in healthcare - as human beings caring for human beings– is about the choices we make. From leaders guiding organizations on what priorities are set each day, to frontline caregivers across healthcare settings we are making choices in every moment, not just on what care to deliver, but how to deliver it as well.

This power of choice is profoundly important, and of increasing influence in our healthcare systems today. While we once may have gone directly to our local physician or hospital and listened intently with respect, following every word and instruction, the nature of healthcare itself has changed. I know to some this poses a great concern and others even disdain. For me, it reveals the true potential for excellence we have in healthcare systems around the world.

The debate has long simmered on if patients are customers of care. Using this term allows supporters of the historic healthcare hierarchy to diminish the very voice of patients, most often unintentionally. And you may be surprised to hear that I agree. Patients for the most part in healthcare today are not the customers of care. Customers are those individuals or organizations that choose to pay for a product of service. In fact following this logic, most often, insurance companies and/or government entities are the true customers of healthcare as they are the one’s directly funding services or paying the bill.

What does this mean then for our choice as patients? While many rightly make the argument, that as patients we do not choose to fall ill, have an accident, etc., that is we do not most often choose to be customers of healthcare, we overlook what I suggest above – that as human beings we still have choice. This distinguishes to me where patient experience plays it most significant role, especially economically. Patients are without question consumers of healthcare, regardless of systems, locality or structures. From an economic perspective it is the consumer who drives markets and influences business viability. Consumerism is the consideration that the free choice of individuals strongly influences what is offered to a market, what grows and what is overlooked. Therefore consumers and the choice they bring have strong economic impact.

The bottom line is that as patients have independence, even with some constraints based on insurance or in governmental healthcare systems, and therefore they have choice. Patients will note where the experience – the culmination of quality, safety and service – is best. And they wont keep it secret. Outside of the increasing use of government surveys globally to measure and publicly report performance, other consumer outlets are quickly booming – have you yelped your physician’s office lately, or seen the dialogue on Facebook about the care in your local hospital? This is consumerism at its finest and it is having great impact.

Patients have discovered they too have choice in the system, to not just expect, but to directly ask for and seek the best care they can find. Yes, patients do not choose a healthcare encounter like they would a hotel or an entertainment experience, they actually do so MORE significantly because this choice is about their own or a family member or friend’s well-being. A dear colleague, an inspiration for patients as true consumers of care, and a contributor to our Voices of Patients and Family paper – "e-Patient Dave” deBronkart clearly expresses the need for us as patients and family to choose to engage in our care, in ensuring we are fully informed and in doing so make the right choices.

I too am reminded about a story a gentlemen shared once with me about his 80-year old mother who when finding she needed hip replacement, scoured the internet for information on the procedure, recovery times, outcomes, etc. She discovered, that while scheduled for surgery at her local hospital (where she had gone for years), there was a better place for her to have her surgery in another state a plane ride away. She booked the ticket, made the trip and had her surgery. Now while all patients choices may not be that extreme, we must acknowledge that we all have choice – in some ways it is all we have – in how we decide to deliver care or on where we decide to receive it.

On a week where independence is held high, it is important that we remember it is not just a holiday in the United States, but a statement about the very freedom we have as individuals, as consumers: the freedom to choose. The Declaration of Independence declared that individuals "are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” There may be no stronger place for us to remember these choices than in the decisions affecting our health. As healthcare leaders we must remember this, as caregivers honor it, and as patients and families never forget – the choice is truly ours.

 

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

Related Body of Knowledge courses: Metrics and Measurement.

Tags:  Choice  Consumerism  culture  Customer  Customer Service  Freedom  Hospitality  improving patient experience  Interaction  Patient Experience  service excellence  voice 

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Patients are Partners in Experience, Not Just Recipients of One

Posted By Jason A. Wolf Ph.D. CPXP, Thursday, June 6, 2013
Updated: Thursday, June 6, 2013

In my most recent Hospital Impact blog I noted that "how” we choose to do things in healthcare will and should trump the "what”. This is supported by my travels through numerous healthcare organizations where it is becoming evident that the core practices organizations are using to drive patient experience success are more and more consistent. While some might see this as limiting, I see it as encouraging.

Why is that? It means we are listening to one another, learning from each other and showing an incredible willingness to "steal ideas shamelessly” as a well respected CEO once shared with me in describing a component of their organizational success. That means the ‘what’ we do is not very different location to location. The distinguishing characteristic in experience is not the things you do, but the way in which your deliver. This is at the core of the very definition of patient experience as "the sum of all interactions, shaped by an organization’s culture”.

This ability to listen and learn from one another is a central value of all we do at The Beryl Institute. As a global community of practice we can (and must) learn from all edges of the community – those Institutions rated the "best” or seen as the "biggest” do not represent the only expertise. Rather it is in trying and executing of ideas in organizations of all shapes, sizes and focus through which excellence is supported and shared. It is based on this premise that the idea of a broad and inclusive range of voices has been so central to our work.

In returning to the conversation of "how”, I reflect on the recent conversations I had with 18 incredible patient and family advocates committed to the work of improving quality, safety and service for patients and families around the world in preparing the most recent paper from The Beryl Institute – Voices of Patients and Families: Partners in the Patient Experience. The stories these individual’s shared of compassion personified and at times the uglier side of care help us realize that there is power in how we choose to manage the interactions we have in healthcare every day. That it is truly more than the tactics, and rather the execution that matters.

The point I make here is all the tactics in the world amount to very little if all they are is something we do TO people in our care. The old language of provider and recipient may well still be used in healthcare, but its use is outdated and indicative of a system in need of change. Patients – yes, you and I, our children and parents, family and friends – are active parts of the healthcare equation, not passive recipients of it. We need to ensure we start acting this way. This perspective is exemplified through the work of such great organizations as the Society for Participatory Medicine.

While there are countless lessons shared by the individuals interviewed in the Voices paper, we inherently know many of them ourselves. Our contributors helped frame three central ideas in ensuring partnership in the care environment:

1. Acknowledge patients are not subjects in the healthcare process or "something” you should talk about or plan for in third person.

2. Recognize patients are not necessarily wired to actively engage in the healthcare process, due both to the complexity of healthcare and the nature of the system itself (that potentially diminishes the role of the patient in an unspoken hierarchy of expertise). You must ask, encourage, and act on the patient’s voice.

3. Consider coordinating efforts to identify and incorporate patient perceptions into the overall planning of care.

Personally, as I continue the journey of new fatherhood, I saw this play out in the very interactions we have had with our pediatrician. At our stage as new parents, we could be scolded, challenged or even talked down to about how we handle situations. Instead our doc engages us based on our questions, our hopes and fears. I know she is getting all the needed clinical work done, but she is including us as patients and family, as partners in the process. This is an active decision on her part, it is one that engages us in the care of our son and ensures a positive experience with every visit. "How” is a choice we can all make in healthcare and is one I believe will make all the difference.

 

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

Related Body of Knowledge courses: Patient & Family Centeredness.

Tags:  bottom line  choice  culture  defining patient experience  employee engagement  expectations  healthcare  improving patient experience  Interaction  Interactions  partnership  patient engagement  Patient Experience  patient stories  service excellence 

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Patient Experience is About More than Making Patients Happy

Posted By Deanna Frings, Tuesday, May 7, 2013
Updated: Tuesday, May 7, 2013

My dearest friend recently received news that her breast cancer is back after 11 years of remission. She struggles daily with eating enough to maintain a healthy weight, feeling strong and motivated enough to walk in the pool to build her strength, and to find relief from the constant pain. I’m not sure the word happy is in her vocabulary these days. But expressions of gratitude, a decrease in her anxiety, and a feeling of comfort are certainly emotions she has experienced when interacting with her healthcare team.

During the past several years in my various roles leading patient experience efforts, I have had frequent conversations with physicians, leaders, and clinical staff about what patient experience is, what it’s not and why these efforts are so important.

Some physicians express frustration about measuring patient satisfaction. After all, "It’s impossible to make every patient happy, why are we spending so much time and money sending surveys?” I have also experienced hospital administrators share their belief that if staff would just be nicer to people, the scores would improve. And, I have witnessed nurses and other clinical staff push back on patient experience activities saying, "We are not Disney, we are not here to make sure people have a good time, we are here to take care of patients.”

As I think about the evolution of the Patient Experience (PX) movement, I understand these various viewpoints. My PX journey began when the organization I worked for hired a consultant to teach the importance of customer service. After about 18 months, this turned into an initiative called "Service Excellence: Our Values in Action”. We continued on this journey for 5-8 years and recently the language and movement changed to what we know today as Patient Experience. I fully embraced this change, as it is a demonstration of applying our ongoing learning of what PX is really all about.

I don’t believe the goal of delivering the best to the patient and their families should be framed within the context of making them happy. I don’t believe patients give us the gift of their feedback, respond to a survey or write a heartfelt note because people simply made them happy. I believe it’s about so much more.

I tell physicians that patient satisfaction surveys do not measure patient happiness, but they can determine whether you listened with a compassionate ear as they expressed their concerns and worries.

I vividly recall reading a letter from the niece of a patient after her uncle died. She expressed her deepest gratitude not only for the care and compassion her uncle received but also for the care and comfort she received at a most difficult time in her life. The letter she wrote focused on the nurse who called to inform her that her uncle passed away in the middle of the night. This nurse went on to explain that he did not die alone. Hearing this brought instant comfort to the niece. Was she expressing happiness in her letter? Of course not. Rather, she was thanking this nurse for the compassionate way in which she shared this difficult news.

I’m not saying that in healthcare we should not be nice to people or that those simple courtesies are not important parts of the way we deliver care. What I am saying is that we must reach higher, go deeper, and deliver care in the most compassionate way. That is why I fully embrace the next evolution in our PX journey.

Fred Lee talks about this in his three levels of care framework. Wendy Leebov’s works with clinicians building their skill in compassionate communications and Colleen Sweeneyraises awareness in patient’s biggest healthcare fears in her Empathy Project.

Hospitals, clinics, outpatient centers etc, do not have the same goals as Disney. We must look beyond the happiness factor. We must comfort, care, listen and convey compassion in every interaction. That is what the patient experience is all about and why I’m more than happyto listen to what our patients have to say about their healthcare experience.

Deanna LW Frings
Director, Education & Professional Development
The Beryl Institute

Related Body of Knowledge courses: Patient & Family Centeredness.

Tags:  choice  defining patient experience  Field of Patient Experience  global defining patient experience  HCAHPS  improving patient experience  Patient Experience  perception  service excellence  storytelling  value-based purchasing 

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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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