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The Beryl Institute Patient Experience Blog
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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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Engagement: A Cornerstone of an Unparalleled Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, August 7, 2012
Updated: Monday, August 6, 2012

Over the last decade, engagement has been a consistently evolving strategic management term, first from the perspective of employees and more recently in healthcare with a line of sight on patients and families. In the simplest of terms, I see engagement as the involvement that someone has in a process or effort. Common discourse has had it tend to the positive by asserting employee engagement is a desired state versus just an action or behavior. Recent research (Shuck and Wollard, 2009) on the term employee engagement noted that with its rapid increase in use the definition of engagement has become muddied. Yet across the descriptions of this phenomenon there was consistency in describing engagement as a personal decision (not an organizational one) and one grounded in individual behaviors (as they relate to organizational goals).

This has significant implications for both employee and patient engagement. In the end it is about creating the environment in which individuals can choose to actively engage. Organizations cannot create engagement. Rather they can create the environment and reinforce the behaviors in which engagement can grow and thrive. This has significant implications for our work in healthcare overall.

Some have said that patient engagement is the latest buzzword for how we work to involve patients and families in the overall care experience. As a concept it has ties to safety and quality and links to the discussions on the application of meaningful use. Patient engagement is focused on ensuring patients take actions in order to obtain the greatest benefits of the healthcare services available to them.

The Nursing Alliance for Quality Care (NAQC) has deemed patient engagement "a critical cornerstone of patient safety and quality”. Their efforts have outlined a comprehensive set of nine principles to consider when engaging patients in their care. They stress "the primary importance of relationships” between patients, families and providers of care as key to effective engagement overall. This work stresses the foundation of relationship and partnership as central to the care experience.

These ideas are essential elements in how we identify experience overall at The Beryl Institute. At the very heart of the definition of patient experience is every interaction that occurs between a patient, family and the healthcare system in which they find themselves, from the deepest of relationships to the briefest of encounters. I believe we need to consider engagement more broadly and link its contributing values to the cornerstones of quality, safety and service. Together, quality, safety, engagement and service establish the legs on which the most comprehensive and positive patient experience can be built.

The same perspective can be taken when looking at the employee aspect of engagement. If engaging employees is around the behaviors of individuals that contribute to the goals of an organization, there is truly one means by which we can influence this action – the culture on which we build our very organizational existence. This leads us again to how we define experience at The Beryl Institute.

In reinforcing that the patient experience is "the sum of all interactions”, as we noted above, "based on an organization’s culture”, then healthcare organizations must have a strong commitment to not only create a positive environment for our patients and families, but one that supports the efforts of our staff, employees, and associates as well. In my travels to hospitals on behalf of the Institute both in the U.S. and abroad, I am continuously reminded that there is great power in the culture of an organization to drive excellence in experience. It is the foundation on which care givers and those that support them act and it shapes the environment in which care is delivered.

In considering engagement, I encourage us to move beyond the concept as a "nice to have” in our organizations, to a "must have” if we are to provide the best experience for patients and families alike. Engagement is not what we directly create, it is the result of doing the rest right – of creating vibrant and supportive cultures of service, quality and safety – of care at the highest order at every touch point across the continuum of care. If we do so and do so well we ensure the greatest of perceptions from our patients and the unparalleled experience we would want for our families and ourselves and we know they undoubtedly deserve.

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

Related Body of Knowledge courses: Employee Engagement.

Tags:  culture  defining patient experience  employee engagement  improving patient experience  Interactions  meaningful use  Nursing Alliance for Quality Care  patient engagement  Patient Experience  service excellence 

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Regardless of U.S. Supreme Court Decision, Patient Experience is Central to the Future of Healthcare

Posted By Jason A. Wolf Ph.D. CPXP, Thursday, July 5, 2012
Updated: Thursday, July 5, 2012

One question I was consistently asked in anticipation of last week’s U.S. Supreme Court decision was what impact the outcome would have on the importance of patient experience. My response was unwavering; that if healthcare organizations are simply driven by policy or perceived political pressure they might want to reconsider their true purpose and very existence. Regardless of the outcome of last week’s decision, I believe the increasing focus on experience in healthcare is more than practical or pragmatic; it is central to the highest quality healthcare encounter.

This week I was posed the question again during a workshop I had the privilege of leading titled Shaping Healthcare Experience: The Power of Interaction. The audience included healthcare and service professionals from across Europe. The discussions that were ignited and the passion with which the participants engaged in the subject supported my belief that the effort to achieve excellence in patient experience is not simply a phenomenon in the United States or one simply driven by policy. This is also reinforced by the fact that over 23 countries are represented as members and guests of The Beryl Institute itself. Patient experience is a without question a fundamental and global discussion.

Whether it is global perspective or political or policy motivations, those of us engaged in healthcare in whatever capacity need to consider the impact of our work on the experience of patients and families. As I discussed in my workshop, we are all touched by healthcare in some way either directly or indirectly through family or friends. More so we are aware of not just the outcomes, but also the stories we take from those encounters. Those stories are comprised of powerful and important interactions – as suggested by the Institute’s definition of patient experience as "the sum of all interactions…” In the workshop I posed the question of which interactions are most important in the healthcare encounter. After a long brainstorming effort the realization was that every interaction from the most critical clinical interventions to the almost unnoticeable or mundane encounters collectively equate to the experience people have and all are equally important.

At their core, each of those interactions is about a choice. As healthcare organizations you choose how to structure processes or determine what behaviors and expectations to establish and reinforce. With this, healthcare organizations are also held to the individual choices their people make at every touch point across the care continuum. It is here where you may be making things more complicated then necessary. By focusing on policy or political constraints you overlook the simplest of human factors; that people most often want to do the right thing. What must be done as leaders is to provide the support, the environment, the culture in which the right choices can be made, the right interactions provided and the best of experiences ensured.

I hope we can shift the discussion on experience from "why” and "what”, from policy or politics, to understanding there is a fundamental choice to provide the best experience possible for our patients, families and guests. In the desire to engineer this process we overlook the basic fact that healthcare at its core is human beings caring for human beings. In recognizing this, you ensure patient experience is a central and driving force to a continuously improving global healthcare system. It just starts with a simple choice.

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

Tags:  ACA  choice  culture  defining patient experience  global healthcare  healthcare  improving patient experience  Interactions  Patient Experience  patient stories  service excellence  Supreme Court 

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The Power of Celebration: A Simple Secret in Improving The Patient Experience

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, June 5, 2012
Updated: Monday, June 4, 2012

Last week I had the privilege of attending an award ceremony designed to recognize the accomplishments of healthcare organizations for performance on patient experience measures, HCAHPS scores and service innovations. The recipients came from across the spectrum of care settings including acute care, critical access, physician practices, outpatient and home health. I have attended a number of events like this in the past and have always been moved by the enthusiasm and excitement generated by this type of recognition. Yet at this event, I was struck by something I may have been missing all along.

Whether a large national event of this type or a recognition event in a single healthcare organization, what I discovered is that there is something significant hiding just beyond our efforts at recognition. Recognition is a powerful tool in organizational settings. It has been shown to bolster engagement of staff, increase satisfaction and even boost motivation. Yet, what I suggest is often missed is taking one more step beyond acknowledgement and recognition. It is a magic opportunity we often fall short of in healthcare, the power of celebration.

I am not talking about hanging a sign on a unit to say congratulations for a performance achievement or even singing happy birthday at monthly staff forums. All these activities are important, but remain the rational part of creating cultures of engagement. One could argue these are celebrations, and while I would not disagree, they seem more often to be a thoughtful acknowledgement of accomplishment. By celebration I also don't suggest the need for costly or even lavish events, I am talking about the emotional connection we have to our success. Celebration is not a certificate or sign, it is the true expression of appreciation from the heart and shared with colleagues and peers.

So how can you use celebration? It may be the attendance of a senior leader at a unit huddle to express why the service efforts of a staff member had a positive impact on the experience of a patient or family member. It could be bringing the prom or an anniversary or birthday party to a patient’s room. It could be a red carpet welcome in the lobby for a volunteer on her 20 years of service or a thoughtful send off for a long time patient who healed and is now leaving your facility. So how do you know that you are celebrating versus recognizing? You feel it on the inside. Versus a virtual handshake, it is a virtual hug. Recognition is something you do; it is rational and thoughtful. Celebration is something you experience; it is emotional and heart-felt.

In a work environment where stress can run high and emotion sits just below (and at times above) the surface in every encounter, by moving beyond recognition (not leaving it behind) and ensuring true celebration, we intentionally provide an experience for our team, our patients, our families and our communities. The reality is they are having an experience whether we design one or not. In celebration we create lasting memories, the very essence of experience itself – that which is remembered. In doing so we unleash the potential of our people, acknowledge the humanity of our patients and allow the true purpose and passion in our work to emerge. Through celebration we enliven and enrich our organizations and we create new opportunities to positively impact the patient experience.

At The Beryl Institute we work tirelessly to ensure we celebrate the amazing work taking place in healthcare every day. I invite you to share your story. How do use celebration to enliven the patient experience in your organization? Provide your comments below.

Jason A. Wolf
Executive Director
The Beryl Institute

Related Body of Knowledge courses: Employee Engagement.

Tags:  bottom line  celebration  culture  improving patient experience  Patient Experience  recognition  service excellence 

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Creating a Field of Patient Experience – A Call to Action

Posted By Jason A. Wolf Ph.D. CPXP, Tuesday, May 8, 2012
Updated: Monday, May 7, 2012

Something powerful took place at this year’s Patient Experience Conference and it took some time in reflection for me to sort it out. We opened the conference with the powerful video "I am the Patient Experience” showing the faces of the many individuals key to the Patient Experience. We then reviewed the efforts underway to create a Body of Knowledge, shaping a model for ongoing development of patient experience leaders, and the potential for formal certification. The days together were filled with the connections and learning central to the vision of The Beryl Institute (see the pictures and review the lessons learned).

It culminated with our closing speaker, Tiffany Christensen who brought us the voice of the patient and suggested something profound. She noted that our work in patient experience is truly a movement. In fact, what we are doing together is shaping a field. As the faces of participants declaring "I am the Patient Experience” flashed on the screen to close the time together, it was evident something bigger was happening than a conference or even the growth of a global community of practice.

Captured in the energy and spirit that filled those three days in April, was the same commitment and possibility that was shared by the over 300 individuals from 8 countries that have contributed to framing the 15 domains in the Patient Experience Body of Knowledge or even the over 8,000 members and guests that engage with the Institute community every month. The Body of Knowledge now stands for something bigger than just things we "need to know” to be effective practitioners in patient experience. It represents the foundation of a field grounded in knowledge and experience that can have lasting and profound impact on how those in healthcare work and how patients and families are ultimately cared for.

Creating a field is no small task and will not emerge from any one individual or organization. It must result from the voices of many, which is why I encourage your continued involvement in the Body of Knowledge effort. At The Beryl Institute, we look to be the catalyst, convener and coordinator of this important work. The next steps in the process will be the creation of work teams that will outline the key content for each of the domains of knowledge. Together with respected subject matter experts these outlines will help shape the learning needed to sharpen the skills of current practitioners and create a path to develop future leaders for the field. I invite you to learn more about the process and consider contributing to the work of these teams

I mentioned in a recent Hospital Impact blog that patient experience is not a fad, but is now a critical component of healthcare overall. We must work together to solidify the knowledge needed to lead, continue to support the research that will stretch our ideas and practice and come together as a global community that will take a stand for what we know is right in ensuring the best of experiences for our patients and their families. If we do this with the passion that I saw during our three days together at Patient Experience Conference 2012, there is no doubt that what we are doing is truly creating a field of patient experience.

Jason A. Wolf
Executive Director
The Beryl Institute

Tags:  body of knowledge  culture  Field of Patient Experience  improving patient experience  Interaction  open comment period  patient  Patient Experience  Patient Experience Conference  thought leadership  Tiffany Christensen 

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