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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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Experience Innovation: Connecting Motive to People and People to Action

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

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

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

IDENTIFYING MOTIVES BY UNDERSTANDING WHO WILL BE IMPACTED

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

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

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

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

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

KNOWING THE “WHY” BEFORE CONSIDERING THE “HOW”

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

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

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

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

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

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

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

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

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

 

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

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

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When the Patient Experience becomes more Personal

Posted By Stacy Palmer, Wednesday, March 2, 2016

We have an incredibly passionate community at The Beryl Institute. I know for many that passion has been fueled by personal experiences that drove them to be part of this work. Others have been inspired to join the patient experience movement to spread what they believe is the right thing to do for those we serve. And sometimes while doing this work they have encountered their own life experiences, whether small bumps in the road or larger life-changing events, that reinforced the importance of patient experience and provided new perspective to guide their efforts.

Last year I experienced this firsthand when my daughter, Maya, dislocated and fractured her elbow while cheerleading. She had an emergency reduction surgery the night of the accident to put her elbow back in place and a second surgery a few days later to insert a screw to correct the fracture. All went well, but they decided to keep her overnight to help control her pain and that one night provided an incredible opportunity for reflection and perspective for me as a person who has built a career in patient experience. 

While I work everyday to share stories and practices of how our community works to improve the healthcare experience, I’ve been fortunate to have very few patient or family experiences myself. It’s amazing how your perspective intensifies when you’re sitting inside a hospital room observing the care of a loved one.

A few ideas were reinforced for me that night and, as simple as they are, I believe they are important considerations as we address overall experience.

  • Patients (and those who love and care for them) are incredibly vulnerable in a healthcare setting. Maya and I are pretty confident in our regular routines, but we were a bit clueless at the hospital – even with simple things such as ordering meals and turning on the TV. More significantly, we were at the hands of the staff to know what medicines she should have, if her body was reacting as it should to the surgery and how to best control the pain. We had to trust the healthcare team. As a children’s hospital, I must acknowledge they had several things in place that helped Maya feel more comfortable. Volunteers brought her a stuffed lamb and they let her select from a fun collection of super soft blankets to use while there that she could also take home. The hospital even had a Build-a-Bear Workshop on site, which I believe was the key motivator in getting her walking around post-surgery. Any steps, however large or small, an organization can to take to comfort and ease the feeling of vulnerability can have a significant impact.  
  • Healthcare workers are human. I think people often place doctors and nurses on pedestals in their minds assuming they should have perfect accuracy, bedside manners and responsiveness. While Maya had some great people caring for her, I was quickly reminded they were human. They had varied levels of experience, focus and relationship skills. As humans they also had their own lives that did have an impact on how they cared for my daughter – maybe stresses at home, conflict with co-workers or even their own health challenges. Regardless of how dedicated and professional, humans make mistakes. I came to appreciate all the checks and balances they implemented to help prevent that. At first I was a little disturbed by the redundant questions like “What is your name? Birthday? Any allergies?” But as I reminded myself the staff were each caring for multiple patients, I learned to appreciate their diligence to make sure everything matched up. I encourage healthcare workers to explain the needs for these steps to patients as this goes a long way in giving them confidence in their healthcare team.
  • Patients need advocates. The vulnerability and realization that the staff treating Maya were human reinforced a point that sometimes gets overlooked in healthcare – the important role of the caregiver. A few years ago a co-worker’s husband was in the hospital and she refused to leave his side. As much as she respected the healthcare team caring for him, she realized no one had his best interest at heart as much as she did. She was there to be sure they gave him the right medicines, at the right times and in the right amounts. She kept a journal of his condition and symptoms to share with the doctor, and she was there to be sure he ate, had food choices he liked and any assistance he needed. After being in the hospital with Maya for just one night, I understood her point completely, and not just because Maya was 11. The caregiver can play a vital role in helping ensure quality, safety and experience are what they should be in all care settings.

Maya was lucky that her hospital stay was short and she was quickly on the road to recovery. Being with her that night enriched my perspective and purpose, both as a mom caring for a child and as a professional committed to help make the healthcare experience the best it can be for everyone.

We are currently working on a white paper at the Institute that will share the stories of many patient experience leaders who, in the face of a personal health experience – however large or small, shifted their perspective from PX leader to patient or patient’s family member. If you are willing to share your story, we encourage you to participate in this project. 

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

Tags:  choice  community  engagement  Field of Patient Experience  improving patient experience  patient  patient and family  patient engagement  Patient Experience  perception  service excellence  voice 

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Considerations for Patient Experience Excellence: 2016

Posted By Jason A. Wolf, Ph.D., Thursday, January 7, 2016

As we have watched the patient experience movement grow in the last five years of our journey at The Beryl Institute, we have seen increasing levels of commitment to this effort and a refocusing on what matters versus simply what is measured. Many began their involvement in patient experience efforts purely due to motivation by policy, measurement and then eventually financial implications for outcomes. These dynamic shifts driven by policy in the United States were not unique to the country, but rather we have experienced a global wave of acknowledgement of and commitment to action around addressing the experience in healthcare.

What has stirred this broader global movement and created a dynamic shift in how healthcare operates regardless of system or policy? I offer it is connectivity and proximity – not necessarily physical proximity, but what I would call "social proximity”. Social proximity, driven by connectivity, access to information, an open willingness to share ideas, constant access to research, news and even rumors all contribute to an environment for humankind that has dramatically shifted in the last decade and with increasing speed in the last few years.

So what are the implications for this on patient experience? We are now at a critical turning point where one can no longer diminish or downplay that experience matters. In fact, I would warn those that do or more so resist or fight this shift, that you will soon be swallowed up by the tides if you choose not to climb aboard. We are at a pivotal time in the journey due to these and many other dynamics changing how we deliver care and how consumers of care perceive and expect it.

2016 provides an interesting transition point now 15 years into this rapidly flowing century. In thinking about the year ahead, I offer some considerations whether patient and family member, healthcare provider or a company providing services and resources to healthcare – we are now all in this together.

  • Experience is a MACRO issue. We are no longer talking about "experience of care” as first portrayed in the Triple Aim. Rather we are now readily acknowledging and acting to encompass quality, safety, service, cost, environment, transitions and all the spaces in between in the experience equation
  • Patient and family (consumer) voice is stronger than it has ever been (and won’t be quieting down any time soon). Patients have found their voices in new ways and are showing a fearless willingness to challenge what was once a paternalistic model to raise their own wants and needs.
  • Technology is no longer a differentiator, i.e., specifically saying you are engaging in technology solutions. It will be how you use technology, the information it can provide and the way it impacts your ability to provide care and more positive experiences that will matter most.
  • Tactics, even strong ones may move you forward, but will not support you in achieving ultimate success. There is now a clear recognition that experience efforts are no longer driven simply by a list of tactics, but rather by comprehensive strategies with unwavering focus and committed investment.
  • The "soft stuff” matters and all engaged in healthcare are expressing this in their own ways. Our latest State of Patient Experience study reinforced this very point; that culture, leadership and the people in your organization are the primary keys to driving strong outcomes and overall success.
  • We need to stop calling the "soft stuff” soft. It is perhaps the most challenging and intense area of focus we can and should have in organizational life. Culture change, aligning leadership, ensuring actively engaged people is perhaps the hardest work we can take on. So while deemed soft (perhaps even as an excuse for an inability to affect them), we cannot relent in a commitment to make these efforts central to any plan.
  • "Sharing is cool” – yes for you parents out there I just quoted Pete the Cat (Pete’s Big Lunch to be exact). It remains astonishing to me how so much of what we espouse to our children as critical skills, we lose as we move forward in our careers. Experience excellence is driven not by how much you know as an organization, but rather how much you are willing to share. A value-based world competes on the execution to excellence not simply volume and we should not be hypnotized by one "way” as sacred. It is in our willingness so share broadly and openly that we collectively win. The new healthcare environment calls on us to do this.
  • The global dialogue on experience excellence is emerging as boundary-less and systems will look beyond organizational constraints to the commonalities they can find in driving the best in outcomes for all being cared for or caring for others.

I conclude with one more consideration:

  • Aim high, but start where you have solid ground. I remain resolute that we all have a commitment, whether we have yet acknowledged it or not, to provide the best in experience in healthcare (and must be willing to fully engage in what experience encompasses). Change will increasingly be transformational in healthcare and in simple choices great shifts can occur, but it will take the building blocks of success on which to reach the greatest heights.

Icarus, who in an act of great hubris and in an attempt to achieve it all, flew too close to the sun with his wax wings and fell to the sea. As we look to 2016, we must never let the big ideas fade from view or the small ideas impede our progress. It will be finding a way in which to move each of our organizations forward from where they are, with an understanding that the world is dramatically shifting all around us with increasing speed, where success can be achieved. This is our new world in healthcare and in the patient experience movement that now churns at its core. I believe if we are clear in our efforts and intent, we can and will achieve the best in outcomes for all. Here is to a great year ahead.

 

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

Tags:  consumer  culture  global healthcare  Interaction  patient and family  tactics  technology 

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Patients and Families Included

Posted By Jason A. Wolf, Ph.D., Tuesday, August 4, 2015
Updated: Tuesday, August 4, 2015

Just a short, but incredibly exciting 5 years ago, I was writing my fourth patient experience blog in what has become a monthly occurrence. In that blog I introduced the definition of patient experience created by early contributors to The Beryl Institute community. In those first months of our work we were focused on reinforcing some fundamental ideas and values that have remained at the core of our work at the Institute since that summer we got underway.

In introducing the definition we offered,

"A positive patient experience is created by partnering with patients and their support network (i.e., families or caregivers) to anticipate needs and exceed expectations, recognize the individuality of each patient as a decision maker, form a caring, compassionate and lasting relationship.”

From those very roots we have operated, not from the perspective of providers only, or espoused a singular model or organizational perspective. Rather, we have comfortably left that to those with personal or business interests in what they saw and see as the potential of the patient experience marketplace. Our belief was and remains that the ability to improve the patient experience at a global level is grounded in collaboration and partnership, a welcoming of all perspectives and encouraging open sharing of ideas across segments of healthcare, organizational boundaries and even national borders. This philosophy has led to the largest community of practice dedicated to patient experience improvement, now almost 35,000 people strong representing almost 50 countries around the globe.

The significance here is that from the very beginning of our work we have operated from the mindset that patients and families are partners in the overall experience conversation, or simply stated, patients must be included. I offered this perspective as recently as my Hospital Impact Blog last week, but perhaps more importantly have lived it through our work as we have continued to learn and grow as a community. These efforts have been realized through the inclusion of patient and family voice on our boards from the outset, in our establishment of our Global Patient and Family Advisory Council (GPFAC) and the cutting edge work they continue to push us to explore (including some exciting news to be announced later this month), and they have been seen in our provision of learning and content from webinars and papers, to Patient Experience Conference itself, which has included patient and family voice on stage, in breakouts and in participation for the past few years.

It is for these reasons and grounded in our founding values that we are excited to also reinforce our commitment to the formal efforts around having patients included in healthcare gatherings. The phrase "nothing about me without me” is not new to healthcare, but what is emerging is a more critical intent on ensuring the consumer voice is engaged and included in the broader healthcare conversation – not simply around individual episodes of care, but in the very discussion of policy, procedures and processes that impact all engaging in healthcare globally.

For this reason, "patients included”, is much more than a nice phrase, it is our commitment and should be the commitment of so many other organizations espousing to include or more significantly represent the patient and family voice in healthcare. As a community comprised of all voices, we believed it was important to reinforce this important point.

The "patients included” movement was inspired by an experience and subsequent blog authored by a virtual colleague and thoughtful healthcare leader Lucien Engelen. He offers in recounting the roots of this effort, "When it was my turn to deliver my keynote, I asked the audience ‘How many patients are present here?’ Not one, it appeared. That there should be so much talk about what patients need and want without them being present prompted me to take action.”

The action resulted in the "Patients Included” movement and most recently a full charter guiding a true patients included effort around healthcare events. The charter, created by the voices of patients, caregivers and healthcare leaders in Spring 2015, calls on healthcare events to commit to the following:

  1. Patients or caregivers with experience relevant to the conference’s central theme actively participate in the design and planning of the event, including the selection of themes, topics and speakers.
  2. Patients or caregivers with experience of the issues addressed by the event participate in its delivery, and appear in its physical audience.
    • The Beryl Institute Patient Experience Conference 2016 keynote speakers includes patient and family voice and perspective. In addition, when sessions are selected late August, they will also reflect patient and family representation.
  3. Travel and accommodation expenses for patients or carers participating in the advertised programme are paid in full, in advance. Scholarships are provided by the conference organisers to allow patients or carers affected by the relevant issues to attend as delegates.
    • The Beryl Institute Patient Experience Conference 2016 offers patient and family scholarships to conference participants to support engaging more patients and family members in the overall patient experience conversation. In addition, patient and family voice throughout our conference keynote speakers are fully covered for fees, travel and accommodation.
  4. The disability requirements of participants are accommodated. All applicable sessions, breakouts, ancillary meetings, and other programme elements are open to patient delegates.
    • The Beryl Institute Patient Experience Conference 2016 will accommodate all disability requirements of conference participants for all parts of the program elements.
  5. Access for virtual participants is facilitated, with free streaming video provided online wherever possible.
    • The Beryl Institute Patient Experience Conference 2016 will provide conference access and updates to virtual participants through social media and the #PX2016 hashtag. Conference participants actively engage online via social media and conference presentations are made available to participants after the event.

While not every organization may be able to accommodate these commitments due to constraints or other considerations, they reinforce a powerful statement on what including all voices and providing the access to do so truly means. At The Beryl Institute, we ourselves have met these very commitments for our own Patient Experience Conference. Patients and families contribute to program development and review and are critical voices on stage and in breakouts. Scholarships, though modest are provided and accessibility, one of our core operating values, is reinforced, including virtual access to the extent possible via social media and other means.

We do this for more than it being the right thing to do. As a community of practice committed to experience improvement, we also believe that which we espouse and encourage in organizations behavior, we must be willing to do and model ourselves.

Patients included is more than a nice slogan or a feel good effort, it is a fundamental premise to executing on the best in patient experience efforts in healthcare today. We welcome the opportunity as we continue to grow to ensure we maintain this perspective and challenge and encourage the patient experience community and the broader healthcare community to take note. Patient and family voice matters in our ability to provide the best in outcomes, it has and always will.

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

Tags:  caregivers  community of practice  defining patient experience  patient and family  patient and family advisory council  patient experience 

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Reframing Patient & Family Experience

Posted By Jason A. Wolf, Ph.D., Thursday, June 4, 2015

As the experience conversation grows and more voices enter the discussion, I have come to recognize a need to reframe how we think about experience overall. In much of what I have written and shared in my talks, I have stressed an important point, that experience at its broadest point is all a patient, long-term care resident and/or family member encounters while they are engaged in our healthcare system. Critical to this idea is that, as outlined in our stand at The Beryl Institute, experience also reaches across all segments of the continuum and the spaces in between.

I raise this again now for as recently as this week I have been asked about how experience fits with quality and safety efforts or compares to patient engagement. My concern and therefore my desire to align our conversation is that many in the experience discussion have become trapped by our own warnings – that we continue to address experience from the perspective of providers rather than what the actual experience is for those in our systems.

I start by reinforcing what patient experience is not, in order to build a framework and encourage a discussion of what experience truly must be. For a long while experience was simply aligned with service or service excellence or even more simply satisfaction. For many it still is. Service in healthcare is critical, as it is the domain through which we find ourselves engaging people with dignity and respect, as one human being to another. Yet service is also not the full extent of what the users in our healthcare systems experience. It is but one piece of a complex pie inclusive of quality, safety, service, cost, outcomes and influenced by caregiver engagement, in which we must work diligently to drive integrated actions. 

This leads to the question is experience engagement? There has been incredible work around the processes and tools to drive patient and family engagement and in their very creation believe our answer is provided. If engaging patients and families in care encounters is of value, which it has proven to be, this too becomes a critical practice in positively impacting experience. Engagement tools, and in similar light the concepts of patient and family, or person centered care, all provide an incredibly important set of resources for ensuring the critical positioning and involvement of patients and families as partners in their care. These ideas too then are not experience in total, but rather are central to ensuring a positive experience overall.

I continue to raise this issue for one central reason. That in all we do to ensure the best in healthcare as I note, from quality, safety and service, to driving outcomes or addressing cost, to implementing processes of engagement or person-centeredness, these ideas are OUR language inside healthcare looking out. Yet when looking from the outside in, they are all but parts of one experience.

With this mindful integration I do not suggest we eliminate all distinct efforts to drive results in these various segments of experience. In fact in order to manage the dynamic nature of healthcare today, we need to focus our work on each of these critical efforts to ensure directional progress and continuous improvement. Rather, I do suggest we MUST NOT tackle each of these efforts in isolation, or under the false pretense that they are not part of the broader experience for patients and families.

So what is the opportunity we then have in reframing patient and family experience? I believe we must:

  1. Look beyond experience as just satisfaction or service to the reality of what our patients and families see every day. We do them great disservice by simplifying this idea in a way it becomes tangential or even "soft” to the hard work we do in healthcare every day.
  2. Align and coordinate our divided efforts, and in doing so, our collective language, to reinforce a commitment to the perspective of the end user in healthcare today. We can still segment our work efforts and improvement opportunities to tackle these often complex opportunities and problems, but we cannot and must not do so to the detriment of providing a coordinated and comprehensive experience.
  3. Work together to address experience from the broadest perspective across and at all touch points and the moments of truth we create clinically, interpersonally, virtually, etc. and include the voices of those we care for and serve to ensure an integrated and experience focused effort overall.

Yes we must focus on the basics – the blocking and tacking of what impacts experience everyday on the front lines of care, at points of transition and in the many seams we have created in between, but if we lose perspective on the broader opportunity, our smaller steps may not help us realize our greater goal. If we are committed to providing the best in experience for all in our healthcare systems – quality, safe, service-oriented, cost efficient, outcomes driven, inclusive, coordinated and compassionate – like I know most in healthcare are, then we still have great opportunities ahead. I challenge us to think about reframing our view of experience. In doing so I believe we will identify and achieve all we know is truly possible for all those touched by healthcare every day.

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

Tags:  conversation  defining patient experience  outcomes  patient and family  Patient Experience 

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