Posted By Tiffany Christensen,
Tuesday, November 13, 2018
Updated: Tuesday, November 13, 2018
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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:
- Do we know the problem we are trying to solve is a) really a problem and b) is a priority for those impacted?
- 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:
- What are we trying to accomplish with this innovation? How will it help people?
- How will we know we have helped people?
- 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
improving patient experience
patient and family
Posted By Tiffany Christensen, CPXP,
Monday, October 8, 2018
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It's been an important realization for me to see that the way in which I look at the patient experience is dependent on my orientation to it at the time. Most of the time, I look at it through my professional eyes, using the Experience Framework and the Eight Lenses of how to operationalize improvement.
When I am actually experiencing the need for medical care, my orientation shifts. Wearing the skin of a patient, the primary focus becomes:
- Physical sensations (pain, SOB, cold, etc)
- Emotional experience (worry, fear, elation, etc)
- Relational (engagement w/care team, co-design of plan, etc).
When I went into my ENT’s office a few years ago my priority was definitely based in the physical experience. I was having chronic headaches and every morning it was taking an hour for the headache to subside enough for me to begin my day. As a cystic fibrosis patient, I was unusual in that I had never had sinus surgery, so it seemed like a good and natural next step.
I liked my surgeon a lot. When we spoke, I felt like he really cared about my outcome and my quality of life. He did a good job of preparing me for the surgery itself. I went into the procedure confident in his ability and comfortable with our relationship.
When I first noticed that I couldn't smell anything after surgery, my surgeon assured me that my sense of smell might return. I was not aware that losing my sense of smell was a possible result of sinus surgery but I also wasn't very worried about it. Who really needs a sense of smell anyway?
It's been two years since I have been able to smell anything. My life has been more dramatically affected by my lack of a sense of smell that I could have ever imagined. My sense of smell, as it turns out, is directly related to my sense of safety, decency and love.
First, there is the safety element of it. There have been more times than I'd like to count where something was burning in the oven and I had no idea. If a friend hadn't been around during those times I can only imagine that it could have started a fire or at the very least filled my kitchen with smoke. It makes me very uneasy knowing that there may be things happening around me that are generating a smell as a warning sign that I am not able to heed.
In this culture, bad smells are considered indecent. As a person who cannot smell, I find myself in situations in which I am fraught with paranoia; worried that I may be unknowingly violating this decency. What if, when my friend stops by to visit, my trash smells? What if the dog smell in my car is overpowering? What if, God forbid, I smell? There's most certainly a layer of anxiety in my personal interactions that was never there before. (On the flip side, I will have to add, not being able to smell things like smelly trash cans is one of the perks of this issue!)
I really had to mourn the loss of my sense of smell when I fell in love. As it turns out, one of the most powerful senses that we use when we're falling in love is our sense of smell. Smell plays a huge role in the romance of falling in love. Smell is part of what builds a unique bond between two specific human beings. Smell is what you carry with you when you're missing the person that you love. The loss of smell during this important time in my life was incredibly sad. I now know that there's a direct line between my olfactory nerve and my heart.
I can easily understand why a conversation about the surgical side effect of losing a sense of smell would not be priority during my pre-surgical visits. When working with a CF/transplant patient, I'm sure there are much more pressing clinical and safety considerations. When we orient ourselves to the patient experience by way of a clinician perspective, the lived experience may get missed.
When we orient ourselves to the patient experience through the actual physical experience of being that person, however, it's easy to see that talking about the potential side effect of losing a sense of smell is absolutely something that needs to be part of the conversation. One might argue, it's even a potential reason to not move forward with an elective surgical option. While losing my ability to smell doesn’t prevent me from living a good life, it all adds up to a change in my life’s quality.
Would I have done anything differently had I known I would lose my sense of smell? I honestly can't answer that question. My perception of that overall surgical experience is, admittedly, now quite clouded from this outcome. I can’t help but feel as though my person-ness was not taken into consideration in the way that I hoped and believed that it was during the surgical consult process.
As we continue to explore and unpack the Experience Framework, it’s my hope that we will also begin to routinely ask ourselves to check our orientation to experience. When we hold the 8 Lenses up to the light we can ask ourselves: how does the picture change if we look at it through the eyes of a patient? A family member? A clinician? A leader? If we begin to see the Framework at 3-dimensional, so too will our efforts become 3-dimensional. I believe it is important for experience professionals to become more cognizant of the fact that there are different orientations to Experience Improvement and priorities will shift depending on that orientation.
And, if nothing else, I hope this blog reminds you to enjoy the smells of love all around you!
Tiffany Christensen, CPXP
Vice President, Experience Innovation
The Beryl Institute
Posted By Deanna Frings,
Tuesday, July 10, 2018
Updated: Friday, July 6, 2018
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The title of this blog is not original to me but was a headline on the cover of the July-August 2018 issue of Harvard Business Review (HBR) referencing an article, Creating A Purpose-Driven Organization. It seems everywhere I turn, there is another book, article or referenced research on the neuroscience of purpose as a driving force that gives our lives meaning. And let me be clear, I love that there is currently an abundance of discussion on purpose and meaning.
I have worked in healthcare my entire career from being on the front line as a respiratory therapist, leading teams in multiple leadership capacities to my current role as Vice President of Learning and Professional Development of The Beryl Institute. From my experience, conversations on meaning and purpose are not uncommon in the field of healthcare. I don’t know, maybe it’s because those of us who work in healthcare can easily connect that what we do really matters? We save lives. But how is this knowledge being lived out in our day to day practice as leaders in healthcare. Are we creating cultures that facilitate a discovery of purpose for ourselves and our employees?
Organizations are focused on employee engagement and acknowledge its critical role in their experience efforts as reported in our, State of Patient Experience 2017: A Return to Purpose. And, it’s not surprising given the 2017 Gallup State of American Workplace report, that only 33% of employees are engaged in their work and workplace and only 21% of employees strongly agree their performance is managed in a way that motivates them to do outstanding work.
These startling figures are not a new phenomenon. Previous Gallup Reports have shown much of the same. So, while we acknowledge the importance of an engaged workforce, the data suggests we continue to struggle, despite all the focus on improving it.
I often speak on the critical role of leaders in achieving experience excellence and I would suggest that leadership is the critical link in transforming organizational cultures and creating engaged environments where individuals can reach their full potential. During these speaking engagements and workshops, I love taking people through a journey of discovery of purpose and meaning and I have witnessed the immediate and powerful impact it has. I hear a higher level of excitement in their voices, a clarity in vision and a drive in their commitment as they share their stories with each other.
The conversation continues as we take the critical next step and determine actions we, as leaders, can take to not only share our purpose but invite employees to do the same. It’s one way to connect people to purpose. Simply stated in the HBR article, leaders most important role is to connect people to purpose.
Acting on a higher purpose can often motivate us to learn and develop our skills so we can excel in our performance contributing to what’s meaningful to us. It’s one reason I’m excited about Patient Experience 101(PX 101), a new educational resource releasing next week from The Beryl Institute. PX 101 is a comprehensive community-inspired and developed resource to build patient experience knowledge and skill for all employees across an organization by taking individuals through a discovery of purpose. It’s one of several new opportunities we’re launching this year in an effort to support global patient experience efforts based on the needs of our community.
PX 101 offers the tools and activities you need to engage in deeper and authentic conversations on what patient experience is, what it means to your employees and how they positively impact experience excellence. It invites them to share their own accounts of how they make a positive difference resulting in a stronger sense of purpose and meaning to the work they do every day.
When we find meaning and purpose in our work, the sky’s the limit to how high we can soar and how much we can contribute to our individual and organization’s success.
As leaders in healthcare striving for excellence in experience, how do you connect people to purpose?
Deanna Frings, MS Ed, CPXP
Vice President, Learning and Professional Development
The Beryl Institute
improving patient experience
Posted By Jason A. Wolf, PhD, CPXP,
Thursday, January 4, 2018
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Happy New Year and I hope the first few days of January find you rested and ready for an exciting year ahead. I also recognize that 2018 brings continued uncertainty for healthcare and shifting pressures on our healthcare systems globally. This potential friction of calm and chaos is the boundary on which I believe we will find ourselves in healthcare for some time to come. And it is on this very active boundary where I believe we can and will thrive.
In the last year, we saw great strides in our efforts to elevate the patient experience conversation. Patient experience gatherings dotted the globe covering continents, inspiring national systems to refocus their intention, and encouraging new thinking and renewed purpose. Evidence continued to mount on the value of a broader commitment to experience and healthcare overall showed increasing commitment to a focus on experience as a central and integrated component of all we do. The State of Patient Experience 2017 revealed increasing investments, expanding scope and a realization that experience efforts are a clear path to achieving desired outcomes.
We were also guided by the powerful stories of those experiencing care. I was particularly inspired by the thoughtful call for compassion raised as we closed the year by Dr. Rana Awdish from Henry Ford and Tiffany Christensen, our new VP of Experience Innovation at The Beryl Institute at the IHI National Forum. Rana reinforced “We really can't presume to know the answer, we must ask generous questions to really know what matters to our patients,” while Tiffany challenged us to reconsider our perspective, asking, “What would happen if we admired our patients rather than pitied them?” and reminded us, “There is room for compassion on both ends of the bed.”
This idea of the need to connect, of a “both/and” versus an “either/or” in many ways is in direct conflict with much of the political and cultural climate in which we find ourselves today, where extremes are elevated and common ground eroded. This too represents that very boundary on which I believe we can thrive. It is through this expanded perspective on what actually matters that we realize we are talking about something much bigger – we are moving to a focus on the human experience at the heart of healthcare.
As I have reflected on this “evolution” in our journey, what I believe we have been doing is driving back to the very purpose on which healthcare was initially grounded. Before there were systems and structures, methods and machines, there was one human being engaging with another, one committed to help and one in need. It required both to participate, it took both to succeed…and it still does.
Jeff Bezos, founder and CEO of Amazon recently said that while he frequently gets the question: 'What's going to change in the next 10 years?' he almost never gets the question: 'What's not going to change in the next 10 years?'. His point being the second question is actually the more important of the two. It is those things that remain stable on which we can build and through which we can find our greatest success.
While we cannot predict how policy will change and in what ways or what new constraints or challenges we will face at the boundary of calm and chaos, we do know that each of us in the business of human beings caring for human beings will continue to have choices. While they are not necessary choices in what illness or disease may befall you, you do have the choice of how you believe you deserve to be treated, in what ways you want to be treated and therefore ultimately where you will choose to be cared for. You have choices in how you will care for others, in what you will do to understand what matters to them and to you and ultimately choices in how you will care for yourself as someone committed to helping others.
That is the essence of human experience. That is the essence of healthcare. Where we go from here depends on that idea. We can use the uncertainty of the moment or the lack of clarity or variability of what lies ahead as a distraction, or even an excuse, or we can focus on what matters at our core. In our efforts to focus forward, I offer four considerations:
1. Intention and clarity matter.
The growing number of organizations defining what experience is for their organization reinforces that a clear intention and shared commitment to that purpose is central to any opportunity to drive excellence in healthcare.
2. Consistency is the antidote to uncertainty.
When the ground feels unstable we must find places of strength on which to support ourselves. Being consistent in efforts to elevate and expand experience excellence is a central way to remain focused on purpose, ensure positive outcomes and manage through uncertainty.
3. Shared understanding/ownership will change how we work.
The opportunity now presents itself to move beyond engaging people at the personal level, to activating them as co-owners in their care. This is more than a focus on centeredness, which represents a one-way relationship, to a dynamic sense of shared awareness and understanding in which all engaged contribute to outcomes.
4. Listen to understand ALL the voices that comprise the healthcare ecosystem.
There must also be a commitment to listening at the broadest levels in healthcare to understand what drives people’s choices, what motivates their actions and why this work is important overall. In acknowledging that each voice in the process is critical we also reinforce the value and purpose that had people choose healthcare as a place to work and elevate those receiving care (as Tiffany challenged us) from passive participants to individuals we should admire.
As we move into 2018 we will push this idea further, learning from each of you, honoring the voices of all engaged in healthcare, truly clarifying what matters to those impacted by what healthcare chooses to do and ultimately reinforcing that in each of those choices we each make tiny ripples that touch thousands and thousands of lives around our globe. That is the opportunity for us as we look to the year ahead and beyond, to thrive at the boundary on which we find ourselves and use the energy that this dynamic tension creates to spur us on. In doing so, with our eyes forward and our hearts grounded in the human experience, we can continue to change healthcare for the better for one another and for all it serves.
Jason A. Wolf, PhD, CPXP
The Beryl Institute
Posted By Jason A. Wolf, Ph.D.,
Tuesday, July 5, 2016
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In my most recent Patient Experience Blog I suggested we are now entering the Experience Era, offering eight considerations we should act on to not only usher in its arrival, but also support its place at the heart of our healthcare conversation. At the same time, we are seeing in all corners of healthcare and all touchpoints across the care continuum that the conversation on healthcare is dramatically shifting. Beyond a simple acknowledgement of the rise of consumerism in healthcare there is a more fundamental commitment to a focus on experience and all that encompasses.
Even with a much clearer and measurable focus on experience, we still are in our infancy in identifying and measuring key points of value that are realized in efforts to drive the best in experience. Yet, I believe we can say with some confidence that experience efforts, when approached with the requisite breadth and depth, have a significant influence on the outcomes we look to achieve – both in clinical practice across quality, safety and service and in broader operational results – including clinical and financial outcomes and consumer loyalty and community reputation.
With that recognition, we are excited to open a global inquiry into what people see as the value in a focus on experience overall. Our hope with this exploration is to understand the motivations, actions, impact and outcomes associated with a focus on patient experience. As part of this inquiry we are also looking to identify the proven practices being implemented to address patient experience excellence from the perspective of not only healthcare organizations, but also consumers of healthcare, be they patients, family members or other support networks. I invite and encourage you to participate.
Respondents will be asked to provide thoughts from a primary perspective – that of a patient or family member or member of a support network, that of a healthcare team member, or that of a healthcare leader/administrator – but are invited (and encouraged) to provide insights from the other perspectives they may bring to the conversation. This is critical to reinforcing that all voices matter and in healthcare many actually engage with multiple voices. Through this exploration, incorporating this range of perspectives will help us identify commonalities and distinctions in how people both approach and evaluate patient experience and will allow us to frame a broader picture of how value is perceived.
I believe, as I have seen on our journey in expanding the patient experience conversation these last few years via The Beryl Institute, that we must be willing to ask the big questions and dig into the critical issues that will continue to create the greatest opportunities for healthcare globally. As the experience movement grows we must be rigorous in reinforcing value, committed to continuing to push the edges of our efforts and willing to engage with one another in the topics that will help us to focus with intent on all that is right in healthcare. It is through these efforts that patient experience has found its place at the heart of healthcare overall.
I invite and encourage you to participate and to share this inquiry with your peers and networks. The survey itself should take about 5 minutes to complete and includes 3 open comment questions to answer so respondents can provide the full extent of their thoughts. A report of the findings will be presented this fall and respondents can sign up to get special updates on the survey. You can start the survey here: https://www.surveymonkey.com/r/ValueofPX.
Thank you in advance for your perspective, but more so thank you for your commitment to this movement and to this effort to ensure the experience era in healthcare continues to grow for many years to come.
Jason A. Wolf, Ph.D.
The Beryl Institute
Continuum of Care
patient experience era