Posted By Barb Davis,
Monday, March 25, 2019
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In January 2017 I received a call from my doctor’s office to schedule a routine check-up. I told the scheduler that I had recently experienced a life-altering event that prevented me from putting weight on my leg. She responded, “The doctor wants to see you.” I took a deep breath and planned out my visit, realizing I would have to use a wheelchair to get there.
This, then, is my story of seeing the world through the eyes of a wheelchair user and my realization that we in healthcare can do a better job of seeing the patient experience through a different lens.
From the moment I exited the car, I experienced barriers and challenges:
- A gas guzzling car was idling in front of the ramp, blocking my ability to wheel up it.
- Although I had other options, I automatically went to the registration kiosk which I have used many times for check-in. Although great when I was standing, it was impossible for me in a wheelchair. The screen was too high and I couldn’t see my selection options.
- Getting into a busy elevator was another humbling experience. Before sitting in a wheelchair in an elevator, I had not realized how invisible a wheelchair-bound person is in a crowded space
- The exam room was too small to accommodate a wheelchair, requiring the Medical Assistant to remove furniture, rearrange the exam table, and adjust the computer monitor.
- When I told my physician about the scheduler’s insistence to see him, said: “oh, we could have put this off.”
Throughout my life, I have been fortunate to have not experienced any challenges with mobility. Although sensitive to the ADA and a proponent of individual rights in hospitals, I had not personally experienced what it is like to not be able to hear others speak,to see my pathway, or to able to walk to the next room. Throughout my work in patient experience, I realized that my organizations had not fully incorporated the needs of all types of patients in its design.
In hindsight, I wish my team and I had taken more time to see the barriers that different patients may experience. When we evaluate signage, could we have taken a more holistic approach? When implementing a new process, did we explore how it may impact different types of patients?
Once mobile, I recommended that the office undertake an “access” walk-through. They could ask people to assume roles in which one person would be in a wheelchair, another would be blindfolded and another had their hearing obstructed. In this challenge, the mock-patients travel from the parking lot to the diagnostic appointment and back again. The team would do a de-brief to identify the barriers and opportunities and discuss their observations on how the organization accommodates patients and family members with visual, auditory and physical challenges.
I urge you to consider how your organization addresses the challenges and opportunities of meeting patients and families where they are--in wheelchairs, unable to read signs, or unable to hear audible clues, or the variety of other differences that could alter their visit. We must consider these challenges in our important work to improve the experience of all patients.
Barb Davis has over 30 years of health care experience in quality, safety and patient experience. She currently works for CipherHealth as VP, Clinical Services.
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Posted By Sarah Suddreth,
Monday, March 25, 2019
Updated: Tuesday, March 19, 2019
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In just a few years, 89% of organizations will earn or lose business based on customer experience.1 Delivering exceptional patient experience is not optional and begins with a patient's first interaction with your health system. While demand for online booking options is on the incline, the phone is still the preferred first touch point for many patients.2 However, the most significant root cause of poor service is callers having to repeat themselves and being trapped in automated self-service. If the caller is routed incorrectly, sent to hold, treated rudely or not adequately helped, that can poorly affect his or her perception of the care they’ll receive. In many health systems, staffing challenges and inefficient phone processes are just two contributing factors to an overall poor first impression.
Let’s consider the following scenario: A patient calls your health system to book an appointment with a dermatologist. After reaching an operator, she is sent to another operator who immediately places her on hold for “just a moment.” More than three minutes pass, and she becomes increasingly impatient. The call reconnects with someone new, and she hears an abrupt “Hello?” and instantly feels her pre-existing anxiety grow for the anticipated consult. After providing specific details about what she’s looking for, she hesitantly asks to schedule an appointment, but wonders what kind of care she’ll receive if she arrives.
Even though the patient committed to an appointment, your office now faces an uphill battle to overcome the patient’s poor experience from that initial phone call. In fact, it takes 12 positive customer experiences to make up for one negative experience.3 This is just an example of one patient’s call journey. Poor routing, sending patients through loops or blindly to voicemail and untrained staff handling the phone decrease the likelihood of booking a happy patient.
Here are two essential steps to improve patient phone experience and your staff’s ability to schedule.
Step One: Create a patient-centric mindset
Since a phone call is usually a new patient’s first interaction with your healthcare system, staff who handle phone calls should be prepared to confidently and knowledgeably answer questions and collect necessary information. In almost all cases, enhancing the skills and demeanor of your phone handlers is the first issue to tackle, because when staff doesn’t properly execute on every phone call, appointment conversions are directly impacted.
Coach them how to best handle scheduling conversations so new patients are fully helped. Phone handlers’ tone must also reflect the brand – so make sure they answer with a friendly hello, state their name and the health system’s name, and ask “How can I help you?” Hold them accountable and provide a suggested phone script to create consistency with patient conversations. With proper usage, it conveys professional and clear communication which puts patients at ease and strengthens provider-patient care.
Finally, make sure schedulers are inviting every new patient in to see a provider on the phone call. Our data shows that 90% of the time, the caller will say yes to scheduling if an appointment is extended. Once an appointment time is established and agreed upon, your staff should then set expectations for the visit by letting patients know the expected wait time, parking information and directions, and which documents and paperwork they will be asked to provide upon arrival.
Step Two: Evaluate your processes & simplify
Beyond just phone handling, understanding where callers are originating from and where they should go is extremely valuable to eliminating phone call transfers and hold times. The number one reason for caller dissatisfaction is waiting too long on hold.4 This means acquiring a detailed analysis of phone numbers dialed by patients, evaluating caller flow, and tracking ongoing trends are necessary to maximize call routing.
Evaluate the structure of your call flow and caller trends. Are there certain times of day or days of the week when call volume increases, total hold times are up, or callers are transferred more than once?
Leverage caller trends and call volume data to make staffing decisions and provide feedback on how to transfer callers. Optimize your FTEs (full-time employees) and strategically stagger schedules at identified peak hours and challenging times for getting patients quickly connected to someone who can help.
In the instance when transfers need to occur, there should be a clear process in place. Encourage a warm transfer process to avoid callers being blindly transferred to voicemail. Phone handlers should check the availability of the intended party before transferring the caller, so no patient is sent to voicemail unless specifically requested.
A proper phone configuration for efficient routing reduces hold time and increases the likelihood of scheduling a happy patient.
An exceptional phone experience can set you up for long-term success. The patient remembers the interaction with the exceptionally friendly and helpful phone handler he or she talked with. Before arriving, the patient feels prepared and is confident in the care you will provide. These two simple steps can positively improve your callers’ journey and build your reputation as a valued healthcare provider.
4. "Consumer Survey Reveals the Customer Care Experiences That Most Impact the Relationship Between Cable Operator and Subscriber.” CSJ International Press Release. May 12, 2010.
Sarah Suddreth is a proud member of The Beryl Institute and Director of Business Development at Call Box, the leading telephony and artificial intelligence technology firm that works with health systems and providers to present more insight into their phone calls. Healthcare providers turn to Call Box when both internal and external patient experience issues continue to arise over the phone. Living in Dallas, Sarah works with healthcare executives across the nation to enhance Patient Access and Experience standards for patient interactions over the phone.
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Posted By Dan Cohen,
Friday, February 22, 2019
Updated: Sunday, February 10, 2019
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If a new drug was discovered that alleviated symptoms for people living with dementia, a pill that helped them to feel joyful and able to communicate again, why wouldn’t we rush to make it available to every person in our care? All the more so if that same medication reduced falls, delirium, and pain; if it improved post-surgical and rehab outcomes; and if it reduced reliance on antipsychotic medications.
Believe it or not, those outcomes are happening today in the largest public hospital systems in the U.S. and Australia. But no miracle pill is involved. Rather, the effective intervention of personal music, used according to evidence-based best practices, is proving how personalized playlists offer an effective, side-effect-free, non-pharmacological approach to improving the patient experience.
When I first started providing music, it was based on a hunch that re-connecting people with their favorite music would provide enjoyment and comfort. I didn't expect them to "light up" quite as much as they did. Whenever any of my friends or family members were hospitalized, I would offer to bring them their music. One 91 year-old friend was admitted to the hospital to address chest pains, so within 24 hours I dropped off an MP3 loaded with his favorite big band tunes. On day 3, when I entered his room, he was out of bed with his headphones on dancing to the music with a big grin on his face. Until he passed away two years later, he'd always refer to the "great time" he had in the hospital.
Little did I know that personalized music would become a standard of care. For example, hemodialysis, spinal cord injury, surgical intensive care, ventilator units all use M&M to improve the patient experience, according to Sui Unzelman DNP, RN, VHA-CM, Nurse Educator, South Texas Veterans Healthcare System, Audie L. Murphy VA Hospital. One patient's family, upon the passing of their loved one who listened to their favorite music, commented, "so grateful he was listening to music in his final moments, rather than listen to the hospital noise."
Observations about the power of personal music are backed by extensive research. Recent studies include:
- In Scottsdale, Arizona, Dr. Kari Johnson, PhD, RN, with HonorHealth, examined the connection between listening to favorite music and delirium prevention in hospital trauma ICU settings. Her controlled study found that patients in the music intervention group experienced a statistically significant reduction in physiological measures of anxiety, a major factor in delirium onset.
- The University of California-Davis School of Nursing is about to release results of the most comprehensive research to date involving the use of personalized playlist for 4,100 residents across 300 California nursing homes. Results reflect Music & Memory’s impact as a relatively low cost, non-pharmacological intervention that has a significant positive impact on elders with some form of dementia, behavior or mood issue. The report documents both a clinically and statistically significant reductions in aggressive behaviors, reliance on antipsychotic, anti-anxiety, and antidepressant drugs, as well as reductions in pain and falls.
- Researchers at University of Utah Health in Salt Lake City used brain imaging to demonstrate that familiar music may facilitate attention, reward and motivation, which in turn makes it more possible to manage emotional distress for people with dementia.
- A pilot study published in conjunction with Stephen Post, PhD, of Stony Brook University Hospital indicates that listening to personal music favorites improves swallowing in individuals with advanced dementia, making eating easier and potentially diminishing reliance on feeding tubes.
I'm so pleased that not only Music & Memory will be present at the Patient Experience Conference as the charity partner, but also that we'll be hosting a special screening of the Sundance audience-award winning documentary, Alive Inside: The Story of Music & Memory, Wednesday evening of the conference. Out of 4,000 US documentaries submitted to Sundance in 2014, the 50,000 attendees to the Park City, Utah festival voted "Alive Inside" their favorite.
Music & Memory is honored to be selected as The Beryl Institute Patient Experience Conference 2019 charity partner. We look forward to meeting you at the film screening or in the PX Collaborative.
Dan Cohen, MSW, is founder and Executive Director of Music & Memory, a nonprofit that promotes the use of personalized music to improve the lives of those in our care. “Alive Inside: A Story of Music & Memory,” a Sundance Audience Award-winning documentary, is its inspirational story. Music & Memory operates in thousands of long-term care communities, hospices, hospitals, and home care organizations internationally (musicandmemory.org).
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Posted By Amy Vanderscheuren, MHA,
Monday, February 18, 2019
Updated: Tuesday, December 18, 2018
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In today’s highly competitive healthcare landscape, where health system leaders are challenged to achieve both clinical and operational excellence, while at the same time providing an exceptional patient experience, cultivating a decidedly engaged workforce has never been more important. Research shows that employee engagement directly impacts an organization’s bottom line: healthcare organizations with an engaged workforce – one that truly cares and consistently puts forth a discretionary effort – have fewer instances of hospital acquired conditions (HACs), better mortality rates, improved patient satisfaction scores and lower rates of turnover and absenteeism1. Inarguably, it behooves healthcare leaders to consciously invest in employee engagement.
Leadership Rounding, a structured activity, whereby executive, nurse and/or department leaders intentionally and purposefully engage with staff (and patients!) to collect firsthand, actionable insights, is an important and effective strategy for cultivating and improving employee engagement. A proven technique for connecting with staff in a meaningful way, informing leaders across the organization about patient care and other work-related challenges and highlighting the extraordinary work performed by frontline staff and managers, Leadership Rounding has the potential to transform an organization.
The benefits of Leadership Rounding for an organization are many: improved clinical outcomes and patient experience; higher rates of employee satisfaction and loyalty; ability to attract and retain talent; a recognized culture of continuous improvement; and increased employee engagement (which differs from employee satisfaction). Following are four ways Leadership Rounding directly contributes to cultivating and improving employee engagement.
- Build trust and accountability
Some estimates suggest that managers are responsible for 60% of all the reasons people quit their jobs, which is one reason manager-employee relationships are so important2. Leadership Rounding demonstrates that leaders care about their employees as people and shows employees that their leaders are interested in day-to-day operations and quality of work performed. Further, Leadership Rounding gives employees a voice, allowing them to share ideas about what is going well in their workspaces, what tools they may need to be more productive, and what they are most proud of at work – important aspects of forging relationships that are grounded in trust and accountability.
- Improve communication
Leadership Rounding enables two-way communication between leaders and staff and serves as a platform for collecting information and then closing the feedback loop. During these rounds, leaders have an opportunity to enforce key strategic messages, explain decision-making processes, correct misinformation, and note key behaviors. At the same time, Leadership Rounds also provide a conduit for employees to express their opinions and share their ideas for improvement.
- Boost morale
When leaders consistently connect with employees and show genuine interest in and appreciation for their contributions to the organization, staff (and leaders alike!) are energized and motivated to excel. Leadership rounding presents a level playing field, where leaders and employees can connect over their shared purpose: achieving the organization’s mission.
- Recognize staff
According to Dale Carnegie: “Nothing else so inspires and heartens people as words of appreciation.” And he’s right. One of the most powerful benefits of leadership rounding, particularly in relation to improving staff engagement, is identifying and publicly acknowledging employees who deserve recognition. Recognizing and appreciating employees for their good work confirms their work is valued by others, which leads to higher rates of job satisfaction and increased productivity (a happy worker is as much as 12% more productive than his unhappy counterpart!3). The value of employee recognition cannot be underestimated.
Leadership Rounding is a proven, best-practice strategy to collect vital information, reward and recognize, build relationships and validate key behaviors. Ultimately, leader rounds improve engagement levels for all stakeholders, leaders and employees alike!
1. Kruse, Kevin (2015). The ROI of employee engagement in hospitals. Forbes. Retrieved from: https://www.forbes.com/sites/kevinkruse/2015/02/26/the-roi-of-employee-engagement-in-hospitals/#6642044554ce
2. Schwantes, Marcel (2017). Why do employees really quit their jobs? Research says it comes down to these top 8 reasons. Inc. Retrieved from: https://www.inc.com/why-do-employees-really-quit-their-jobs-research-says-it-comes-down-to-these-top-8-reasons.html
3. Craig, William (2017). 3 reasons why employee recognition will always matter. Forbes. Retrieved from: https://www.forbes.com/sites/williamcraig/2017/07/17/3-reasons-why-employee-recognition-will-always-matter/#315c68463c93
Amy Vanderscheuren, MHA is a Performance Improvement Coach for TruthPoint. She has been partnering with clinical and administrative leaders, frontline staff, and patients and families to improve clinical outcomes, the quality and safety of healthcare, and the patient experience for more than a decade.
Posted By Nicole L. Cable, CPXP,
Monday, January 28, 2019
Updated: Thursday, January 24, 2019
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Service culture is defined as "organizational culture where there is a collective way employee think about providing outstanding service, act to provide it and understand how and why they do it" (Toister, 2017). Simply put every employee in your organization lives and breaths customer service. You may be wondering how do I create an environment in which service is a part of the DNA. You must first start with your employees.
In a modern healthcare context characterized by inclinations towards human-centered care, institutions have to pay attention to culture to meet their service excellence objectives. Author Simon Sinek captures the importance of culture in service excellence, observing that “customers will never love a company until the employees love it first.” Within such a reality of practice today, new employees or leaders also have to concern themselves with culture. Beyond just possessing the most proficient skills and qualifications in one’s field, I strongly believe that how one interacts with his or her new colleagues and the new workplace may determine success. New employees find themselves in not only a strategic position to influence culture, but also a sensitive situation in which the wrong approach could backfire. As a result, attaining the right balance between understanding the new place and introducing fresh ideas is pertinent.
The very first step through which the new kid on the block can influence culture is through leveraging universally desirable traits and qualities. These refer to attractive characteristics that would prove desirable across all settings of practice, pertaining to both people skills and being great at one’s role. It would be a mistake to imagine that one can impact culture positively when one’s new colleagues already feel that he or she is the weak link. As a result, consummate technical performance and exceptional people skills in aspects such as communication and teamwork provide a strong base upon which to win trust and establish professional camaraderie that then place one in a position to impact culture desirably.
It would also be foolhardy to attempt inspiring culture change before understanding the new organization’s existing culture, values, beliefs, vision, and other key aspects. The quickest way to lose favor and genuine attention is through being a smarty-pants who assumes the high ground and deems all pre-existing aspects of culture inferior. As a result, through employing discernment and mindfulness, one has to take his time to understand the organization and its people, ethos, and strategic direction, as well as the rationales behind different elements of culture. Such a respectful demeanor would provide a good base from which to then impact culture, whereas a dismissive or scornful attitude would have the opposite effect, especially considering the new employee may still not be part of the in-group.
The third step then concerns how to actually impact culture, having established the right workplace relationships and understood the organization. The work already done ensures that the ideas proposed on improving culture, however novel, build on the organization’s strengths and opportunities, which maximizes chances of success. Offering evidence of efficacy and positive outcomes on the shared goal of excellent service delivery, either through citing examples or best practice standards, provides a way through which to convince the executive leadership, change agents, and colleagues on the new ideas. At the same time, being the new kid on the block, one may need to champion a piecemeal, iterative approach that helps provide direct evidence of success while also ensuring organizational learning. Such an approach would foster the permeation of the new values or practices within the organization. Ultimately, to impact culture as a new leader, one has to convince others that he or she shares in the overarching organizational service delivery goals, and that his or her ideas serve such goals.
Delight at Work article. http://www.delightatwork.com/delight-at-work/customers-will-never-love-a-company-until-the-employees-love-it-first
Toister, J. (2017). The Service culture handbook: A step-by-step guide to getting your employers obsessed with customer service. Toister Performance Solutions.
Nicole Cable is currently the Chief Experience Officer at InnovaCare Health – a company offering population health management services by creating and implementing innovative solutions for value-based healthcare.
Nicole has been a strong advocate of patient experience in healthcare. She has played a pivotal role in designing patient experience practices as a panelist and keynote speaker at several healthcare forums and conferences.
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Posted By Chantal Backman INF./RN, MHA, PhD,
Monday, December 10, 2018
Updated: Friday, December 7, 2018
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Older adults with multiple chronic conditions typically have more complex care needs that require multiple transitions between healthcare settings. Poor care transitions often lead to fragmentation in care, decreased quality of care, and increased adverse events. Emerging research recommends the strong need to engage patients and families to improve the quality of their care. However, there are gaps in evidence on the most effective approaches for fully engaging patients and families in their transitional care.
As part of The Beryl Institute’s 2015 Patient Experience Grant Program, our organization looked to use participatory visual narrative methods to explore older adults’ experiences of managing multiple chronic conditions during care transitions. By engaging older adults with multiple chronic conditions and their family members in the detailed exploration of their experiences during transitions across health care settings, we hoped to identify potential areas for future interventions.
Based on the study results, three areas for improvement specific to older adults managing chronic conditions during care transitions emerged:
- Strengthening support for person- and family-centered integrated care
Older adults and families in our study described the nurse as the central hub that links them to healthcare providers and community resources. In addition to the medical needs of this population, it was clear that appropriate assessment and mechanisms to support patients in the broader context of health, which includes economic, access, and social issues/barriers are needed. Older adults and families often do not know who to contact to obtain support. As one participant mentioned, the care is often focused on the medical issue, and thus providing a very “siloed” system. One consideration to facilitate better integration is assigning a primary provider as the central hub to be the link during the patient’s transitions across the health care system. Previous studies show that such system navigator roles have reduced readmissions to the hospital and return visits to the emergency department.
- Engaging older adults and families in their care management and care transitions in meaningful ways
Our study indicated that older adults and family members who were actively involved in their care were better able to navigate their journey through the health care system. This is consistent with other studies. Emerging research is focused on further engaging patients and families in their care. Further work is needed to develop personalized care which provides individualized access to relevant resources in order to better manage not only single but also multiple chronic conditions. One promising option would be to explore the use of technology to provide a personalized care plan approach to ensure safe, effective and person- and family-centered care transitions. The development of new technologies for personalized care could potentially help to facilitate and to manage multiple chronic conditions while navigating our complex healthcare system, thereby better empowering the patient and their families.
- Providing adequate support/resources for family members and informal caregivers
It is clear from this research and from other studies that family members and informal caregivers take an active role in helping patients during their care transition experiences. Further resources are needed to better support family members who play an active role in care. However, it is also important to assess a patient’s social context to determine if further support is needed, and whether or not there is the presence of informal caregivers and family members who can help to support the patient.
Our study reinforced the importance of active involvement in managing care transitions, positive experiences during care transitions, accessing community services and resources, challenges with follow-up care, lack of meaningful engagement during discharge planning as well as the presence of systemic barriers in care transitions. The results contribute to our understanding that person- and family-centered care transitions should focus on the need for active involvement of older adults and their families in managing care transitions.
To learn more about the study methodology and findings, visit: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3292-6
Dr. Chantal Backman RN, MHA, PhD is an Assistant Professor at the School of Nursing at University of Ottawa in Ottawa, Ontario, Canada
Posted By Magali Tranié,
Wednesday, November 14, 2018
Updated: Wednesday, November 14, 2018
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As one of the eight active lenses of the healthcare experience framework1, staff engagement is recognized as fundamental to the successful realization of a positive patient experience2.
An organization’s staff engagement strategy should comprise of numerous elements3, and some form of community giving activity should be one. It’s the holiday season after all, a wonderful time to remember the importance of helping others! Yes, it’s something close to my heart so I’ll admit I’m a bit biased, but there’s actual some science behind the benefits too.
According to research, giving back benefits not just the recipient(s), but your health and happiness and communities by creating social connections. Talk about a win-win-win!
So, if you’re ready to implement community giving as one of your staff engagement initiatives, here are four things to consider for maximum impact:
- Get Senior Leadership Support
The first step should be ensuring leadership buy-in, which should seem obvious since “culture & leadership” is another active lens of the experience framework1. For example, we list “community” as one of our company’s purpose along with associates, customers and their patients. We post this purpose all over our offices’ walls and desks as a way of making that commitment public!
- Leverage Your Field – or Simply Your Neighborhood
Your facility’s discipline can help guide you towards charities that are within your space. It makes sense for an imaging center to rally around breast cancer awareness, or for a cardiologist to support the American Heart Association, to point out the obvious. There are many healthcare-related non-profits to pick from – as well as many healthcare recognition days to leverage.
For instance, since we provide linen rental and laundry services to healthcare, we partner with some local chapters of Ronald McDonald Houses to clean their linen at no charge, and we donate to St. Jude Children's Research Hospital through payroll deductions, to name a few.
Alternatively, you can decide to support your local community too, directly impacting your staff and perhaps even patients. Is there a park nearby that needs a little TLC? A charity close to a staff member’s heart? Our ImageFIRST Fort Myers team had planned a Habitat for Humanity volunteering event only to find out one of their recent hire had been a beneficiary of Habitat!
Your patients may also be a great inspiration for ideas. In May 2018, we partnered with one of our customers Surgery Care Affiliates and nonprofit One World Surgery, which they are foundational corporate partner of. Our entire leadership team got to work to donate and assemble 250 backpacks of school supplies for young students in Honduras who cannot afford these basic necessities.
- Involve and Empower Staff
Once you get leadership buy-in, you’ll need a small committee. Build a team made up of positive and passionate “locker room leaders” who can spread the enthusiasm and create energy around the activities you decide on. Ensure their managers is on-board with their participation and commitment.
This team can help execute, gather ideas, give you a pulse of what’s important to your staff (so you can bring community giving activities that matter to them), and gather feedback after each event. For example, we found out some of our associates have difficulty leaving the office to participate due to recurring weekly work. We’ve modified our community giving activities to include events both outside and inside the office walls.
- Integrate Community Giving Activities Within Staff Engagement Calendar
After a kick-off meeting, set recurring quarterly meetings to plan the next three to six months. Work with your committee to develop a calendar of activities that you can integrate within your (hopefully) pre-existing staff engagement calendar.
Community giving is a wonderful way to engage your staff, so long as you plan ahead and dovetail it into your existing activities. Here’s a checklist and calendar to help you plan!
1. Wolf, J. A. (2018) Introducing a Framework for Experience in Healthcare. The Beryl Institute.
2. Wolf, J.A. (2017) The State of Patient Experience: A Return to Purpose. The Beryl Institute. https://www.theberylinstitute.org/page/PXBENCHMARKING
3. Gallup Q12 Survey https://q12.gallup.com/Public/en-us/Features
Magali Tranié is the Director of Marketing for ImageFIRST Healthcare Laundry Specialists. She has 20 years of experience working in various marketing disciplines, leading teams and contributing to employee engagement strategies. She is passionate about community giving, being an active weekly volunteer for a local animal shelter since 2006, giving annually to a variety of non-profits, participating to one-off volunteering opportunities throughout the year, and sponsoring a child in Rwanda since 2017.
Posted By Zal Press,
Wednesday, November 7, 2018
Updated: Wednesday, November 7, 2018
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Vernon Law, a baseball pitcher in the 1950’s is credited with saying "Experience is a hard teacher because she gives the test first, the lesson afterwards." As a patient living with a chronic condition for over 37 years, I can testify to the powerful truth behind the hard lessons that come from the lived illness experience. The pain and suffering endured are often excruciating in nature, and without question are lessons most of us would rather have done without. One of my colleagues refers to this education as her PhD in Lived Experience.
Progressive organizations around the world have learned one key lesson – that experience has to be at the table before lessons are fully learned. Patient involvement is now a global effort that numbers thousands of persons. It has evolved to the extent that Medical Sociologist Carl May describes it as “People with chronic conditions are now explicitly conceptualized as part of the healthcare workforce, are delegated tasks by the system and given performance targets. This can create new inequalities.”
In the context of May’s statement, the question emerges as to how to value the human resource component of involvement in the improvement exercise. What ostensibly began as a volunteer driven enterprise has evolved over time with various models of compensation and reimbursement deployed in different jurisdictions. This inconsistency across the care and research universe underscores May’s warning of inequalities.
As a patient advisor for over 8 years, I’ve been privy to increased chatter by patients on the topic of compensation. Many contend that their experience, time commitment, personal skills and expertise, make huge contributions to improving experience. They are evolving beyond the volunteer state to a partnership state in parallel with all the rhetoric coming from the system side about the nobility of partnering with patients. Meanwhile, the challenges of equity, equality, parity, etc. are being raised by patients but the culture of health care has for the most part resisted compensation as a part of a solution to these issues.
In an effort to provide guidance to organizations to tackle this thorny issue of compensation, myself and three patient colleagues landed on the following five principles that shed light on the patient perspective. With these principles as a starting point, organizations can open up the conversation about compensation with their patient advisor community.
- Barrier Removal
With diversity a key challenge to patient participation, compensation is a powerful tool that removes barriers and can ensure diversity and inclusivity. Without compensation, participants are only those who can afford to volunteer, limiting the involvement of all voices in the community the organization serves.
A fundamental power imbalance exists when all team members are paid except the patient partner. Patients bring experience, expertise and skill, just like all others in the team. To participate in these activities, patients sacrifice other duties. Overall, there is a cost to the patient to be engaged in improvement projects.
- Different Motivations
Patients participate for different reasons than the professionals with whom they collaborate. For professionals, the activity is part of their job, providing social capital, increased prestige and career advancement. These factors can impact future earning potential. For patients, these motivations are generally not the case and need to be understood in the context of the social and emotional values that inspire participation.
- Respect for Vulnerability
Patient motivations originate in their unique lived experience which brings with it a personal vulnerability. People expose their painful and intimate experiences in the name of improvement. It is not a risk free exercise and there can be traumatic, unintended consequences. This risk taking for the sake of improvement deserves respect and recognition of the value of this work.
Some people prefer not to be compensated while others view it as reflective of the type of commitment that is required. Patients often juggle time for medical duties, jobs, family, etc. Making participation a paid engagement generates deeper commitment given their competing interests.
This blog is meant to kick start a broader discussion on this topic. Along with three other patient leaders, I have co-authored an article in Patient Experience Journal which tackles this subject in greater detail, going beyond the principles to provide a guide for organizations that will equip them with the ability to address the perspectives of patient participants. Our hope is that the lessons learned from this exercise will advance the experience movement towards an authentic and respectful partnership between patients and organizations across the continuum of care.
Zal Press is past Co-Chair of The Beryl Institute Global Patient and Family Advisory Council and an active patient voice. His website is the most diverse collection of patient stories that enrich our understanding of the lived illness experience. He tweets as @patientcommando.
patient family advisors
Patient Family and Advisor Council
Posted By Samir Batra,
Monday, October 29, 2018
Updated: Thursday, October 25, 2018
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The role patient experience is playing in the provider environment today cannot be understated.
The Beryl Institute State of Patient Experience 2017 Study showcases the growth our industry has seen over time.
Organizations with individuals (CXO, Directors, Managers) with primary responsibility and direct accountability for addressing patient experience has gone from 22% of US hospitals to 58% in 2017 (n=944 US Hospitals).
On the other hand, consumers who say patient experience is significant to them in their healthcare decision making went from 67% in 2015 to 76% in 2017.
The importance of patient experience has been so far-reaching that boardrooms across the industry are taking account. In fact, according to the Advisory Board’s Annual Health Care CEO Survey in 2018, “meeting rising consumer demands for service” was in the top 5 priorities along with cost control, and exploring diversified, innovative revenue streams.
The good news is that there is overwhelming research that shows that improving patient experience not only leads to better quality outcomes, it, in fact, also leads to greater profitability for healthcare providers.
The not so good news is that while experience leaders are proactively focusing on experience, they are overwhelmingly finding themselves tasked with the other key initiatives in addition to their obvious focus areas (evaluating the patient, addressing patient feedback from surveys and reviews, execute improvement strategies) such as:
- Improving physician and staff well-being and experience
- Collaborating with quality/safety and performance improvement leaders and in some circumstances oversee the functions, drive patient engagement
- Establishing communication plans, manage interactions with patients – digitally and in person
With increasing demands on their time, patient experience leaders and executives have to turn to technology to facilitate the impact patient experience can have on the bottom line of a provider organization and the resulting patient outcomes. In fact, technology is so closely tied to the major initiative of “meeting rising consumer demands for service”, consumer technology and the ability to get access in the palm of your hand has driven the focus on providing more information and an exceptional care experience to patients alike.
And the importance of technology in the provider arena around patient experience is being noted by leading CIOs across the country as well.
A new study by Impact Advisors and Scottsdale Institute shows that more than 80% of CIOs reported that their high priority is finding ways to improve digital health engagement and optimizing the patient experience. The high level of interest “underscores a growing recognition – especially among industry leaders – about the critical need to be able to compete on convenience, access to care and value – as defined by patients”, states the report.
Hospitals and clinics have to offer technologies that make care more accessible, convenient and the experience more seamless.
Which leads me to the question: If CEOs are focused on consumer demands for service, the CIO is focused on technology related to patient experience; then what should the patient experience leaders do?
And the answer is clear - they need to take charge now and guide the technologies that are being looked at by their organizations that are focused not only on patient experience but also engagement.
On the other hand, patient experience leaders also need to get intimately involved and have their voices heard by technology innovators and pioneers developing solutions for the industry. The technology industry needs to hear from those who spend their daily lives creating a better environment and experience for patients and providers alike.
The time is now to collaborate, share and move the patient experience industry forward and bring a realistic consumer revolution to the table that is validated by the key stakeholders. One of the best ways to do so is to get involved in The Beryl Institute's PX Solutions Feedback Program. Solutions providers gain access to the subject matter expertise of patient experience leaders and decision makers to obtain feedback to evaluate and assist in developing or enhancing programs and services. The candid feedback provides the potential for widespread and global application for healthcare and the opportunity to reinforce the commitment to support the patient experience movement.
Experience leaders are in a unique vantage point to share their insights – and the time has come to take lead and help usher in a new era of breakthrough tech innovation!
Samir Batra has been in healthcare for 17 years and has worked with many global healthcare provider organizations in helping them achieve operational efficiency and implementation of their strategic plans. Majority of his work has focused on the patient experience, workflow and cost optimization and the effective use of technology. Currently, Mr. Batra is the Founder & CEO of BAHA Enterprises. BAHA is focused on helping health tech companies grow by raising capital, providing strategic advice and guidance, and validation of their solutions. Prior to BAHA, he spent over 10 years in executive roles at start-ups (Oneview Healthcare, CareInSync, pCare - TVRC, and GetWellNetwork) focused on applying technology to effect clinical and patient processes to improve the patient experience and drive engagement. Passionate about contributing to thought-leadership, he is active with HIMSS (NorCal Board Member), ATA (Start-Up Health Advisor - American TeleMedicine Association), and The Beryl Institute (Resource Advisory Council).
Posted By Kelly Makino,
Thursday, October 25, 2018
Updated: Tuesday, October 23, 2018
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One framework that is beginning to demonstrate considerable value as a resource for innovation in patient experience is design thinking, an approach that leverages the creative process to craft solutions for ambiguous challenges and has recently been gaining steam at a global level with proven success in a wide range of industries. This perspective has quite a bit to offer healthcare as well, and it’s easy to find some great literature on the innovative partnerships, impactful accomplishments and deeply empathetic moments that design thinking and healthcare have created together for patients.
Design thinking often brings to mind revolutionary leaps, but it also carries practical value for day-to-day PX innovation. By infusing the principles of design thinking into our daily work, we are able to create a culture that is ripe for wide scale innovation, and build a healthcare practice that is at home with ongoing evolution. To create some inspiration, here are some concrete examples of simple ways that one could put some of these principles into practice.
Walk through your health center and look at things like a patient. Focus less on what they are doing, more on what they are feeling at each step. How much thought has been given to designing their emotional journey through your system? What do the directional signs look like? Are they welcoming, or do they look like warning signs? Are they outdated? What message are they sending?
Also, look up. Staff rarely look at the ceiling, but patients do. How are those ceiling tiles doing? Where in your health center will your patients learn – without talking to anyone - the story of why your staff come to work every day? That they are your priority? That you will offer them the compassionate care they are seeking? Do they learn that when you want them to?
Lastly, how inclusive are the messages in your health center? Who is being left out of the welcome?
Mindful of Process
Do your employees know the full process of the patient experience or just the sliver they interact with? Carve out 30 minutes at your next staff meeting and do a Patient Journey Map with front line staff. It’s a great opportunity for them not only to showcase their knowledge but also to find places they can improve the system, support patients and have empathy for the humans in front of them.
It only takes a whiteboard, markers and supportive, thoughtful questions that challenge thinking, like: “What situation do you think a patient is in when they’re trying to make an appointment?” Or “Ok, now that they’ve taken their clothing off, how cold is the room? The floor?”
There is assumption in design thinking that the solutions to problems of an industry often can often be inspired by studying and collaborating with other fields. What fields have mastered your biggest challenges and have you really looked hard to find the answers to your problems outside medicine? Did you know that Formula 1 pit crews have helped medical teams improve the way they resuscitate newborns? However, the day Doug Dietz lost his MRI scanner to pirates is probably my favorite design thinking PX stories; and so, I will leave you with it as my closer. If you haven’t heard this story yet, please check out his TED talk.
Doug Dietz’s MRI scanner was the most effective he’d ever designed. But children were frightened of the dark, intimidating machine - they were so worried they couldn’t even lay still without “sleepy drops.” When he found this out Doug was upset - he didn’t get into product design to scare kids. And so, one day not long after, his MRI scanner was hijacked by some pirates at IDEO who turned it into a ship – complete with a gangplank. The problem didn’t stop at pirates, either. Another machine sank into the ocean, a third was lost in the woods on the way to the hospital, one accidentally launched into space.
Yet somehow, the staff of University of Pittsburg Hospital didn’t seem upset at all this chaos with their MRI machines, instead encouraging mischief, cranking up music, turning on a bubble-making disco ball, making the place smell like lavender and telling fantastical adventure stories that their littlest patients couldn't help but lie still and listen in fascination to. According to legend, if a patient is completely motionless for a certain time, fish will start to swim by in the magic adventure machine. Underneath all this pretend play, MRI scans are more effective, more accurate and need to be repeated less often than back in the old days when children had to be sedated to undergo these potentially life-saving scans because they so scared of the loud, terrifying MRI machines and gloomy UV lighting.
If that’s not PX innovation, I don’t know what is!
Kelly Makino, MSW is the director of Training and OD with Planned Parenthood of Orange & San Bernardino, based in the greater Los Angeles area. As a former LSW from the New York area, she is passionate about infusing person-centered approaches into healthcare that holistically advance the patient experience, support clinicians in their craft, and improve the systems that support them both. She is a graduate of Georgia State University, University of Pennsylvania, and is working on a doctorate at University of Southern California researching ways to improve communication training outcomes for people in clinical settings.