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The Beryl Institute invites members to submit posts on patient experience related topics. For guidelines and information on submitting a post for consideration, please contact us at info@theberylinstitute.org.

 

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Top tags: patient experience  healthcare  communication  culture  patient  HCAHPS  Leadership  patient engagement  empathy  physician  survey  compassion  perception  physicians  technology  caregiver  community  data  employee engagement  family engagement  healing  Hospital  improving patient experience  collaboration  Consumerism  Expectations  interactions  patient and family engagement  pediatric  person-centered care 

Preventing Burnout: Investing in Your Staff

Posted By Julie Danker, LCSW, CPXP, Thursday, September 20, 2018

It may begin with the sound of the alarm, your eyes still closed, your body curled in the fetal position as for months now you have found this to be the most comfortable and secure position you can assume. As your arm shoots over to the nightstand to silence the alarm, thoughts begin to churn:  What lies ahead, the monotony of your day, the dread of facing your work world coupled with the feeling of exhaustion from a restless night. None of this is providing motivation to begin the day, let alone leave the cozy cocoon of your bed.

‘I can’t be alone in feeling this way,’ I thought. ‘Is this relatable?’ I wondered, and so I inquired what burnout means to others and this is what I learned: 

“I felt unappreciated at work and that this would never change.”

“I’m tired of my job and started to feel robotic.”

“I was sick of going to the same place over and over again. Literally sick to my stomach.”

“My brain felt like it was shutting off and I knew I was not doing my best.”

“I began hating Sunday, our family day, because I knew I had to go back to work on Monday.”

“I’m quitting because I need more joy in my life.”

There seems to be a variation in how we each see, feel, and define true burnout which is unique to the individual and reminds us we are not in a position to ever judge. If the experience of job burnout was truly black and white there could be an alert, not unlike the sound of that Monday morning alarm, to let us know we were going to be late to our best work life. How great would it be to be ahead of the game and implement strategies to reignite our passion for our jobs. Unfortunately, that is not the reality. We become calloused for various reasons, hardened from the effects of day to day and numb to the real source of our discontent. Pride can also prevent us from sharing our struggles and leaning on those we trust. And sometimes, we may fear what will happen if we do come to terms with our reality.

A universal truth that does exist is that burnout does impact an employee’s self-esteem and productivity and this bleeds into the culture of all organizations. This process occurs over time and it begins with finding the day very routine in which we enter into; to check off the boxes, to then start all over the next day. Phase two then begins with some realization of this monotony and identifying ways to increase the value of the work that we do; which is overextending ourselves to add to the workload, to then start it all over the next day. Phase three is where we need some recognition to the hard work we are doing; the creativity we bring to the table and the endless devotion we are giving. When this recognition, acknowledgment or appreciation is not reciprocated an individual begins to slowly lose motivation to continue to operate at this pace.

What does this picture do to the culture of an organization? Is the C-suite important? Are influential leaders important? Of course, they are, but can they do it all? Can they define and maintain a culture of collaboration and a great place to work independently? No! A GREAT organization is a collaborative force inclusive of each and every employee, at every touch point, to maintain a culture and environment that symbolizes the vision, mission and values of the organization. This starts with the individual who maintains the grounds as the patient drives onto the property, the employee who maintains the cleanliness of the entry as the patient enters the building, the greeter who welcomes every patient who enters the building and to those who care for each and every patient. 

How do we get here? How do we prevent burnout? How do we empower each employee to have and bring value each and every day?  It can be quite simple and something that leaders need to ask themselves: “Who mentored you to get where you are and how did they treat you?”  Odds are, leaders’ value that person who stimulated an idea they had or helped create a pathway to help them achieve their goal of growing and leading within the organization.  What if every leader treated every employee this way? Employees would see that this is an organization where leadership is as much invested in them as they are in themselves.  This collaboration, support and investment defines an empowered individual who is going to show up each day acting as if this is their organization.

There are 5 MUSTS that all leaders need to encourage every employee to do:

  1. Take a Break. Not just during your workday but take your vacations too. Unplug, we all need this rejuvenation and if you do not recharge, you will fall short as this pace is simply unsustainable.
  2. Take care of you. Are you sleeping, hydrating and eating healthy? Not only do we need to refuel our bodies with proper nourishment to keep our energy and brain flowing in a healthy manner, but we also need to move around, pull our eyes away from the screens we find ourselves engrossed in each day, hour, minute and second.
  3. Find Humor. Are you laughing, finding fun in all that you do?  If you are not, ask yourself WHY? Life is to be fun, work should be fun, and you should be fun! Fun brings joy and the best game you have to offer. Smile, laugh and be fun!
  4. Be a team player. Have you ever known a leader to be successful without a team? That is a simple NO. Life is about being a team player, linking arms with those you trust and relationships.  You can never have a big enough team, continue to look for these key people and build upon one another’s strengths.
  5. Be a supporter. Support brings confidence; confidence in oneself and confidence in others. We feel more confident when we feel someone is supportive of us and our ideas. This does not mean you have to be a “yes ma'am” individual, providing constructive criticism or challenging feedback can also be viewed as supportive. Remember, it is in the means of how you deliver this communication.  Communication is KEY in every relationship.

Leaders, too, need to follow these guidelines, for as with anything else if we do not take care of ourselves, we cannot care for others. Remember; we do have some control of our destiny. Never let pride, fear or that voice in your head hold you back. Life is short, precious and your chance to have fun!  I challenge organizations to make burnout prevention a priority.  Invest in your team and your ROI is limitless! This investment will have your employees waking up before the alarm, eager and ready to begin their day; by bringing ideas forward and positively influencing others.

Julie Danker, Chief Experience Officer for Smart-ER is passionate about Patient Experience and capturing the voice of the patient. Julie has worked many years in healthcare providing Social Work, Case Management, Patient Advocacy and functioning as the Director of Patient Experience. Julie is a Licensed Clinical Social worker and also holds the CPXP certification. In her role at Smart-ER, which is a Stage 2 technology company that automates communication the day after a healthcare encounter to check patient wellbeing and uncover any service issues, she has been able to learn a lot from the voice of the patient and improve services for providers and consumers. Julie enjoys spending time speaking nationally on this topic and working collaboratively with other organizations on improving the experience for all.

Tags:  burnout  empower  productivity 

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Employee Perceptions are Key to Culture

Posted By Sara Laskey, Monday, September 17, 2018
Updated: Tuesday, September 18, 2018

Someone recently posted on LinkedIn that the most important thing about customer service is the perception of the customer and not the perceptions of the employees. I’m not sure that I agree. Yes, experience, including patient/consumer experience is all about perception. However, exploring the excellent definition provided by The Beryl Institute (“The sum of all interactions, shaped by an organization's culture that influence patient perceptions across the continuum of care.”) it becomes clear that culture is key to perception. And culture is another way of saying the sensitivities and behaviors of our employees.  

Employee perceptions are building blocks that make up the experiences we create for all who interact with our organizations. If our staff members and providers perceive they are valuable to the institution they will, in turn, treat others with value. If they feel appreciated by managers, they will act with appreciation to those they are managing and caring for.

As an example, let’s explore the spaces where we work. Cleanliness is something we measure and something our patients and visitors notice and associate directly with quality of care.  Are we taking time to make sure that the bathrooms and shared spaces for our staff are as pleasant and clean as the spaces for our customers?  

The locker and bathroom at one of the emergency departments where I worked was always understocked, the toilets were never cleaned, the call room beds never changed and the trash cans overflowed in the staff lounge. Old take-out containers lined the shelves in the lounge and cups of day old coffee were constantly cluttering the counters. If the organization couldn’t/wouldn’t provide us with a nice, well maintained locker room, why wouldn’t staff begin to treat the shared spaces with the same disrespect? This ultimately bled over into the public spaces that patients and families experience. The perceptions of employees were influencing the perceptions of the customer.

What was our solution? Not surprisingly it was multi-factorial. In this instance we instituted an idea called “Own Your Space”. We spend as many waking hours at work as at home and we all bear some responsibility for keeping our spaces well maintained. Too often we assume that our environmental service teams will not only take care of patients and the public but will clean up our messes as well. This isn’t a fair assumption. By asking staff to “Own Their Space” we gave them accountability and responsibility for their environment. Essentially, we needed to make our work spaces something we could be proud to call our home away from home. By recognizing what we could control it became a lot clearer what we could ask other teams (environmental services, operations) to help us improve. 

To impact mood and atmosphere we worked with the Arts in Medicine department and identified a series of photographs taken by one of our own physicians. Staff members then selected which of these would be printed and displayed throughout the ED in both onstage and offstage areas.  

Involving staff in in the design and upkeep of the work space impacts their well-being via accountability, respect and a sense of ownership.  Patients and families have also benefited. They enjoy the artwork and they interact with an engaged and appreciated staff. Staff who feel as valued and valuable as the care they offer.

Dr. Sara Laskey was the inaugural CXO for The MetroHealth System in Cleveland Ohio. In that capacity she was responsible for all aspects of human-centered design and improving the experience for patients, families, visitors and staff. During her tenure she created three progressive culture-change programs culminating in the transformative “Caring People Caring For People – Welcome. Listen. Care.” workshops. Currently she is consulting for healthcare systems and progressive healthcare technology firms.

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Does Response Rate Impact HCAHPS Scores?

Posted By Hope Brown, Monday, August 27, 2018
Updated: Monday, August 27, 2018

Proactive hospitals always strive to improve patient experience, knowing that the best way to obtain this valuable feedback comes directly from patients, relying on surveys to create measurable results to continually improve hospital practices. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is one metric used to gain this valuable insight from patients. The key for this prized patient insight is to ensure that a reliable number of patients provide survey feedback. Response rate refers to the number of patients who responded to the survey, in relation to the total number of patients in the sample.

A quick review of HCAHPS publicly reported data shows the national average response rate has dropped since the initial program implementation. The average response rate in 2008 was 33%, compared to 28% in 2016. The decrease in response rate shows that today’s hospitals are receiving valuable feedback from a smaller percentage of their total population.

Why worry about response rate?

CMS stressed the importance of response rate to measure reliability in their April 2018 podcast highlighting ways to improve response rates. The Hospital Quality Institute (HQI), California HCAHPS Improvers Playbook identified a relationship between California hospitals’ response rates and HCAHPS scores. In addition, a nationwide in-depth analysis of the July 2016 - June 2017 publicly reported HCAHPS data found a correlation between all HCAHPS dimensions and response rate.

This table shares the correlations found in the nationwide analysis of Hospital Compare data. A correlation value is a number between -1 and 1. A positive relationship indicates that when one variable increases, the other measure is likely to increase as well. As you can see in this table, correlation values range from .310 - .506, exhibiting a moderate-positive relationship. As a practical application, for every in 1 point increase in response rate a hospital achieves, the hospital could expect to see an increase of .501 in their Overall Rating score. 

 

With the possibility of all HCAHPS dimension scores increasing in relation to response rate, this has the potential to impact Value-Based Purchasing (VBP) reimbursements as HCAHPS dimension scores are associated with VBP points and Medicare reimbursements. 


These values surprise even the most astute industry leaders; this relationship would be unlikely if feedback was received from a truly representative sample. Just as an increase in response rate is correlated with an increase in dimensions scores, the converse has been found—when response rate decreases, dimension scores tend to decline as well. This research suggests hospitals with low response rates may not be getting the best representation of their total population, negatively impacting their HCAHPS scores.

With recent research in mind, it’s critical that hospitals consider the importance of response rate to capture the true patient experience at their facility. Increasing and maintaining response rates allow a hospital to receive patient feedback on topics that matter most to patients, and allow for more accurate score in HCAHPS dimensions.

Since joining PRC in 2000, Hope has applied her expertise in statistical analysis, physician studies, and patient experience to help clients use data to improve customer service and achieve market leadership. She is recognized as a leading consultant to hospitals and health systems seeking to leverage best practice models to maximize Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Her skills in executive training and physician engagement, and her deep-seated knowledge of multiple product lines, round out a broad base of experience that has enabled her to contribute significantly in a number of key roles at PRC. Hope earned a Bachelor of Science degree in Biology from Trinity University in San Antonio, Texas.

Tags:  HCAHPS  response rate  survey  Value-Based Purchasing 

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The Patient Experience Blind Spot. Three Ways to Fix It.

Posted By Dan Peterson, Tuesday, August 21, 2018
Updated: Tuesday, August 21, 2018

What blind spot?

Simply stated, the patient’s financial experience. With patients on the hook for higher deductibles, larger copays and growing out-of-pocket costs, many are more concerned about the cost of care than their health itself. This reality is affecting whether people seek care and their satisfaction with the experience when they do.

Depending on the research you subscribe to, including this study published by WestHealth earlier this year, anywhere from 44%-64% of covered Americans are avoiding care because of concerns about cost. Whether due to an inability to meet their high deductibles or uncertainly about how to afford treatment, more and more patients are foregoing care entirely. The consequences for longer-term health and cost outcomes can be dire – for patients and the providers that care for them.

Among those who do seek care, many cite dissatisfaction with a host of financial matters including: 1) The lack of pricing transparency to make informed decisions, 2) Little or no access to payment planning to improve the affordability of care, 3) Confusing, inconsistent billing and 4) Cumbersome payment processing. Alone and together, these points of friction in the patient’s financial experience have a detrimental effect on their overall care experience.

A problem for patients. A problem for providers.

Patients aren’t the only ones feeling the pain. Providers are impacted by rising patient balances, high collection costs (including patient bad debt) and frustrated population health initiatives. Additionally, we hear from staff and clinicians that financial matters contribute significantly to difficult patient encounters. The patient financial experience is a phenomenon that can’t be ignored. It’s created a new and growing class of patients-as-consumers. Consumers who are looking for care and value they can afford. This emerging demand is opening the door for competitors with new, potentially disruptive, care delivery models. Loyale Healthcare CEO Kevin Fleming addresses this very issue in a recently published blog post and video titled Adapting to a Changing Healthcare Playing Field.

Providers now find themselves in a situation that didn’t exist when most of their revenue came from payers – that of having to compete for the business and loyalty of their patients. And they’re competing in an environment conditioned by their patients’ experiences with companies like Amazon, Apple and Zappos. Increasingly, the providers that meet these expectations are the ones that will thrive in healthcare’s consumer age.

Three ways to fix the patient experience blind spot

  1. Measure patients financial experience satisfaction. Most providers rely on HCAAHPS survey results as the definitive reflection of their patients’ satisfaction. But these clinically-focused metrics overlook the financial dimension of care. As with any important strategic objective, routine intelligence-gathering in the form of patient surveys and data analysis should be conducted to establish benchmarks and set goals.
  2. Innovate. Enlightened healthcare providers are making investments in technology and reengineering processes to illuminate the patient financial experience and continually identify and correct the gaps. These organizations are recognizing that the patient experience begins long before diagnosis and treatment and lasts ‘til well after. Consequently, they approach the challenge holistically, from end-to-end.
  3. Personalize. Unlike institutional payers, patient-payers behave in wildly different and difficult to predict ways. Using predictive analytics technology, it’s possible to segment patient populations using a wide variety of inputs to deliver financial experiences that are satisfying for patients and revenue-positive for providers.

The Patient Experience movement championed by The Beryl Institute, its members and other industry advocates is a critical catalyst for important and positive change. Let’s make the patient financial experience a part of the communication. Let’s fix the blind spot.

Dan Peterson, Chairman and Founder of Loyale Healthcare (2016), is a serial entrepreneur with a passion for solving seemingly intractable organizational challenges with user-centered digital solutions. Previous ventures include CashNet (1990), a financial platform serving complex, multi-facility environments in higher education and ePAY Healthcare (2010), a pioneer in the development of online patient and provider experiences to improve patient service and provider financial outcomes. Mr. Peterson continues to serve on a number of technology company boards and is a sought-after authority on technology and innovation.

Tags:  billing  financial  payment processing  pricing transparency 

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The Clinician Progress Note as a Tool for Improving Patient Experience

Posted By Jeffrey H. Millstein, MD, Friday, July 20, 2018
Updated: Monday, July 16, 2018

Earlier this year, our practice was asked to become part of a project enabling patients to view our progress notes along with other chart elements via our online portal. My initial reaction to this was curious, and a bit defensive, as was the case for my colleagues at our site. Don’t progress notes belong to us, the providers? Why should we have to share our tool?

In large scale studies, patients report feeling a greater sense of control over their health with this element of transparency. This is a continuation of a national movement toward greater patient autonomy and collaborative care which began with the creation of the “Patient Bill of Rights” in the 1970s. With the momentum unlikely to change in the foreseeable future, the question then becomes: do we resist this, or embrace the change? Making this win-win means re-evaluating the purpose and potential of our notes.

Until recently, I viewed progress notes as serving three purposes: documentation of what transpired during the visit and thoughts on diagnosis and treatment, providing information for colleagues reviewing the chart, and determining level of service for billing. Making shared notes most effective requires reframing our notes as primarily serving the interests of education, improving safety and reinforcing a caring connection. These are already a part of our core mission in patient care, so we can leverage our notes to those ends. They will still fulfill the other traditional goals, but with a shift in priority.

It has been demonstrated that patients often retain little from their office visits, which causes concern about safe adherence to prescribed regimens. Shared notes, along with teach-back, offer a strong opportunity to reinforce clinical plans. It requires adjusting our documentation style a bit, with some effort to avoid language that may be viewed as disparaging, clarify instructions and avoid abbreviations the patient may not understand. I have seen some providers create a separate section at the end of their notes titled instructions, beneath which are clear directions written specifically for the patient. I like to conclude my visits with a reminder, “Mr. X, remember that you can go on the portal and see my notes. If there is anything you forget about our plan, the notes are available for your review.”

There is no question that the EHR is a source of frustration, and a core contributor to clinician burnout. I will not mourn if someday I am able to delegate more EHR keystrokes to another care team member, but I view shared notes as an extension of my connection with patients. I can still view my notes as my own tool, but one which I choose to share in the interest of taking better care of people. Further, if my notes are collaborative in nature, then I can engage my patient while writing them, making the EHR less of a barrier. While there is a little extra up front effort, my patients may be safer and better informed. Who knows? It may even cut down on some after-hours calls and messages. Imagine that.

Jeffrey Millstein, MD is a practicing internist, and physician champion for patient experience at Clinical Care Associates of Penn Medicine.

Tags:  charts  Electronic Health Records  Patient Experience  patient records  providers  transparency 

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Exploring Outside the Healthcare Silo

Posted By Sara Laskey, Friday, July 20, 2018
Updated: Monday, July 16, 2018

Silos. We talk about them all the time in our healthcare systems. We talk about how much easier it would be if we could break down the silos or work across them. We talk about this because we know that when we collaborate and learn from each other we create an experience that is easier for providers and better for patients and families.

But, even we in the experience and engagement world can find ourselves working in our own silo. As healthcare experience leaders, we work in one of the largest ‘customer service’ systems in the world, but how often do we wander outside of healthcare to explore how other industries are managing and dealing with what are often the same types of issues that we deal with daily?

Yes, I know, a bad fitting shoe is not a broken arm, and a missed airline connection is not the same a missed diagnosis. However, many industries deal with lots of consumers in various states of emotional distress and anxiety (think airlines), regulations (banks, insurance) and strive to meet the needs of those customers in ways that we in the healthcare space could learn from.

Recently, I had the opportunity to participate in the Consumer Loyalty Forum. This was an interactive 2-day session of high-level customer experience executives from organizations including MasterCard, Etsy, Hilton Hotels, Ally Bank, DFW Airport, Stratifyd, Hallmark, AARP and representing healthcare – me, from The MetroHealth System.

My key takeaways to share:

Voice of the customer:

We hear from our patients through many sources: surveys, complaints and grievances, social media, posted reviews. For all the data we have, how well are we collecting, analyzing, understanding and applying this information in a meaningful way? Many organizations are using tools that bring all this information together in ways that look not only at the sentiment but at the volume of the sentiment. They try to use the where/what/when information to help determine top issues for their organizations and drive change. By bringing everything together into a ‘single source of truth’ it becomes easier to quantify what customers’ top issues are. For a healthcare system this can be very meaningful.

I came back and looked at the top three issues from my System’s complaints and grievances in 2017. Then I looked at the top 3 negatives comments from my surveys during the same period. Not only were 2 of the 3 different, there was a 10X difference in the volume of issues brought up in the surveys. (800 complaints about communication; 8,000 complaints about wait times). While I absolutely addressed the communications issues – my process improvement goals will focus on wait times. This also ties in directly with the strategic goals for my organization.

User Journey Mapping:

If you aren’t doing this - you should be. Identify any area of your system where you want to improve the experience and work with an organization to better understand the highs and lows of the user journey from every angle. It is the true basis of human-centered design and a key element of knowing where to focus energy, time and dollars.

Low effort:

Customers are drawn to the effortless experience. Each of the two above concepts help us understand where people using our systems are expending the most effort to obtain our care. The goal for many of the organizations at the conference was to create experiences that decreased effort and increased the engagement of their customers. Healthcare is well-positioned to do the same. As we know, so many things about being a patient are hard, obtaining care shouldn’t have to be.

I had much to learn from these experts from other industries and believe I had a thing or two to teach.

I was pleased to share that healthcare has key learnings to teach other industries as well. We have done a remarkable job in developing and spreading the culture of human beings caring for human beings and the idea that we are ALL the patient experience. The fundamental concept that everyone involved in the healthcare system has a role to play in implementing and managing an easy and effortless experience was one I could share with my customer experience colleagues. One I am hopeful they will take back to their teams.

Dr. Sara Laskey was the inaugural CXO for The MetroHealth System in Cleveland Ohio. In that capacity she was responsible for all aspects of human-centered design and improving the experience for patients, families, visitors and staff. During her tenure she created three progressive culture-change programs culminating in the transformative “Caring People Caring For People – Welcome. Listen. Care.” workshops. Currently she is consulting for healthcare systems and progressive healthcare technology firms.

Tags:  communication  healthcare industry  improving patient experience  journey mapping  silos  wait times 

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Phone Skills: Making or Breaking The Patient Experience

Posted By Sarah Suddreth, Friday, June 22, 2018
Updated: Tuesday, June 19, 2018

A patient’s first interaction with a healthcare organization sets the tone for his or her overall experience. In fact, it only takes two negative phone experiences to diminish a patient’s view of his or her healthcare provider1. In non-emergent situations, the patient’s first touch is most often a phone call. Since the patient experience begins on the phone, your staff’s ability to consistently execute on every patient call is crucial.

Why?

Just think about the ease of today’s landscape: We order groceries to our doorstep, request cars from our couch to take us virtually anywhere and have prescriptions refilled by pressing a button. Almost every task is performed over the phone; we are increasingly turning to our handheld devices to fulfill our wants and needs.

Your patients expect the same ease and accessibility when scheduling an appointment or interacting with your healthcare organization at all. Let’s give them the most optimal patient experience every time that phone rings. They deserve it.

What should scripting look like on a patient call?

1. Identify yourself and your health system or practice.

  • “Thank you for calling [Your Provider Name], this is [Your Name], how can I help you?”
  • Assert that you can help and collect the caller’s information.
  • “I can help you out with that. Whom do I have the pleasure of speaking with?”
  • Ensure that you refer to the caller by name throughout the conversation to establish rapport and a personal connection.

2. Knowledgeably answer questions and collect necessary information. 

  • Be prepared to confidently obtain information and answer questions regarding:

    • Accepted insurances
    • Cash discounts or payment plans
    • Services offered in office
    • Schedule availability for particular services
    • Doctor availability
    • Consultation / initial exam price (for emergent care)
    • Address and hours

  • When someone calls in asking questions, that caller is likely looking to book an appointment. After obtaining all needed pre registration information, request the appointment. If the patient’s answer is yes, offer at least two different appointment times. “Is morning or afternoon better?” “Morning, great! I have an appointment available at 9:30 Wednesday or 8:00 Thursday. Which do you prefer?”

3. Provide the Optimal Patient Experience

  • Increase your appointment show rate and set the caller’s expectations for next steps. “We have you down for 8 a.m. on Thursday. Be sure to arrive 15 minutes early to complete initial paperwork. Do you know where our office is located?”
  • Let the patient know what’s to be expected upon arrival for the appointment, such as check-in steps or needed documentation for the appointment. This is also a good time during the call to discuss payment expectations. Increase your cash collections by articulating what the patient should expect to pay, or collect it over the phone.
  • When wrapping up the call, provide instructions for what the patient should expect to happen next. If he or she will be contacted by another individual to confirm paperwork and financial responsibility prior to the visit, make that known. Finally, do a self assessment. Did the patient feel at ease? Did you receive the necessary documentation and payment information? Is there anything that needs to be looked at again?
  • “Thank you so much for calling XYZ Health System. We look forward to seeing you on August 8 at 11:15 a.m. Be sure to bring your insurance card and desired form of payment with you. Is there anything else I can help you with today?”

Proper usage of scripting on calls is homologous with an unparalleled patient experience. It puts patients at ease and strengthens provider-patient care. Having said that, for a health system to offer that white glove experience for patients calling in, there needs to be constant feedback on key performance aspects of every phone call, rather than just a sample call size. Other than scripting, what is your health system doing to monitor and enhance the patient experience on every single patient call?

1. “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.

Tags:  calls  communication  patient experience  scripting  technology  telephone 

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Re-centering Our Attention on Clinical Excellence

Posted By Kelly Parent, Wednesday, June 20, 2018
Updated: Tuesday, June 19, 2018

“Unless someone like you cares a whole awful lot, Nothing is going to get better. It's not.” - Dr. Seuss

If your health care organization is anything like the ones for which I have worked, you have been exposed to a myriad of philosophies, principles, and tactics (i.e., service excellence, patient/person and family centered care, patient and family engagement, relationship-centered care) that seek to define a culture that achieves optimal patient and family outcomes and experiences through the creation of trusting and empathic relationships, effective communication tactics, and patient and family engagement and activation. There is compelling evidence for the value of such efforts, for they have been shown to improve clinical outcomes, decrease harm events, reduce litigation, and save health care dollars.

However somewhere along the way, the health care industry has become a bit preoccupied by “the test,” viewing the patient experience largely through the lens of patient satisfaction scores. Somewhere along the way, we have allowed ourselves to transpose the patient experience with the customer experience as incongruously defined by hotel standards. We are spending large amounts of time (and money) focusing on a number instead of a person, reacting to mismanaged expectations, and trying to surpass our competition by offering gourmet food, fancy wait space amenities, and concierge services. It is time to get back on track re-centering our attention on clinical excellence. We must re-focus by respecting the needs and perspectives that patients and families bring to the table, communicating with them in ways that are understandable and affirming, welcoming and encouraging their participation in care planning and decision making, and evaluating success in meeting goals of care.

“It's not about what it is, it's about what it can become.” - Dr. Seuss

Fifteen years ago, my family was thrust into the world of doctors, hospitals, fear, and pain when our daughter was diagnosed with a serious illness. Being health literate, we were relatively well positioned to navigate this complex world, for we understood medical jargon, knew how to get answers to our questions, and most importantly, grasped the importance of becoming an active member of her health care team. However despite our confidence, knowledge, and skills, at times we were too vulnerable, too intimidated, and too exhausted to comprehend every conversation, engage in every discussion, and speak up every time that we were unsure. We learned to appreciate the staff who took the time to see where we were (sometimes with needs changing from shift-to-shift) and adapt care tactics accordingly. During highly emotional and difficult times, we needed staff to take care of us and do things “to and for” us. At other times, we needed to be fully present, engaged, and activated to partner “with” our daughter’s providers to make decisions and learn how to manage her care at home, and we always needed staff to know our daughter, the little girl, and not just our daughter, the illness.

My daughter’s illness turned out to be my training ground to become an advocate for patient and family centered philosophy and culture and create institutional readiness for patient and family partnerships. Over these past twelve years, I have learned that patient and family centered care is the way to achieve optimal outcomes and experiences, but to accomplish culture change it takes all of us:

  • We must commit to finding our passion to care for those who come to us at their most vulnerable needing us to provide emotional, spiritual, and physical support.
  • We must remember that unless you ask, you have no idea what patients and families fear most.
  • We must commit to creating and sustaining a culture of teamwork, trust, and compassion welcoming our patients and families as full members of their health care team.
  • We must remember that no one knows more about our patients than the patients themselves and their families.
  • We must commit to welcoming family presence and participation across the care continuum.
  • We must remember to acknowledge family expertise and point out strengths.
  • We must commit to providing transparent, understandable, and timely access to medical information and coordinating care and communication across all settings.
  • We must remember to explain “why” and teach “how”.
  • We must commit to respecting and encouraging patients and families to speak up if something does not feel right.
  • We must remember that what is routine for you is far from routine for patients and families.
  • We must commit learning what matters most to patients/families.
  • We must remember to truly listen.

“Today I shall behave, as if this is the day I will be remembered.” ― Dr. Seuss

Kelly Parent has twelve years’ experience leading patient and family engagement efforts across clinical, education, research, and quality/safety initiatives. Kelly started as a Family Advisor, served as PFCC Program Manager at a large academic medical center, worked as a PFCC educator and consultant, and is currently the Vice President for the Patient and Family Experience at Beaumont Health System.

Tags:  patient and family engagement  patient centered care  patient experience  service excellence 

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Techniques for Bringing Compassionate Communication to Telehealth Interactions

Posted By Anthony Orsini, D.O., Wednesday, May 16, 2018
Updated: Wednesday, May 16, 2018

One of the hottest topics in medicine today is the continued growth of telemedicine.

According to a survey by Jackson Healthcare, Telehealth is expected to grow in the U.S. by 27.5%, reaching $9.35 billion by 2021. It is estimated that by the end of this year alone, the number of patients using telemedicine services will reach 7 million, with 44% of private practices making the development of telemedicine services, their number one priority. This approach is especially popular in rural areas where accessibility to physicians can be difficult.

As an increasing number of patients choose telemedicine as a more convenient option than emergency or urgent care visits, the challenges that physicians and other healthcare professionals face to build relationships with patients have become even greater.

The communication techniques healthcare professionals use to build trust are even more important during physician-patient video conference calling. The impersonal nature of communicating via screen amplifies the need to focus on communication techniques that build trust between the physician and patient. Without trust in their healthcare provider, patients are less likely to follow their treatment and have poorer outcomes.

Healthcare providers can use the following communication techniques to build trusting relationships with patients during telemedicine visits:

  1. Give the patient your undivided attention - It is easier to forget during videoconferencing that the patient is watching and interpreting your body language. Remember that 70% of all language is non-verbal. Take limited notes during the conversation. Writing or entering data in the EMR (electronic medical record) during conversations is perceived as multitasking and not interpreted by patients as being thorough. Be aware of your facial expressions. Since the patient cannot see your body positioning, he/she will be watching you even more closely than if you were in the same room. Your facial expressions can either be interpreted as compassionate, disinterested or rushed. The perception of eye contact can be felt even through video.

  2. Remember that each interaction with a patient is a conversation and not an interview. Don’t interrupt or ask follow up questions before the patient has finished speaking. Patients are even more sensitive to the feeling of being rushed during telemedicine. It is very important to let them feel that even though you may not be in the same room, they are the most important person to you at that moment.

  3. Be a genuine person. Although healthcare professionals will often be video conferencing with patients they have never met before, there is still an opportunity to form a trusting relationship in a short period of time. Today’s patient wants to interact with their healthcare professional on a personal level. Avoid the “all business” attitude. Relate on a personal level. Ask the patient where they are from and find a common interest if possible to help form that relationship.

By all accounts, telemedicine will play a large part in the future of healthcare. It has the potential for dramatic cost reduction, increases in healthcare accessibility and improved patient satisfaction. It should not be a replacement for the strong relationship between a patient and his/her healthcare provider as that is critical to any healthcare visit. By learning proper techniques in compassionate communication, healthcare providers can build relationships even through video conferencing.

Dr. Anthony Orsini, Founder and President, BBN, is a full-time neonatologist and expert in compassionate communication in medicine. He is currently the Vice-Chairman of Neonatology at Winnie Palmer Hospital in Orlando, FL. He also serves as the President of BBN, the organization he founded in 2012 that offers training services to educate professionals in the art and science of compassionate communication.

Tags:  access  communication  improving patient experience  physician  telemedicine  trust 

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A New Framework for Putting Patients at the Center of Digital CARE

Posted By Niall O’Neill, Tuesday, May 15, 2018
Updated: Wednesday, May 16, 2018

"Oh great." I hear you say. Yes, this is another article about consumerism in healthcare. McKinseyForbesDeloitteNYTimesHarvard Business Review, you name it – industry leaders and commentators have all called this trend in recent years, and consumerism was a hot topic at HIMSS. But the truth is, this conversation started at the turn of the century.

A long, long time ago, in the year 2000 AD...

The Institute for the Future made some alarming projections about healthcare. They identified early connections between healthcare spending and consumerism.1

 

Patients

 

Consumers

Passive recipients of care

Actively making choices about care

 

A healthy economic market requires competition, and therefore, informed and engaged consumers empowered by choice. Other industries like retail, travel and technology2 have adapted rapidly, and consumers expect the same in healthcare services.

This isn’t about Siri replacing your primary care physician or Amazon’s robot surgeons replacing hips at Whole Foods. While we might get there one day, let’s dim the science-fiction fantasies for now and focus on the present reality.

We need a simple framework to drive today’s digital solutions so we can adapt quickly to healthcare consumerism, put patients at the center of care, and create a meaningful, interoperable platform to enable the future. Solutions for this new landscape must adhere to four fundamental principles of digital CARE:

  • Convenience
  • Accessibility
  • Relationships
  • Empowerment

Convenience

Once upon a time, patients may have had one choice - the community hospital. With the ongoing consolidation in the US market, super-systems now compete regionally for consumer loyalties.

Today, consumers have a choice, and are influenced by the same drivers as other industries – a need for convenience and responsiveness.3 When we look at the evolution of digital tools like smartphones, convenience drives us.

A zero-friction customer service model isn’t just “nice to have.” It’s absolutely necessary for acquiring and retaining consumer relationships. For patients, particularly those with ongoing care needs, convenience will reduce the burden of these interactions.

One technique is to map the consumer’s journey, starting from the point at which they have a need for care. Try thinking from the user’s vantage point. Even if a process works well for you and your staff, it may not optimally address your consumers’ (or their families’) needs. When we walk in our consumers’ shoes, we better understand what they are thinking and feeling, and can identify new opportunities for improvements.

Only when you understand your opportunities for improvement should you identify digital solutions.

When you can anticipate your consumers’ needs and think holistically about their interactions with your organization across multiple channels you can design personalized solutions that make it easy for them to get the information and communication they need, at the right time, in the right way. Reduce the friction, make it easy for your consumers.

Accessibility

Ron Mace, founder of the Center for Universal Design has defines Universal Design as the “design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.”

To achieve this, involve as many consumers as possible in your design process. Connect with patient leaders through Patient Advisory Boards, or through organizations like WEGO Health and the Savvy Coop. Ask them to share their stories, and let them shape your diverse, realistic user personas. For those who don’t speak software, that just means your consumer experience must work for everyone, even outliers. Real life is messier than fiction, so let them inspire you to test your design in ways you wouldn’t have otherwise. And remember, your consumers speak many languages – emotionally, culturally and literally. Will everyone know what to do? Feel understood? Heard?

Technology creates new possibilities for accessibility.

Relationships

It is the best of times, it is the worst of times. Providers that meet or exceed expectations will gain and sustain relationships with consumers. Sounds great if you’re a consumer, but do providers have the time to be heroes?

They do if you leverage technology to automate their routine administrative and clinical tasks, so they have time to spend enriching patient interactions. Look for tools that enable them to focus on care and the interpersonal relationship, rather than data entry.

But remember, technology can do A LOT more than automate. Think of a time when you talked to an old friend living 10,000 miles away, or followed a new friend on Instagram because they had the best kitten memes...we are delighted in these moments. Can you foster the same humanity between doctors and patients using technology?

Digital tools have the power to improve communication in our relationships and foster partnership among consumers and caregivers. Today’s open, secure platforms for video and text-based dialog with “carers” (providers, family, friends) allow consumers to access care, share preferences, ask questions, and make shared medical decisions in the hospital or at home.

Empowerment

Knowledge is [em]power. *Knowledge (noun), the application of information through actions. We need to transition from information-sharing to knowledge transfer.

Patient portals are the standard patient engagement tool, thanks to Meaningful Use requirements. They give patients a view of some data captured in an EHR, but in many cases that information lacks context or helpful next steps about disease management. It’s not actionable.

Tools that empower consumers impart knowledge to facilitate self-care, give context and ensure that patient preferences, fears and motivators are factored into a longitudinal plan of care. We live in an exciting time for innovation in healthcare, and I believe that digital technologies can help truly put patients at the center of CARE.

1.  https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/debunking-common-myths-about-healthcare-consumerism

 

Niall O’Neill is the Vice President of Business Development at Oneview Healthcare, a health technology company focused on improving the experience of care for patients, families and providers. Based in Dublin, Ireland, Niall turned to healthcare after over a decade of management consulting in other industries with Accenture and Deloitte, driven by a belief that technology can make healthcare better for all.

Tags:  choice  Consumerism  patient experience  relationship  technology 

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