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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, contact michelle.garrison@theberylinstitute.org.

 

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

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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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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How Much Does Culture Matter in Today’s Healthcare Environment?

Posted By Katie Owens, Monday, April 17, 2017
Updated: Wednesday, April 12, 2017

What is culture? Culture can consist of many different elements in healthcare. From the way things are done in the organization. The shared relationships among people which dictate how they behave. To a set of shared beliefs and values. Each belief (while uniquely described by many) universally acknowledges that culture is an important part of the fabric of their organization.

Despite the fact that many people have conviction that organizational culture will either enable an organization’s success or serve as a barrier to achieving outcomes, sometimes broaching the subject of Culture can cause leaders or front line team members to shy away. Culture can feel messy, hard and inconvenient. We may be proud of some aspects of our culture but disappointed in others. Our team sought to find evidence outside of anecdote and theory to help leaders understand the role culture plays in creating excellence. That query led us to conduct our recent study demonstrated that culture does impact outcomes. The two big learnings we had conducting our study published in the Journal of Healthcare Leadership is that:

First, high performing cultures are more likely to do better than low performing cultures on key balanced scorecard metrics: Employee and Physician Engagement, Patient Experience, Value-Based Purchasing and Turnover. These cultures did not outperform by a small margin but a margin of magnitude and statistical significance (see Video on Culture Imperative). In other words, our team found that culture is not “nice to have” but critical to create demonstrable outcomes.

Second, engaging your employees in your culture is the most powerful step to create positive results. Your workforce is the lifeblood of your organizational culture: their engagement, relationships with leadership and each other and commitment to your mission. We found four key levers that are more likely to support achievement of outcomes:

  • The extent to which patients are treated as valued customers.
  • You find that your values are very similar to the values of this organization.
  • You feel that being a member of this organization is very rewarding.
  • You are proud to be a part of this organization.

There is no question healthcare leaders, staff and physicians are perservering day in and day out to provide the very best care to patients despite a myriad of challenges. Our teams are craving cultures that give them a sense of purpose and joy. As we work to create a “new normal” that equips our organization to provide person-centered excellence across the continuum of care, our findings indicate that leaders should pay attention to culture and actively steer workforce engagement to create employee pride, a focus on the customer and shared values.

Katie Owens, MHA is Vice President of HealthStream Engagement Institute, a HealthStream Company. Katie is a highly regarded thought leader in the healthcare industry who is a national speaker, executive coach and facilitator of leadership. Katie is founder of Lumen, a monthly podcast dedicated to shining a light on the bright spots where excellence happens in healthcare. KatieOwens.org

Tags:  culture  employee engagement  improving patient experience  metrics  physician engagement 

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Bedside Shift Report from the Patient’s Perspective

Posted By Brooke Billingsley, Friday, March 17, 2017
Updated: Wednesday, March 15, 2017

Patients spend little time thinking about the nurse’s list of tasks to complete. They aren’t aware of the excellent job their nurse did charting their care, how staff made sure safety precautions were adhered to or what it took to provide a meal on time. 

Patients are functioning on an entirely different level. They are focusing on what they can control – which is very little – and how external forces are making it easier or harder to achieve their goals of getting better and getting out of the hospital. What registers with patients is ‘touch’ – those memorable moments in which staff made a genuine effort to connect with patients.

A positive transformation occurs in a patient’s perception of their care when touch is added to a task. That is certainly true with the Bedside Shift Report.

The BSSR is often misunderstood because it is seen as time consuming, does require effort, and for some, is uncomfortable. But the BSSR must be seen from the patient’s perspective to be fully appreciated. The benefits and value to the patient far outweigh the arguments against. 

Consider what the patient sees when a fully functioning Bedside Shift Report is conducted:

  • The BSSR allows patients to hear and physically experience how committed the organization is to their care and illustrates how unique and important their case is.
  • Patients are very conscious of how staff interacts with one another through conversations and body language. The BSSR presents an opportunity to show unity and camaraderie, which patients ultimately associate with good care.
  • Staff has the opportunity to give patients the assurance that they will receive the same great care from the new nurse as the previous nurse. It also increases the chance for mutual praise and promotion of the rest of the team.
  • Because the Bedside Shift Report is not a patient expectation (they are not likely to say, “Hey, I think I should be in on that get together in the hallway,”) the act itself is (novel) and memorable lending itself to increased satisfaction.
  • The BSSR demonstrates that time spent with the patient has value, which in turn shows respect for patients and their participation.
  • Adding some personality to the process completes the recipe for a guaranteed touch opportunity.

There are a few additional things you should consider in making the transition to a Bedside Shift Report a successful one.

  • Have a plan to determine what would be most beneficial for the patient to know and work out the details of the information exchange.
  • Practice until it feels comfortable. In time this should become second nature.
  • Communicate in a way that is most understandable to the patient.
  • If the patient is not able to participate, include family if they are present.

And finally, when you formally conclude your time with your patients, the BSSR shows that you care enough to say good-bye adding touch to a required task.

Brooke Billingsley is the CEO at Task To Touch™ e-Learning & Perception Strategies, Inc. a healthcare perception research company. Brooke is a speaker, consultant and author.

Tags:  bedside shift report  communication  improving patient experience  our  perception 

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Reflecting Back on The Patient Experience

Posted By Hannah Doty, Tuesday, November 18, 2014
Updated: Monday, November 17, 2014

People often talk about being deeply affected in their adult lives by experiences in their childhood—For example, if you had a bad experience with a dog, you may be afraid of dogs. Or if you had an amazing teacher in third grade, you’ll always remember her and the book she read to you. This same sort of lasting impression is made on kids who are hospitalized for long periods of time. In this respect, the pediatric-patient experience is extremely important since it can affect not only the healing process, but how a person views encounters with health professionals for the rest of his/her adult life.

The hospital is a microcosm—often the only world a child knows if they aren’t able to go home or attend school for long periods of time. A child who is hospitalized will not refer to that time in their life as their "Hospital Experience,” but rather their LIFE experience.

As a childhood cancer survivor, I now find myself reflecting on that time in my life to determine how it has impacted me and shaped me as an adult.

Overall, I believe my experience as a patient was more positive because my parents were actively involved in making sure I could continue to be "me” while in the hospital. I never felt like my identity was "Cancer Patient.”

Part of "me” was drawing and doing art projects. I often shared my artwork with doctors and nurses and involved them in my projects when I could; I asked the nurses and doctors to sign my scrapbooks, take pictures with me, and look at my drawings. I was able to create personal moments with medical staff through my own initiative and these moments helped me to cope much better.

Looking back, I think there were also missed opportunities. If all encounters with medical personnel could have started with a real interest and curiosity about me – Hannah – and not my disease, I wonder how much more positive those daily interactions would have been for all involved. I think I would have been more cooperative in some trying times rather than thinking, "I don’t like this person.” Or even worse: "I’m not going to tell them what hurts.” For children less expressive and/or outgoing than I was, the need for doctors and others to actively pursue genuine non-medical interest seems even more crucial for the best patient experience and outcomes.

Medical professionals who interact with children in the hospital are in many ways substitutes for the other people who are normally in a child’s daily life: teachers, classmates, friends, coaches, etc. As an important person in a child’s life, a doctor/nurse affects how a child views himself. This role is probably not one that a medical professional thinks about – their main job of course is to help a child get well. But when a health professional takes the time to initiate and share a personal moment with a child (discovering a common interest, sharing a joke, drawing together, etc.) there is a tremendous impact not only upon the child’s current health and experience, but upon his/her sense of self and long-term attitudes toward the medical profession.

Because these moments meant so much to me, I strongly encourage medical professionals to consciously create "me moments” with children in the hospital. I believe in doing so, everyone’s experience will be greatly improved and the positive impact will last a lifetime.

Hannah Doty is the founder of V.I.P. Hospital Productions—an organization with a non-profit branch that creates customized entertainment to enhance the experiences of hospitalized kids and promote positive interactions with their medical team.

Tags:  children's medical experience  improving patient experience  patient  patient experience  pediatric  perspective  physician communication 

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