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The Penn Medicine Experience: Improving the Patient Experience Through Leadership Alignment, Innovation and Skill-Building
What was the challenge, opportunity or issue faced?
At Penn Medicine, our HCAHPS scores, Press Ganey outpatient scores and qualitative patient feedback did not equate with our top-rated clinical outcomes. Value-based purchasing, along with significant variations in data literacy, behavioral expectations and manager skill sets encouraged opportunities for improving the patient experience and the broader organizational culture. We wanted to improve the patient experience as a leadership priority and as an effort to shift the organizational culture, with a strong message to our staff that we all cared about the patient. We began using the "patient experience” language and thinking through the problem statement with the "voice of the patient.”
What did you do to address it?
A design team of internal experts, front line employees and patient advisors created the Penn Medicine Experience program to equip health system employees with tools and skills to provide a consistent, high-quality experience – at each facility and unit, with every patient interaction. The program includes course work for the managers and front line employees, as well as 1:1 simulations with standardized patients, structured to provide individualized coaching and professional development. All employees on a unit participate (cross-role) to enhance the team’s focus on a unifying goal. We decided to launch this program first with ambulatory practices in 2012, followed by inpatient units in early 2013.
Our program is unique with its focus on simulation and use of standardized patients. Using Studer’s AIDET model, we encourage employees to build customized and personal scripts to introduce themselves to the patient, use their name, provide an expected duration, explain their role and activities and thank them for visiting Penn Medicine. Our classroom program brings AIDET to life with standardized patients demonstrating the desired behaviors in the classroom. After the formal training class is completed, each employee participates in a one-hour, one-on-one simulation and coaching experience with a standardized patient. The inclusion of these learning approaches creates a realistic environment in which employees practice skills, collect real-time feedback and better retain classroom content. The feedback from the simulation is designed with a competency-based rating scale and is then shared formally with the employees as well as their managers.
Penn Medicine has also greatly benefited from the consistent and unwavering support of its Executive Leadership team. Penn Medicine’s Executive Director for the Clinical Practices of the University of Pennsylvania since 2004, has been one of these leaders who helped initiate and champion the program and continues to oversee initiatives to sustain momentum around improvements in scores across the health system.
What were the outcomes?
The model has been highly successful in the Penn Medicine outpatient practices, which resulted in a 49 percentile point improvement in their "Likelihood to Recommend” scores from the period of April 2012 to December 2014. This effort represents our organizational commitment to improving transitions in care, and ensuring consistency in patient experience, leader engagement and communication skills in both outpatient and inpatient settings across our health system.
Since 2012, the Penn Medicine Experience initiative has touched over 4,000 front line employees and managers across our health system. Using a consistent approach, we are making significant strides in implementing a strategy that supports a patient-centered experience and matches superior clinical outcomes across the care continuum.
Key principles that validate the success of this initiative include:
- Strategic Alignment – Support organizational goals and integrated efforts in improving patient centered care outcomes with a unified approach that spans across all health system entities and outpatient practices
- Leadership Engagement – Course pre-work and action-oriented approach for clinical directors and patient care managers prior to implementation at unit level
- Innovation in Education – Use of standardized patient simulations to build employees’ confidence in applying classroom skills, and receiving coaching and performance feedback
- Sustaining the Gains – Organizational Commitment & Support – Commitment for 5 hours of dedicated education time for all front line employees across organization; support for unit rounding and reinforcement
Overall, the organizational strategy to improve the patient experience with a unified approach transcends our unwavering commitment to advance patient outcomes through care excellence.
About Penn Medicine
Penn Medicine is dedicated to high-quality patient care and service, advancing medical science through research, and educating the next generation of leaders in medicine. It includes four hospitals and outpatient centers throughout the region.
Penn Medicine includes:
- Founded in 1765 as the nation's first medical school, the Perelman School of Medicine is ranked among the nation's top 10 by U.S. News & World Report.
- The Hospital of the University of Pennsylvania is consistently ranked as one of the nation's best by U.S. News & World Report.
- Penn Presbyterian Medical Center has been providing care to the community for over 125 years.
- Pennsylvania Hospital, the nation's first, was founded in 1751 by Benjamin Franklin and Dr. Thomas Bond.
- The Perelman Center for Advanced Medicine is a state-of-the-art, 500,000–square–foot outpatient facility adjacent to the Hospital of the University of Pennsylvania.
- Penn primary care practices provide care for people of all ages in neighborhoods throughout the Delaware Valley.
- Penn Home Care & Hospice Services includes Wissahickon Hospice, Penn Care at Home and Penn Home Infusion Therapy.
The book The Best Doctors in America includes more specialists from Penn than from any other health system in the Delaware Valley. Penn Medicine has affiliations with some of the area's finest community hospitals and health systems.