On the Road at The Beryl Institute’s Patient Experience Regional Roundtable – Nashville
Deanna Frings, Stacy Palmer and Jason Wolf
The Beryl Institute initiated its Regional Roundtable program with one objective in mind – reinforcing the power of connection, collaboration and sharing central to an effective community of practice. Since that first Roundtable in 2011, hundreds of Institute community members have come together as active participants in the sharing of ideas and the creation of solutions in improving patient experience. Central to the Institute’s mission of creating a dynamic gathering place for those committed to patient experience effort, Regional Roundtables exemplify the importance of community and its critical role in all we do.
The September 2013 Regional Roundtable, hosted by Vanderbilt University Medical Center, reinforced this important purpose. In bringing together patient experience practitioners across healthcare settings, resource providers with broader market perspectives, seasoned caregivers working each day on the front lines and the important and passionate voice of patients and families, roundtables not only provide the space for connection, but also exemplify the power of including a broad range of voices in the effort to improve patient experience.
The hope for these events has and will continue to be that together we can accomplish great things for our healthcare organizations and for the patients, families and communities we serve. The patient experience effort is not a nice-to-do, but a serious and noble cause – a movement that impacts the entire healthcare system. Regional Roundtables serve as an important part of that effort to ensure we keep moving forward. The great stories that emerged from Nashville below may be the best example of the opportunities we have ahead.
Keynote – The Perceptive Patient
The event opened with a powerful keynote presentation by Brooke Billingsley, business entrepreneur and breast cancer patient, who was pushed onto stage covered by a sheet, lying on a stretcher. She sat up and started an emotional reenactment of her experiences as a patient; from the moment she heard her diagnosis to her first chemotherapy to surgeries and port placement. The audience was impacted by the vulnerability she shared and felt her pain as she described in detail the emotional toll of losing her hair, among other experiences.
The overarching theme in Billingsley’s message was the significance of every single interaction she encountered – every word, question, comment, head nod, smile and grunt – from her caregivers and anyone she interacted with during her frequent treatments. She shared the story of one cold, disgruntled front-line employee who’s attitude was so disheartening that it caused her to change care facilities, transferring her treatments to a hospital 20 miles away – a move ultimately costing the original hospital over $250,000.
She offered a powerful, and so important, perspective of care and a reminder of how important every single detail of the experience is to the patient and family. She considers her cancer experience her "Amazing Race” including the chemo, surgery, radiation and infusions. In sharing the journey of her race, she’s helping to make those encounters better for future patients around the globe.
Working Group Session
Supporting the overall purpose of the Regional Roundtable and the core objectives of sharing ideas and building upon those ideas, the participants spent much of the afternoon in active discussion and solution searching. The session began with participants brainstorming a list of the current patient experience issues they are facing in their organizations. The group selected four topics after completing a prioritization activity. The four areas included:
- Culture of responsiveness
- Ensuring sustainability
- Importance of leadership
- Addressing HCAHPS
Once the topics were selected, the attendees divided into four groups to begin detailed discussions with the goal of determining a solution. This deeper dive included defining the issue more fully, discussing the possibilities, sharing what currently is being done within their own facilities and exploring the challenges and roadblocks. Creativity and a bit of fun were certainly applied in the 5-7 minute presentation given to the larger group.
1. Taking a multi-faceted approach in establishing a culture of responsiveness.
The first group shared multiple ideas and tactics they have used and would highly recommend to any organization focusing on this effort. First and foremost of importance, is involving the voice of the patients and families in defining responsiveness. This can be done through a variety of engagement and feedback mechanisms such as rounding, focus groups, patient and family advisory councils, survey feedback, discharge phone calls and a review of compliments and complaints received
Once an organization has defined and set the expectation, the second recommendation is to involve the employees in determining the best solution for their specific area of service. Other recommendations in addressing responsiveness included 1) Communicating to patients and families what they can expect, 2) Immediately acknowledge, apologize and attempt resolution when the organization has fallen short of the set standards and 3) never underestimate the importance of teamwork within and across department lines especially when you consider the multiple handoffs a patient can experience. This circles nicely back to the need of establishing an aligned and well-understood expectation and its importance on the patient experience.
2. Exploring the many reasons why sustainability is a challenge.
The framework the group took in exploring the issue of sustainability was to ask a simple question, "What are the reasons why things we implement are not sustained?” The resulting list was very familiar and included, 1) the "new” effort is implemented as an isolated tactic or task and never connected to the bigger strategy, 2) the employees struggle connecting to the importance or value and 3) compliance is viewed as optional. Here are some of the group’s recommendations to overcome these universal roadblocks.
- Do not underestimate the importance of hiring the right person in the right role.
- Leadership development in hiring and selection is an investment that will be returned ten fold.
- Find multiple ways for ongoing communication on the positive impact this is having on the patients and families. This is especially important well after the initial implementation and keeps everyone focused on the effort.
- Ensure the employees and leaders have the tools necessary to be successful.
- Invest in education both with a focus on behavior based training and building the skills of leaders as coaches.
- Celebrate your successes both big and small and recognize people over and over and over again. These efforts reinforce the culture you want to sustain and drive even deeper the internal motivation and sense of pride of all that are a part of your organization.
3. Taking to the air to explore the critical importance of leadership on establishing a culture of exceptional patient experiences.
Sometimes finding solutions can occur when you look outside your own industry and this group reinforced the value of researching best practice solution outside of healthcare. The scene they presented to the larger group took place onboard an airplane in fight. It was a creative way to not only share their recommendations but also to role-play what a great experience looks and feels like.
Woven through the reenactment was a discussion on the critical importance leadership does have in establishing the culture required in providing the highest quality and most compassionate care to the patients and families served. Upon reflection, common themes begin to emerge from all the solutions offered. Establishing a strong leadership requires a multipronged approach, hiring for the right fit, providing ongoing leadership development, ensuring all understand how the goals are aligned with the mission and vision of the organization, and of course, an accountability loop of ongoing feedback, coaching, good role modeling and proper rewards.
4. A systematic approach to HCAHPS
It was determined that hospitals clearly have a solid understanding of their accountability related to HCAHPS outcomes as well as the financial implications. What is less understood is if healthcare executives fully appreciate what it takes to ultimately improve HCAHPS outcomes. Building on the learning from an earlier presentation, the group emphasized that patient satisfaction outcomes are a lag measure and thus the importance of identifying and monitoring those lead metrics that impact the patient experience. By doing so, one should see an ultimate improvement in HCAHPS scores.
To this end, the group reinforced the need to take a systematic approach focused on building and sustaining a culture of healing in order to experience sustained improvement. The strategy includes many of the elements already discussed above. The call to action must start at the top. Leadership sets the tone, leads by example and requires an unwavering commitment to the patient experience.
It become evident as each group presented that improving the patient experience requires a comprehensive and integrated effort with clear and sustained involvement from senior leaders. The longer organizations focus on patient experience improvement efforts, the increase realization that it’s a marathon and not a sprint.
Keynote – The Future of Patient Experience
The day closed with a thought-provoking look at technologies impacting the next generation of patient experience progress from SmartPatient founder and CEO, Paul Clark. He opened sharing a 1950’s video about a dream hospital featuring "modern conveniences” and then took us through the journey to modern day where smartphones are replacing the PC and mobile apps are surpassing the Internet and possibly even TV.
Clark discussed changing social behaviors and how healthcare must adopt to meet the needs of the engaged patient. He shared popular healthcare apps from personal sleep clinics and health counselors to electronic triage and healthcare blue books, and he left participants with a short list of questions to reflect on:
- Are you engaging patients and families across every channel – and on their preferred mode?
- Are you collecting data across every patient interaction?
- How deeply do you analyze, understand and design your current experience?
- How will you deploy predictive analytics?
- Are you prepared for the future patient experience of asynchronous remote interaction?
The Beryl Institutes’ fourth Regional Roundtable event served to inspire and reconnect participants with their passion to do what’s best for patients, caregivers and family members. It’s in the collaborative discussion and community networking that great ideas surface. It is this power of collaboration, connection and conversation that is central to The Beryl Institute community in all we do. We look forward to helping to continue this powerful dialogue at our next Regional Roundtable event, November 7, 2013 at Balboa Bay Resort in Newport Beach, California.