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Evolution of The Beryl Institute

Over the last decade, The Beryl Institute has worked to establish a global community of practice on improving the patient experience. This effort has been marked by a number of key milestones. It has been grounded in an unwavering commitment to serve as an independent (i.e., not driven by one vendor or provider perspective), inclusive, accessible, valuable and innovative community, focused on connecting people and creating and elevating knowledge on the human experience in healthcare. With this commitment, the Institute has worked relentlessly to positively impact the lives of all served by healthcare and those who serve in healthcare.

The Beryl Institute was initially established as a thought leadership arm for an organization called The Beryl Companies, a group of businesses dedicated to customer service in healthcare. During its first few years, the Institute produced a handful of publications and provided a client conference for the company’s clients. In 2009, Jason Wolf connected with Paul Spiegelman, the CEO of The Beryl Companies, around the idea that an independent global community for those committed to healthcare experience was needed. Wolf envisioned The Beryl Institute could transform to serve that role, creating a safe place where all those interested in positively impacting the healthcare experience could gather to collaborate, share knowledge and ultimately drive improvement.

This led to the birth of The Beryl Institute as it is known today in September of 2010. The name remained, honoring its roots and in appreciation for the support provided to get the Institute underway, but its purpose transformed. The Institute would establish a unique hybrid of membership community and thought leadership organization focused on the simple idea of providing broad resources, innovative research and purposeful and supportive connections. The commitment from the very start was that all voices matter – from those delivering care, to patient and family members, to the vendors supporting improvement – and the focus was not driven by one nation’s priorities, but by a global conversation around a common purpose of elevating the healthcare experience. The Institute was not intended to be a consultancy selling expertise, but rather a community of practice working daily to bring people together, expand knowledge and advance practice from every corner of the globe. This purpose remains true today and is exemplified in milestones that mark the journey since we began.

In the summer of 2010, we believed that patient experience was a concept in need of a shared definition and a formal collection of knowledge; ultimately the opportunity existed to frame a true field of practice. The first step was to establish a shared definition of patient experience – the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care. This definition, created with members of the community, remains at the heart of all we do today. The next step was the establishment of the Patient Experience (PX) Grant Program. The idea was that in supporting research projects at the point of care and providing a means to highlight and disseminate these projects, we could immediately begin to shift how people looked at and approached patient experience with a growing set of evidence. The program continues to support this work today.

It was not long after the launch of the Grant Program in the summer of 2010 that the Institute officially opened its doors as a membership organization. On September 14, 2010, the first member formally joined The Beryl Institute community, and we have been growing ever since. In the years since 2010, we have sustained our commitment to elevate the idea of patient experience and continue our efforts to establish the field of practice in which people work, contribute, build careers and impact healthcare outcomes. Centered around the shared definition of patient experience, we worked to set four cornerstones for the field by engaging people, framing knowledge, expanding evidence and formalizing the professional role. In working to establish the field, the Institute recognized a need to understand how people saw the field, its function, its efforts and its impact. The State of Patient Experience research series was launched in 2011 to address just that. Now a biennial study, we have been able to explore and track the trends in process, practice and the profession and can tell a powerful story about the evolution of patient experience, an evolution that grew from the cornerstones framing the field of patient experience.

The first cornerstone was building the community of practice within The Beryl Institute itself. Through the community, we were able to grow shared expertise, extend contributions and gather stories. The voices of the community became the engine of our work and supported the development of the second major cornerstone, the Patient Experience Body of Knowledge introduced in 2012. The 15 domains that emerged from a comprehensive process of community design, review and validation remain central to the knowledge essential for someone addressing experience and is constantly evolving through the contributions and insights of our members.

As a global community with a commitment to ensuring an active partnership with and elevating the voice of patients, families and care partners, The Beryl Institute established the Global Patient and Family Advisory Council (GPFAC) in 2013. Through this formation, the Institute and the GPFAC created an intersection for patient advisors from around the world to find resources and share knowledge. The Institute’s critical commitment to serve as the hub for all voices impacting the patient experience movement prompted an evolution of the GPFAC into an influential body that brings valuable insights to guide the Institute. Now, as the Global Patient and Family Advisory Board (GPFAB), this body complements the Institute’s other boards, offering strategic direction on and taking direct actions to address policies, programs and practices that affect the care that individuals and families receive while ensuring that the patient and family perspective is included in all the Institute’s global efforts.

With a community base and a framework of knowledge, the next cornerstone was the expansion of evidence. With the launch of Patient Experience Journal (PXJ) in 2014, the first, open-access journal published on patient experience, a formal home for peer-reviewed research and evidence was established and a common space and bridge for the breadth of work in both academia and practice focused on improving patient experience came together. PXJ remains the most widely read journal focused on patient experience with over 16,000 article downloads a month in over 200 countries and territories.

The final cornerstone for the field was set with the establishment of The Beryl Institute’s sister organization, Patient Experience Institute (PXI). PXI provided a place to establish professional credentialing and continuing education. In keeping in line with the very values at the heart of The Beryl Institute’s founding, PXI was established as an independent non-profit, not in the interest of any organization but with a commitment to elevating and expanding a global community of certified professionals globally, now thousands strong.

With the cornerstones set, the Institute has continued its commitment to growth and its spirit of collaboration by extending its efforts in partnerships and collaborations beyond North America, across continents from Europe to Asia, Africa to South America, to Australia. This global commitment underlines the Institute’s central tenet that in healthcare we are human beings caring for human beings, and regardless of the systems in which we work or country we reside, we all share a commitment to the humanity at the heart of healthcare.

Through this lens and guided by the philosophy that collaboration can lead to great things, The Beryl Institute welcomed the Society for Healthcare Consumer Advocacy (SHCA) into the community in 2014 to expand the conversation on patient experience improvement. After a 40-year history with the American Hospital Association (AHA), SHCA found a new home with The Beryl Institute to continue fostering and promoting the concept of keeping patients at the center of healthcare and ensuring their voices are heard. SHCA’s members, now part of the Institute’s Patient Advocacy Community, remain dedicated to patients’ rights, ethics and advocacy. Guided by the Patient Advocacy Council, members continue to engage with one another, sharing ideas and expanding the involvement of Patient Advocate Leaders globally.

A fundamental reality in the patient experience conversation is that, at its core, healthcare is about human beings caring for human beings. For healthcare to be effective and meet both the needs of those it serves and those who chose it as a profession, this reality must remain at the heart of every intention and action. While there are many tactics that people can and should apply to address experience challenges, they are only as effective as the foundation on which they are built. With this in mind, in 2015 The Beryl Institute established The Guiding Principles for Experience Excellence. Developed from the collective knowledge of the Institute’s patient experience community, these eight principles serve as affirmative statements about where individuals, organizations and collectively as a community should focus patient experience efforts. The actions outlined in these principles lay the foundation on which organizations should be built to provide the best in healthcare experiences.

In recognizing the growing imperative to influence and shape policy at the national and state levels on issues directly affecting the patient and family experience, the Institute supported the launch of the Patient Experience Policy Forum (PXPF) in 2017. As a broad-based and diverse coalition of patients, family members, caregivers and healthcare professionals uniquely led by a balanced board of Patient/Family Partners and senior patient experience leaders, PXPF advocates for and helps shape policy on issues that directly affect patient and family experience and elevate the human experience in healthcare. The unique advocacy model of PXPF, a 2-by-2, meaning every action and idea stems from the pairing and equal contributions of patients and those from the delivery side of care ensure a robust and thoughtful effort and reinforces the core values on which the Institute has been grounded from the start, those of partnership, engagement and inclusion of all voices.

With further recognition that the traditional healthcare landscape was being pushed for transformation -  changes that would drive the creation of a healthcare system that focused more on the relational aspect of human beings caring for human beings and less on the transactional cornerstone on which healthcare was built – The Beryl Institute in 2018 explored what factors had the greatest impact on patient experience and the key levers that support transformation toward experience excellence. The paper To Care is Human: The Factors Influencing Human Experience in Healthcare Today was released, reflecting on the 20 years since the 1999 report To Err is Human as the backdrop and starting the conversation on how we must reframe healthcare as a human-centered, relational effort. The results of this study highlighted that the fundamentals of human experience in healthcare are grounded in human connections, ensuring that the transactions that follow drive quality, safe and effective care. This focus on the humanity at the heart of healthcare reinforced this fundamental priority and focus of the Institute since day one.

With this commitment to the human lens of healthcare, understanding and raising the awareness of how consumers view and are influenced by patient experience was also a critical focus of research in 2018. The Beryl Institute released the inaugural global study, Consumer Perspectives on Patient Experience 2018. The study offered insights about what matters to consumers in their own healthcare experience, the expectations they have about their care and what influences their decision-making in healthcare today. The core findings continue to hold true to today, confirming that what consumers seek from healthcare is the ability to effectively address personal health and well-being. It is how that is done that is significant. What patients, families and care partners expect above all else from healthcare is to be listened to, communicated to in a way they can understand and treated with dignity and respect. It also revealed that experience matters to people and is a significant factor in the healthcare choices they will make.

Understanding experience from these perspectives, that it influences performance, outcomes and consumer choice reinforced the critical importance of the fundamental idea the Institute has also long stood for – that experience is an all-encompassing concept impacted by actions taken across the broad landscape of healthcare. This belief fostered an extensive community conversation and ultimately the release of the Experience Framework comprised of eight strategic lenses that are both part of and influence the healthcare experience. The framework underlines how all aspects of healthcare, from the culture of organizations and how they are led, to engagement of both those who work in and are served by healthcare, to the technology employed and the environment in which care is delivered, to policy, governance and how we deliver clinical excellence, impact the human experience in healthcare. It reinforces the need to align, integrate and collectively support the broader strategic and operational items that will ultimately drive healthcare outcomes overall. To bring the Experience Framework to life, the Experience Ecosystem was established, creating a direct connection from each strategic lens to Institute resources, associated peer organizations and solutions providers, all connected around a central idea that by elevating and improving the human experience in healthcare, we drive the best in outcomes for all.

The Ecosystem, linking the full range of voices from our community, built upon the four cornerstones of a field of practice and shaped by the very definition of patient experience, reflects our ultimate aspirations of The Beryl Institute. It is not and never will be about the Institute, our founders or our team, but rather about the community we build and sustain in our actions every day, the shared learning we create and ultimately the lives we impact as a result of the work we do. We remain committed in our continued journey to be true to what we believed before that very first member ever joined. If we can provide a place to come together, to share, to learn, to grow, to improve and to touch the lives of all impacted by healthcare, then we have been true to our purpose and honor the history we continue to write.

This commitment to elevating all voices was further reflected in the 2019 launch of the podcast – To Care is Human. Its name borrowed from our 2018 paper, the podcast brings the voices of healthcare to life through conversations and stories. From our Leading the Conversation episodes where we engage in the global conversation on improving patient experience through the eyes of those leading and driving change across the continuum of care, to our Humans in Healthcare episodes where we examine The Beryl Institute’s 8 Strategic Lenses of the Experience Framework through the eyes of those delivering and receiving care, the podcast digs into how we can continue to and why we must elevate the importance of the human experience at the heart of healthcare. It truly reflects our commitment to ensuring all voices matter.

We continued to expand our collaborative partnerships in 2020 with an announcement to integrate members and resources of the Association of Health Care Volunteer Resource Professionals (AHVRP) into our patient experience community. Previously part of the American Hospital Association (AHA), AHVRP’s 52-year history supporting healthcare volunteer services, retail operations and related support services disciplines brought to The Beryl Institute an additional layer of helpful resources to volunteer professionals who have a tremendous impact on the patient experience. As the new home for AHVRP, The Beryl Institute introduced a special interest community for Volunteer Service Professionals to support the ongoing sharing and networking of AHVRP members and others leading volunteer programs throughout the healthcare continuum.

As the conversation on improving patient experience continued to grow in priority and strategic scope for healthcare systems globally, healthcare leaders also acknowledged that healthcare consumers and their families should be at the center of the dialogue. With changes like new care delivery models and innovative technology accompanied by ongoing healthcare political debate and legislative activity, The Beryl Institute found it paramount to carefully track the implications these changes would have on all aspects of a consumer’s experience. In that context, in 2020, the Institute in partnership with Ipsos, a worldwide market research firm, unveiled PX Pulse, a quarterly tracking poll designed to elevate the understanding of current perspectives on the patient experience. Its initial launch focused on the U.S. healthcare system, but in many ways reflects general insights reflective of how people are engaging in healthcare globally. Through this partnership, quarterly surveys provide current perspectives on patient experience, determine the practices and processes that have the greatest impact on healthcare consumers and track how the market sees patient experience evolving over time. PX Pulse has emerged as the in-the-moment snapshot of the trends and insights impacting the healthcare industry as it leads into the future.

At no other time in the history of The Beryl Institute was our focus on elevating the human experience in healthcare so tangible than in 2020 with the global Coronavirus pandemic. At the onset of the pandemic, we were reminded of the critical role our community members play in supporting each other through shared knowledge and personal connection. Through that lens, The Beryl Institute rapidly launched a COVID-19 resource center. In partnership with our global community, we created spaces for dialogue for rapid learning and social and emotional support, we collected and shared content providing essential information to all in healthcare to help navigate the pandemic, all while maintaining a focus on the human experience further highlighted by this crisis.

In addition to offering community resources in a variety of formats through the COVID-19 resource center, The Beryl Institute also unveiled a platform to celebrate the extraordinary experiences of patients, caregivers, healthcare providers and other essential workers during the pandemic. Honoring Human Service (HHS), a microsite that highlights stories about the strength, love, resilience and the human spirit that can triumph over difficult circumstances, aims to honor those who have given so much in a time of crisis. HHS continues to provide the community a place to find comfort as well as a platform to recognize and appreciate healthcare heroes during the pandemic, and it will serve as a place to celebrate the brilliance and compassion people bring to this work for many years beyond.

In tandem with addressing the COVID-19 crisis in early 2020, The Beryl Institute also acknowledged the need to engage in the rapidly expanding global conversation and call to action on addressing the issues of racism and equity and the associated disparities in outcomes that have haunted healthcare for years. We strongly voiced our commitment to and declaration that we must ensure an unwavering commitment to human experience and rapidly established a dedicated resource center on Racism and Health Disparities. Pulling together content that we have shared in our resource library and drawing from powerful voices in our community helping us to learn and see things with new and/or different eyes, this platform acknowledges the ongoing conversations and actions needed as we actively work to address this issue. In that awareness, the Institute remains committed, personally and community-wide, to continuing to elevate critical conversations that will strengthen our humanity.

Even before the pandemic hit, a conversation about the future of human experience had already started and a foundational framework for the next decade was laid. In April 2020, The Beryl Institute released Human Experience 2030 (HX2030), a framework built from the contributions of more than a 1000 community members around the globe, reflecting the potential and possibilities for healthcare over the next ten years. The intent was to identify the ideas and actions that would drive efforts and holistically guide healthcare forward. This look to the future became even more relevant in the face of the COVID with a recognition that there was no going back to the way things were, but rather there was a New Existence into which healthcare would need to step. With a focus on patients and care partners, the healthcare workforce and the communities healthcare serves, HX2030 reflects a culminating point for the Institute’s first decade, representing the active, inviting and inclusive nature of all the Institute has sought to do. The future of human experience is not just a place we will eventually arrive, but rather it is an awareness of what we must do starting in this moment to lead us through the days, months and years ahead. And our New Existence is something we will create together.

Now with a global community of voices from those who lead experience efforts, to those who provide care at all touchpoints across the continuum, to those who support the delivery of care in a range of capacities, to patients and family members, care partners and support networks, to innovators and entrepreneurs, vendors and solutions providers, we have woven a rich and diverse tapestry that will be hard to pull apart. In our commitment to coming together around the idea of what could be possible if we put experience at the heart of healthcare, we have shifted the conversation. In the end, it is because people came together for something bigger, something we all know healthcare is truly capable of achieving.

We are honored to hold the open and sacred space for this to happen and are humbled in our opportunity to influence the spread of these ideas. We too are appreciative of all who call this space their professional home and for many their professional family and all who have worked to support, contribute, nurture and foster its growth with us. As we look ahead, we also acknowledge this is a journey without end that requires stamina and persistence, and we must maintain our effort, as the forces and currents of healthcare are strong. But as a community, through both this history we have co-created and the stories we are still to write, we will be stronger. That is our hope, that is our commitment and that will remain the possibility, one on which this organization was built and one that will shine a light forward to the road ahead.

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