Reigniting our Intention for Patient Experience Improvement

In just the last few days I had the privilege of spending time with the team at Cincinnati Children’s and then speaking with caregivers, staff, patients, family and community members as part of the Ontario Ministry of Health’s Central Local Health Integration Network Quality Symposium. While vastly different organizations and experiences that crossed an international border I was struck and even moved by the passion and commitment I see growing around the patient experience.

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This is no better exemplified then by the growth of our community at The Beryl Institute and the efforts that have been inspired by each of you. The dialogue on patient experience improvement is growing, not just due to surveys, or even at-risk dollars (though we would be mistaken not to acknowledge its influence). It is not just driven by shifts in policy or even an emerging consumer mindset that has brought the concept of personal choice to healthcare decision-making. We may best describe it instead, by the “perfect storm” of personal awareness, professional passion, and external influence all culminating in this moment. And this is your moment as an individual committed to patient experience improvement.

This culmination guides what we have been inspired to create through our community and in the coming weeks will make available to support this powerful intention. My hope as a servant for the needs of the over 20,000 members and guests of The Beryl Institute and the countless others committed to this movement is that we provide the framework, resources, learning and connections to foster continuous motion.

We start in just a few days with Patient Experience Conference 2014, a physical gathering to engage with one another in learning, sharing, challenging and inspiring efforts. It will be soon followed by Patient Experience Week, a new annual event, inspired by members of the Institute community, to celebrate healthcare staff impacting patient experience. Taking pause during this week provides a focused time for organizations to celebrate accomplishments, reenergize efforts and honor the people who impact patient experience everyday.

In the midst of these major events, are two dynamic resources designed to support the very intention I see burgeoning. The first, the release of the initial Patient Experience Body of Knowledge learning modules, brings this community effort guided by almost 500 voices to its next stage, in providing core learning for current and aspiring patient experience professionals. From this focus on practice we will also see a push for greater research with the launch of Patient Experience Journal (PXJ) and its Inaugural Issue bringing together the voices of academic and practical research from around the world to inform and even challenge our work.

In the weeks ahead, and in the weeks and months beyond, our task together must be to refresh, renew and reignite our intention through these and other efforts. The task at hand may be no simpler, yet never more complex. Your work as champions of patient experience is a relentless effort of doing what is right in every moment. Consider this a rallying cry in a month where powerful people and strong efforts will collide in great possibility. So what can you do about it? I offer:

  1. Acknowledge that whatever role you play, what every title you hold, whatever resources may be at your call, you are a leader for patient experience improvement.
  2. Recognize that complexity may be our greatest foe in dealing with what at its core is our commitment as human beings caring for human beings – keep it simple, that is where great power can be found.
  3. Commit to engaging others in your efforts – be it the voices of patients and families, the insights from community, the experiences of peers or colleagues. While at times it may feel lonely on this journey, know there are so many more carrying this passion with you.
  4. Focus relentlessly on where you can make a difference; the operative concept being there is a place that each and every one of you has a difference to make.
  5. Don’t let complacency be the enemy of your intention; yes there are now scores to earn, objectives to achieve, targets to shoot for, but don’t be afraid to do what you know is right in the end.

The team at Cincinnati Children’s reinforced what I have seen on many On the Road visits and the participants in Ontario exemplified it in their efforts. We all have a vested interest in improving patient experience – be it for ourselves, our loved-ones, our friends, or ourcommunities. This is a cause worth working towards and one in which I hope we will always remember the power of strong and true intention.

Jason. A. Wolf, Ph.D.
President
The Beryl Institute

Nurse Leadership Matters in Patient Experience Performance

As shared by the Robert Wood Johnson Foundation and known by many in practice, nurses represent the single largest group of health professionals who deliver hospital care. This represents a broad range of caregivers from the senior ranks of CEOs or CNOs, to the bedside, from managing triage in emergency departments to conducting post discharge follow-up calls.

Nurse leadership matters in patient experience performance

With this expansive reach, nurses and in particular nurse leaders, have a significant opportunity to impact the experiences of patients and families. I say this reinforcing the strong point found in the definition of patient experience that experience is created in every interaction – meaning by everyone that plays a role in the healthcare system and at all points in the continuum of care, from well before to well after a clinical encounter. With that we would be short sighted to miss the fact that the experience most patients and family members relate to, reflect on and remember is the one they had with their nurses.

In a Hospital Impact blog last year, I wrote about my own experience of quickly leaving at the close of Patient Experience Conference to become a family member at the bedside for the birth of our son. I spoke of Kristen, our L&D nurse, who was responsive and took every opportunity to not only set appropriate expectations, but also answer our questions. She served as a guide through one of life’s most important and incredible moments.

In inquiring why she and other nurses in the unit were so positive and engaged (and not revealing my profession), I was told about how their leaders take time to support the nurse team not simply as individuals there to work, but as professionals, people and partners in care delivery.

In thinking back on this moment I had the chance to share some thoughts with the nurse leaders at my most recent On the Roadsite – Presbyterian Health Services. My realization in the conversations reminded me of how as a family member I had clear expectations about clinical excellence, quality and responsiveness from my nurse team. It was the things they did beyond that though that drove my experience.

As we talked at Presbyterian, it became clear in the dialogue that in the fast-paced world of healthcare, specifically in the nursing realm, nurse leaders have a critical role to play. They set the stage for behavior, they reinforce actions and responses, and they coach, guide, cajole and celebrate with their teams. In the end these nurse leaders, whether aware of it or not, are indirectly driving the experience for so many in their care.

This observation and discussion was supported by the data revealed in the 2013 State of Patient Experience Benchmarking Study. In both the 2011 and 2013 research “clinical managers who visibly support patient experience efforts” was the second greatest driver of experience success after visible support from the top. Here again leadership was reinforced as critical, and more so the clinical managers, those guiding the largest part of the healthcare workforce and with the greatest contact with those served, were identified as central to patient experience performance.

What does all this mean in action. Based on what I have experienced and learned from the many nurse leaders I have had the fortune to work with, the ideas are simple in concept, but sometimes require great effort to execute. Nurse leaders must:

  • Nurture and develop their teams beyond core clinical skills to the behaviors they see as critical to the total delivery of care.
  • Model expectations at all times in their own actions and hold themselves and everyone else accountable when these expectations are broken.
  • Listen and create a space for the words of all team members to be heard. Sometimes the greatest of ideas come from the unlikeliest of sources.
  • Reinforce and create a sense of ownership in staff at all levels that they are leaders in every moment. As every experience happens in the interaction between one human being and another, every individual has the power to choose how they lead in every moment.

In a world where nurse leadership faces continued and growing pressures to perform, these, what some might call, “softer”, non-clinical aspects of leadership and action can easily be pushed aside. But it continues to be the strongest and most successful leaders I see that find the space and time to consider and act on these aspects of the total experience.

It is simple. In whatever way fits their style or the organization in which they provide care, nurse leaders matter in patient experience performance. Of that there is truly no question.

Jason. A. Wolf, Ph.D.
President
The Beryl Institute

In recognition of the importance of nurse leadership in impacting patient experience, The Beryl Institute is excited to join one of our supporting partners, TruthPoint, to offer patient experience resources at the upcoming American Organization of Nurse Executives (AONE) Annual Meeting in Orlando, Florida.

The Patient Experience Deserves More Than 63%

BlogPic_2014-02I have yet to meet anyone in healthcare who suggests patient experience is not important. In fact, I often hear it said to be “one of our top priorities”, “a central pillar in our strategy” or “a critical initiative for our organization”. I do not question the sincerity of these declarations or the intent they suggest. I also recognize in the highly dynamic world of healthcare today we are in a constant struggle to balance our priorities. With that, I offer these thoughts to shift our thinking in how we approach experience overall.

To frame what I mean about patient experience I return to the definition generated by themembers of The Beryl Institute community – the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care. I also want to challenge the perspective of some in equating patient experience only to service and question our inside-out focus in healthcare as we often operationally differentiate quality, safety and service. While we may operate these efforts in distinct and at times competing manners, I do not believe patients distinguish between these areas. Yes, we must focus on quality, safety and service and align the appropriate resources to each, but we must address these efforts from the eyes of our consumer and the perspective that they together create but one experience.

As I have continued to hear patient experience identified as a strategic priority, it has caused me to ask, does this mean based on needs there are then specific times when we actually focus on it (and therefore times we don’t). That is, do we truly focus on every one of our priorities at all times? Continuing this thought, if patient experience is seen as an initiative, it has all but been declared a limited effort, for every initiative I have experienced in healthcare and elsewhere has a beginning, middle and therefore an end. Do we truly think the patient experience is an idea where the effort eventually concludes?

These ideas around alignment, priority and initiative were supported in the findings of the 2013 Benchmarking Study, The State of Patient Experience in American Hospitals. The research revealed something one could potentially overlook in all that was uncovered. In the U.S. Hospital System the individual with primary responsibility for patient experience spends 63% of their time on these efforts. In contrast, I do not know of a CFO that spends 63% of his time on finances. The data itself reinforces the opportunity we may very well be missing. Have we made patient experience a 63% priority? If we take that to the extreme, does that mean it is only something we consider for 63 out of every 100 patients we see? I do not believe any organization or leader has done this intentionally, but it does cause us to hopefully stop and think about how we lead and operate our organizations and systems.

I know those in healthcare are more committed than what the number reveals. We are an industry of caring and compassionate people who give all they can in every moment. But the data opens our eyes to the opportunities we have. Perhaps what we have lost in our efforts to address patient experience is our realization that experience is all we are about in healthcare. I know that if any one of us were laying on an exam table, recovering in a bed, or sitting holding the hand of a family member that we would not expect anything less than 100%. In fact I believe we would say we want the best in quality, safety and service – the best experience – in every encounter. I believe we all do want the best in patient experience for all those in our care. I hope we too agree the patient experience deserves more than 63%. So how can we start to do things differently today? I look forward to your thoughts.

Jason. A. Wolf, Ph.D.
President
The Beryl Institute

How Will You Inspire the Patient Experience Movement? Four Considerations for 2014

InspiredI am inspired. The New Year has arrived with great energy at The Beryl Institute. We start 2014 as a global community of practice of over 20,000 professionals, focused without hesitation on ensuring the best in experience for patients, families and one another in healthcare.

I am inspired by the continued commitments expressed for this work: by The Beryl Institute’s Patient Experience Scholars who met recently to share their research and reinforce their willingness to encourage and support others; by the members of the Global Patient & Family Advisory Council who want to influence how patients and family members are heard and engaged in making a profound difference in healthcare; by the many contributing to the development of the Patient Experience Body of Knowledge courses soon to be available to the community; and by many more.

I am inspired by how in the first two weeks of a new year, such commitment and intent can emerge, built on all that has come before and focused with purpose on the great opportunities ahead. As I reflect on this idea, a question emerged and perhaps a challenge for each of us to consider:

How will you inspire the patient experience movement in the year ahead?

I pose this question with the hope that actions and considerations from the smallest moments of unparalleled kindness to the largest strategic triumphs all find room to take root and grow. Inspiration comes in all shapes and sizes, but in this diversity it has strong commonalities – it causes us to feel a sense of something special and powerful. It provides a boundless energy to influence, lead, change and make a difference. This is an exciting prospect in seeing that each of us can choose to have an impact. And while no two actions will be exactly alike, I do want to offer a few thoughts on how you can continue to frame your patient experience efforts to inspire yourself and others.

As we return to the definition of patient experience, I continue to experience its relevance time-and-time again in the application of these words to central actions associated with excellence. In reviewing its words – the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions, across the continuum of care – I again see clear directions on moving your own experience efforts forward. They include:

1. Reinforce strategic focus. Patient experience has proven itself to be a relevant part of the healthcare conversation. It has surpassed the challenges of being dubbed a fad; it too has shown it has stronger legs than just serving as a policy framework. Experience is a central strategic pillar to organizational performance and success. Patient Experience in its broadest sense should be a clear and transparent component of every healthcare organization’s strategy.

2. Clarify and map your critical interactions. Experience doesn’t happen on billboards or in espoused actions, it happens at the most personal moments, at those points of engagement between one individual and another. The ultimate tool in patient experience improvement is your self, your heart, your hands and arms, your minds, your compassion and your common sense. We have a huge opportunity to map the interactions that occur on the patient path to ensure we consider the most effective way to respond at every touch point.

3. Model desired behaviors. Simply put, if interactions drive experience, then the behaviors that comprise them are the conduits that direct these interactions in one way or another. Organizational culture is shaped by behaviors, they represent the people, presence and purpose of an organization overall and no slogan, policy or program will trump the power of individual behavior. We must model, observe, coach and improve constantly to impact experience outcomes.

4. Expand your listening. As we ended 2013 exploring the Voices of Measurement, we learned that the power of data is only as valid as what we choose to do with it. Collection or reporting data for the sake of data misses the opportunity for learning and relevant action. To capitalize on the value of the voices that surround us in healthcare we must expand our listening. Experience is measured first in the direct voices of healthcare consumers, who remain our most significant mirror into our own efforts, but it is also found in the voices of our peers and colleagues. We are only capable of achieving our strategy through our people. They are much more than pawns to direct, but rather living resources accountable for ensuring excellence.

Perhaps these ideas will help spark your own thoughts on how you will choose to inspire the patient experience movement. Regardless of which direction you go, I hope you recognize the power that exists in your own personal choice and the ability to impact the experience of the person that is coming next. The year ahead can and should be about a great many things both personally and professionally. My hope is that you find you can and will be an inspiration in your efforts. This cause is too great for your efforts to be anything less. Now the question remains, what will you do? I look forward to your updates with great anticipation.

Jason A. Wolf, Ph.D.
President
The Beryl Institute

Reflecting on The Patient Experience Movement: The Power of Voices and Collaboration

As we stand at the end of each year, we tend to look back at all that led us to this moment and anticipate all that lies ahead. I stand here now with all of you that comprise our patient experience community, who live and breathe in your every action this patient experience movement, and can say without hesitation that together we have accomplished great things and together there are even more powerful moments to come.

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This year has exemplified our core values at The Beryl Institute – the importance of community and the integral role of collaboration. We have worked to reinforce the true power of engaging all voices in the patient experience conversation. This gathering of voices has seen our patient experience community grow from 11,000 to 20,000 members and guests this year alone, representing over 45 countries. This gathering of voices has led to a year in which the foundational ideas of this movement have been reinforced and solidified. In our commitment to expand access to the greatest breadth and depth of individuals across healthcare we recently expanded our membership framework to provide access to all associates in any healthcare facility. These Institutional memberships enable staff at all levels, in all roles, across the range of healthcare organizations to engage, to learn and to lead in their own environments.

In expanding the conversation on voice itself, this year has been shaped by the Voices of Patient Experience series in which we heard from the C-Suite, front-line practice, students across healthcare disciplines, physicians, patients and families and those measuring the impact of our patient experience efforts. This collection of voices served to complement the many others that contributed to learning and sharing of ideas via webinars and case studiesPatient Experience Conference presentations and On the Road visits. Hundreds of you added your thoughts to the conversation via these and other outlets. This open sense of sharing, of giving, of collaboration has allowed the patient experience movement to thrive.

The voices series also raised a significant awareness for the community; to be an organization truly committed to patient experience, we had to move beyond the talk about what we do “to” patients and families, and reinforce an unwavering commitment to do “with”. This partnership in care underlines the very intent of the Institute to provide a place to learn from one another, and it was clear that included the voices of patients and families themselves. This led us to establish the Global Patient & Family Advisory Council, comprised of leading patient and family thinkers, writers, speakers and activists. It also had us collaborate with IHI at the 2013 National Forum to support the “Patient is In” Booth in which patients and family members could share input and ideas with forum participants. These voices remind us of the boundless value of this partnership in patient experience improvement.

The expansion of voices also led to the 2nd State of Patient Experience Study, the largest conducted to date on patient experience efforts, and revealed some interesting trends in the both the focus, intent and awareness of patient experience efforts. Yet, while the movement continues to push on, less than 50% of U.S. hospitals have yet to formally define patient experience for themselves. We still have great opportunities to educate and learn from one another.

This awareness made it only natural that we expand our efforts overall on the professional development of patient experience champions, furthering the work on the Patient Experience Body of Knowledge with domain outlines and the anticipated release of the domain courses in 2014. As a community you reinforced your desire and the greater need to shape this work in ways that will allow each and every one of us to grow stronger. The year ahead brings even more exciting work on this front.

In a recent Hospital Impact blog I mentioned my great excitement about the growth of the patient experience family overall, from new sister organizations to research entities focusing on this area, to critical gatherings in numerous places in support of this important discussion. We will continue to support and reinforce the value of all these efforts and maintain that in collaboration we all win in this movement. We remain committed to serving as a hub and connector of the many voices focused on this effort and keep our arms open for the opportunities for further collaboration.

This very idea led to us to begin conversations with and engage in a formal collaboration with the Society for Healthcare Consumer Advocacy (SHCA) and its 40 years of incredible history and commitment to patient voice, rights and advocacy. A strong and storied organization whose roots can be found at the very start of the patient experience movement, SHCA felt they found a home for their future with The Beryl Institute, but I would say while the container is the Institute, the home is the community of peers, of leaders and teachers, of resource providers and caregivers, of patients and families who make up this growing professional home for so many. The integration with SHCA and the purposeful collaboration with a growing number of organizations committed to this cause help reinforce the power that collaboration itself brings to this conversation.

I would be remiss if I did not add a personal note to this reflection on the year, that as I stood on stage to close Patient Experience Conference 2013 and received the call that I needed to rush home for the delivery of my son, I shifted abruptly from champion and advocate for a movement to a family member surround by a healthcare system still admittedly learning itself. My eyes were opened, not only by the magic of the birth of a child, but of a family member watching your loved ones cared for, your new child handled, complications managed and tense moments relieved. We must not forget we are all patients and family members and need to continue our work as such.

The work you do may at times seem like small gestures, part of your standard process or even done automatically as a seasoned veteran, but to a patient or family member you are providing an incredible gesture of service, of quality, of safety – of experience. In every moment we have the choice to create the experience for our patients and their families. And every moment each of you as members of this community, of this movement, have that choice as well…to engage, to learn, to contribute, and to encourage the involvement of others.

You see this is your community, it is built on the power of your voices, it is driven by the collaboration we find with one another and it is from that place that we look to the new year knowing that the greatest opportunities still lie ahead. Thank you for your contributions, support and leadership. May you have a healthy and happy holiday and be ready with great excitement for all the New Year will bring.

Jason A. Wolf, Ph.D.
President
The Beryl Institute

The Patient Experience Must Be Owned By All: Welcoming the Society of Healthcare Consumer Advocacy

In The Beryl Institute’s recent research report – The State of Patient Experience in American Hospitals 2013 – I noted in conclusion that the state of patient experience is growing stronger every day because of the many voices committed to this work. I too reinforced my belief that a patient experience movement is afoot, one that requires continuous and focused efforts and one that should be grounded in and built upon collaboration and alignment versus competition or the desire to stake a claim.

This idea rests at the very core of the global community of practice we have built at The Beryl Institute. We do not claim to own the patient experience, but rather to be a place where people can gather together to share what is best in what they are working to accomplish. Our philosophy has been and will remain that through collaboration not just great, but greater things can happen.

It is in this very spirit of collaboration that I am excited to share the bridging of two great organizations to expand the alignment and dialogue on patient experience improvement. We have been in discussion with and will soon be welcoming the Society for Healthcare Consumer Advocacy (SHCA) into The Beryl Institute community. After an incredible 40 year history and supportive home with the American Hospital Association (AHA), our three organizations – The Beryl Institute, SCHA and AHA – saw great potential in supporting the next 40 years and beyond for SHCA within the Institute (You can read a letter from all of SHCA’s Past Board Presidents here). As of January 1, 2014, our communities will align to continue to expand the patient experience conversation and in doing so model the power of coming together in this critical dialogue.

More details will soon be available around this exciting next step in the history of focus on patient advocacy and more broadly patient experience improvement, but suffice it to say, the commitment to engaging all voices and growing those engaged in this important work is top of mind for us all. I am excited and proud to welcome the SHCA community to The Beryl Institute family as their new professional home and in doing so reiterate the very critical message I share here. That it is in coming together, not attempts at market distinction, in which the greatest outcomes are possible.

I have watched in recent years as patient experience has moved from an emerging term to an active conversation at the center of policy and now financial focus. I have also seen a great game of ownership being played out. Much like one might have experienced during the gold rush, claiming their small bit of mountain stream to pan for hours, days or more in search of that one bright speck, many organizations – some well established, and some quite new – have all worked on positioning for their piece of the pie.

While I am a true believer in free enterprise and recognize the great potential for market savvy in this new world of healthcare, I also believe we have something bigger we are attempting to do in working towards patient experience excellence. It is in the bringing together of disparate thoughts or competing ideas, be they those of resource providers of similar services or healthcare organizations occupying the same market, in which the greatest outcomes can be realized. You see no one organization owns the patient experience, yet we in healthcare must all take ownership of it.

For this reason we have worked to bring the many voices together, for as I asserted above, this is where the strength of our work and its impact rests. This idea has been realized in the Institute’s Regional Roundtables where market “competitors” join together in sharing thoughts and crafting shared plans focused on improvement. It has been realized at Patient Experience Conference where numerous resource providers join in and engage in support of a true, independent community dialogue. It is seen in the willingness of some of the largest players in experience measurement to come together to share ideas between the covers of our soon to be released paper on the Voices of Measurement.

If we are to make the greatest differences in the lives of our patients, families, peers and community we must be open to the idea that above all else through collaboration and coordinated effort profound possibility exists for improvement and sustained impact. And while by my very words, I cannot claim The Beryl Institute is the only place this can or will be done, I do hope and in fact commit that we will continue to stand for the bringing together of all ideas, of every voice and of each hope in each and everything we do. As a community of practice it is our calling, at The Beryl Institute it is our cause and we are so very excited to see (and hopefully be a catalyst in) the patient experience family continuing to grow.

Jason A. Wolf, Ph.D.
President
The Beryl Institute

A Patient Experience Lesson from the Latest U.S. Congressional Showdown

USCapitolWhile I don’t wade into the political spectrum often in these discussions, in light of the news of the day, I am hard pressed not to at least share a reflection on what is taking place in Washington, D.C., its impact on the U.S. Healthcare system, and the broader economic implications it is presumed to have. I do not intend to advocate for one position or another here, but rather share a core reflection on the lesson I see for patient experience professionals in the current state of affairs.

For those of us in healthcare (and in reality for all of those that are not), this week signifies a historic time with some of the first steps underway in the implementation of the Affordable Care Act, also referred to as Obamacare. Regardless of the actions (or inactions) on Capitol Hill, and whether you are in support of or against it, the healthcare law will move forward for now. I do not intend to break down the law and examine its detailed impact on the patient experience here. Rather, I hope to share a simple but significant realization about the entire U.S. Healthcare system revealed in this debate.

Recent polls conducted separately by both Fox News and CNBC found that when asked, Americans often distinguish between the Affordable Care Act (ACA) and Obamacare. Much of this distinction is driven from the very mouths of congressional and other political leaders. In fact in exploring people’s opinions on the programs under these two naming conventions there was a variance in the value, interest and support for each of these programs. The challenge (or perhaps surprise) in this discovery is that in fact these two programs are exactly the same thing – the ACA is Obamacare and vice versa.

The reality is in healthcare we have many words that raise this same challenge in our delivery system, driven by providers, supported by payors and serving patients and families. The example above, of divergent opinions on, in essence, the same idea, driven by language, expert opinion or pure rhetoric, is one of the best I have seen reinforcing with clear data the power of language and more importantly perception.

The concept of perception – the way you think about or understand someone or something – is a central part of the patient experience itself. Defining patient experience as the sum of all interactions, shaped by an organization’s culture, that influence patient (and family) perceptions across the continuum of care makes explicit that perception is both the result of experience and also the lens through which people make choices now and into the future around their care.

For the reported confusion created in the language around two names for the same healthcare law – ACA or Obamacare – there are limitless levels of confusion created in the language of our healthcare system itself, from diagnosis to medications, acronyms to systemic issues. In the simplest of terms we all too often and in many cases unintentionally create confusions for the healthcare community, our patients and their families in the terminology and language we choose to use. I recently sat on a panel at DePaul University on the future of healthcare in the U.S. and this very issue emerged – that in creating true accessibility we have to not only have the proper processes and checklists in place, but also the right, and perhaps more importantly, the clearest language possible.

I am not suggesting the healthcare system is facing the same levels of dysfunction as the U.S. Congress, but I do believe there is a great opportunity for clarity in making the healthcare experience easier and better for all receiving care. Finding language that works for patients and families, as well as for those working in the system, will only serve to better engage and inform patients and families and support the invaluable nature of their role as partners in the healthcare process.

This could perhaps be one of the first and most important steps in driving patient experience success. There is power in language, in its application and perception…the US congress taught us that again this week in a way I don’t think we cared to learn. But in this chaos I see a silver lining, an important lesson for all of us either entrusted with and/or committed to the best in patient experience. Manage perceptions with clarity and honesty in each and every healthcare encounter. It may not change the system overnight, but it will have a positive and powerful ripple effect that will be very hard to diminish.

Jason A. Wolf, Ph.D.
President
The Beryl Institute

The Conversation on Patient Experience Improvement Continues: A Reflection on Three Years

Most people would suggest that change doesn’t happen overnight, and while I believe change does take time, it does not need to take a lot of time. In fact, change, like most things in life, requires nothing more complicated than a simple choice. It is this same idea – the power of choice - that I use to frame all my discussions on patient experience improvement.

I share this idea of choice and change on the week that The Beryl Institute itself turns three years old. As we have seen the patient experience movement grow and flourish, it too has been a journey of change and choice. From the very first member signing on in September 2010, to the now over 18,000 members and guests from 45 countries around the world, The Beryl Institute community has made big choices and as a result driven big change.
Over the course of the last few years I have written about engagement, involvement and community and I am excited to say that the state of The Beryl Institute community is strong. We have seen a growing use of thedefinition of patient experience. We have also experienced almost a doubling in organizations having a formal definition of patient experience (something we stress as critical) as revealed in the 2013 State of Patient Experience study and represented in the recent powerful infographic of the findings. We have also been inspired by the growing “#IMPX” movement with increasing numbers of organizations creating compelling videos of their teams reinforcing the message – ”I am the Patient Experience”!

At the Institute, we have also worked hard to ensure all voices are engaged in the conversation on patient experience improvement. We have authored an extensive series of publications to be a resource to all those working to impact the patient experience – from the C-Suiteto the front lines from students to patient and family members. This effort has been expanded by the launch of the first of its kind Global Patient and Family Advisory Council to ensure this critical perspective is central to all we do. It has been supported by not only our virtual community connections, but also the consistently growing annual Patient Experience Conference providing practitioners the space to reconnect and reenergize every year.

In shaping the knowledge and information base for patient experience improvement, we have led the effort to create a comprehensive body of knowledge focused on developing patient experience leadership now and into the future and guided by the input of over 400 healthcare leaders around the world. We have also awarded over 25 patient experience grants to support direct research projects on patient experience improvement where it is taking place – on the front lines. Most recently we have announced the launch of The Patient Experience Journal, a multidisciplinary, peer-reviewed publication designed to share ideas and research, and reinforce key concepts that impact the experience of patients and families across healthcare settings.

The full history of the Institute is rich, but more importantly it exemplifies the very power of choice and of community I mention above. It was the choices of so many that made these offerings and resources possible. It will be the continued contributions of community members that will maintain this growth and drive the patient experience movement forward. These choices have led to great change and our hope is to continue to support this growth by providing a gathering place for ideas, a dynamic space for interaction and a vibrant hub for continued dialogue on patient experience improvement. We have arrived at this point with the guidance, leadership and support of so many around the globe…for this we are forever grateful. We now humbly go forth knowing there is much more work left to do. Happy Anniversary to you, this passionate and engaged community. We celebrate how far we have come together and look forward to continuing this journey with you!

Jason A. Wolf, Ph.D.
President
The Beryl Institute

Involvement is the Path to Patient Experience Excellence

InvolvementBlogThe words of the day in healthcare of late, especially in light of the policy undertones influencing the system in the U.S., are around engagement and activation, especially of patients, but also focused on staff, physicians and community. Studies show that activated patients are more apt to have greater patient experiences (When Seeing the Same Physician, Highly Activated Patients Have Better Care Experiences Than Less Activated Patients, Health Affairs, July 2013 32(7):1295–1305) and the e-patient revolution is well underway as exemplified by such organizations as the Society for Participatory MedicinePapers espouse the power of staff engagement as the means to better experience (The Role of Organization Culture in a Positive Patient Experience, The Beryl Institute, 2012) and community engagement is reflected by growing involvement in strategic efforts such as what I experienced at the William Osler Health System in Brampton, Ontario, Canada.

While these ideas are external efforts that influence specific organizational strategies and associated actions, I was struck with the recognition this too is what we have worked to model via The Beryl Institute ourselves. As a global community of practice, we have been clear in declaring a mission to create a dynamic space for members to convene, engage and contribute to elevating, expanding and enriching the global dialogue on improving the patient experience.

In just the last two weeks we held the very first call for our Global Patient and Family Advisory Council (GPFAC), an incredible group of patients and family members committed to serving in ensuring patient and family voice is part of the patient experience movement. Their generosity of spirit and commitment to this cause left me inspired and excited for all we still have to do in our efforts to improve experience. We also met with our Patient Experience Advisory Board for their quarterly call to review our direction and strategy as an Institute and ensure we are meeting the needs of those on the front lines addressing the patient experience every day. In that conversation I was moved by the excitement and commitment to the movement we all support. It is through the generosity and spirit of these two groups, and also the continued contributions of members and guests via On the Road visits, sharing case studies, and through a record number of Patient Experience Conference speaking submissions, as just a few examples, that the sense of involvement was palpable.

Involvement, you could argue is a play on all these words: engaged, activated or even participatory. I do not want to play the semantics game, but for sake of discussion, one can be engaged or even “activated” without a true bias for action, they can simply serve as states of “being”, not doing. Perhaps this is why the Gallup Organization uses the term “actively engaged” to reinforce their measures of a highly engaged workforce. Participation, more so, suggests action, as it requires the individual to be doing something. Involvement continues to expand that reason, from one of a state of being to one of acting. In fact one definition of involvement I saw encompassed these very terms (parenthetical comments are my own): to engage (an action) as a participant (an active contributor).

The takeaway for me here is simple, as we have seen in countless organizational visits, cases and presentations, as we have uncovered in research efforts and benchmarking studies and perhaps most importantly what we have experienced in our very organization is that not only does involvement matter, it has significant influence on what can be achieved, how it is achieved and how quickly it can be achieved. An unassuming word on its own, involvement, may provide a profoundly important key to success in a healthcare world now intently focused on the improvement of the experience of all, patients, family members, community and caregivers. I believe that involvement is a fundamental component of any path to patient experience success. The question that now remains is how involved are you in your efforts and how willing are you to involve others in your success? I also strongly invite you to get involved in the patient experience movement and The Beryl Institute. We all still have significant and exciting work ahead!

Jason A. Wolf, Ph.D.
President
The Beryl Institute

Patient Experience and the Freedom of Choice

IPatient Experience and the Freedom of CHoice - The Beryl Instituten writing a blog for a US-based, global organization on the week of July 4th, I am hard pressed not to think about the concepts of independence, of freedom and of what those concepts provide for. To be independent, to be of free will, is something most, if not all, aspire to. It is ingrained in our human nature, for at its base is an idea so simple, yet at times so complex – the power of choice. For me this concept of choice is the essence of patient experience itself.

When I talk to people about the strategies and tactics of patient expedience improvement, I start with the simple recognition that what we do in healthcare – as human beings caring for human beings – is about the choices we make. From leaders guiding organizations on what priorities are set each day, to frontline caregivers across healthcare settings we are making choices in every moment, not just on what care to deliver, but how to deliver it as well.

This power of choice is profoundly important, and of increasing influence in our healthcare systems today. While we once may have gone directly to our local physician or hospital and listened intently with respect, following every word and instruction, the nature of healthcare itself has changed. I know to some this poses a great concern and others even disdain. For me, it reveals the true potential for excellence we have in healthcare systems around the world.

The debate has long simmered on if patients are customers of care. Using this term allows supporters of the historic healthcare hierarchy to diminish the very voice of patients, most often unintentionally. And you may be surprised to hear that I agree. Patients for the most part in healthcare today are not the customers of care. Customers are those individuals or organizations that choose to pay for a product of service. In fact following this logic, most often, insurance companies and/or government entities are the true customers of healthcare as they are the one’s directly funding services or paying the bill.

What does this mean then for our choice as patients? While many rightly make the argument, that as patients we do not choose to fall ill, have an accident, etc., that is we do not most often choose to be customers of healthcare, we overlook what I suggest above – that as human beings we still have choice. This distinguishes to me where patient experience plays it most significant role, especially economically. Patients are without question consumers of healthcare, regardless of systems, locality or structures. From an economic perspective it is the consumer who drives markets and influences business viability. Consumerism is the consideration that the free choice of individuals strongly influences what is offered to a market, what grows and what is overlooked. Therefore consumers and the choice they bring have strong economic impact.

The bottom line is that as patients have independence, even with some constraints based on insurance or in governmental healthcare systems, and therefore they have choice. Patients will note where the experience – the culmination of quality, safety and service – is best. And they wont keep it secret. Outside of the increasing use of government surveys globally to measure and publicly report performance, other consumer outlets are quickly booming – have you yelped your physician’s office lately, or seen the dialogue on Facebook about the care in your local hospital? This is consumerism at its finest and it is having great impact.

Patients have discovered they too have choice in the system, to not just expect, but to directly ask for and seek the best care they can find. Yes, patients do not choose a healthcare encounter like they would a hotel or an entertainment experience, they actually do so MORE significantly because this choice is about their own or a family member or friend’s well-being. A dear colleague, an inspiration for patients as true consumers of care, and a contributor to our Voices of Patients and Family paper – “e-Patient Dave” deBronkart clearly expresses the need for us as patients and family to choose to engage in our care, in ensuring we are fully informed and in doing so make the right choices.

I too am reminded about a story a gentlemen shared once with me about his 80-year old mother who when finding she needed hip replacement, scoured the internet for information on the procedure, recovery times, outcomes, etc. She discovered, that while scheduled for surgery at her local hospital (where she had gone for years), there was a better place for her to have her surgery in another state a plane ride away. She booked the ticket, made the trip and had her surgery. Now while all patients choices may not be that extreme, we must acknowledge that we all have choice – in some ways it is all we have – in how we decide to deliver care or on where we decide to receive it.

On a week where independence is held high, it is important that we remember it is not just a holiday in the United States, but a statement about the very freedom we have as individuals, as consumers: the freedom to choose. The Declaration of Independence declared that individuals “are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” There may be no stronger place for us to remember these choices than in the decisions affecting our health. As healthcare leaders we must remember this, as caregivers honor it, and as patients and families never forget – the choice is truly ours.

Jason A. Wolf, Ph.D.
President
The Beryl Institute