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

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

 

The Power of Expectations: A Thought for the New Year

Expectations are powerful. They influence what we see, how we act, and the way we react. They stir emotions and create real feelings from joy to anger, surprise to sadness. The reality of expectations is that they present an intriguing paradox in how they can and do influence the situations in which we find ourselves. Expectations are an individual and even very personal experience, yet at the same time they can be set by organizations, businesses and other people outside of one’s self. This makes expectation potentially the most valuable and perhaps most precarious tool in the discussion of consumer experience and in healthcare, the patient experience.

The example of how personal expectations can modify the perception of reality has long been part of the healthcare world. As Chris Berdik notes in his new book, Mind over Mind, the power of expectations lies at the center of the placebo effect. Berdik makes a compelling case that what we expect from the world changes how we experience it. He notes that research into placebos is expanding to examine everything that affects a patient’s expectations for treatment, including how caregivers talk and act and even the impact of the wealth of online information now available – and how those expectations can help or hinder healing. I believe the same is true as we look at the overall healthcare experience. Patients and families come with personal expectations and more often with ones that healthcare organizations worked to create. It is these very expectations that impact how individuals experience an organization and ultimately rate its performance overall.

I can share a non-healthcare example of this from just this past week. My wife and I had the chance to take a few days away for the holidays at a small inn near our home. We had heard great things about the service and quality of the experience and were excited by some of the extra amenities they offered. When we arrived we discovered our room was the only one missing the special amenities they touted in their promotions, and while the service was impeccable, this missed expectation had already impacted our experience. The hotel did all they could to accommodate and provide service recovery for our experience. To an extent they even exceeded what we would have anticipated in response, but it was the missed expectation that still lingered for us as guests.

Now imagine in the healthcare setting where our patients and families come with their own set of anticipations and clear expectations. Most do not choose to visit, but rather are dealing with illness or other issues that may be cause for great concern and even fear. They come with expectations of how they will be treated, but even more significantly they come to your doors with the expectations your organization has set through the stories shared and the messages disseminated via advertising or other means.

I saw an example of this at a recent hospital I visited. They were so proud of their new facilities, including new amenities, private rooms, etc. The advertisements and billboards they produced promoted the newness of the hospital. Yet, they still also had an older wing, where the rooms were dated, semi-private and lacked the sparkle and shine of the newer rooms. While the patient experience of the facility was not designed to be about the physical nature of the buildings, but rather the encounter people have with staff, they set the expectations publically that the facility itself was at the heart of their overall experience. In essence, they set expectations they could not always fulfill…and it set up the potential for disappointment before they even had the chance to make an impact.

The lesson here is simple, yet significant and one I think is critical to looking at the year ahead. For as much as we can control our efforts in healthcare, we must work to set the best and most realistic expectations we can for our patients and families. This is not what I have heard some describe as lowering expectations to outperform, but rather it is about setting the right expectations for what you want to deliver in your own organization and ensuring the means – both in resources and process – to deliver on it.

In maintaining a focus on providing a positive patient experience, consider starting the year by identifying the expectations you hope to deliver, ensuring your leadership and staff are aware of these touted expectations and establish a process to check your performance to these expectations at every point in the care experience. While you cannot dictate every expectation people bring with them to your doors, healthcare organizations can shape their own story in a way that ensures expectations are realized and the patient experience is one that will always be remembered. Wishing you fulfilled and exceeded expectations for the year ahead!

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Regardless of U.S. Supreme Court Decision, Patient Experience is Central to the Future of Healthcare

One question I was consistently asked in anticipation of last week’s U.S. Supreme Court decision was what impact the outcome would have on the importance of patient experience. My response was unwavering; that if healthcare organizations are simply driven by policy or perceived political pressure they might want to reconsider their true purpose and very existence. Regardless of the outcome of last week’s decision, I believe the increasing focus on experience in healthcare is more than practical or pragmatic; it is central to the highest quality healthcare encounter.

This week I was posed the question again during a workshop I had the privilege of leading titled Shaping Healthcare Experience: The Power of Interaction. The audience included healthcare and service professionals from across Europe. The discussions that were ignited and the passion with which the participants engaged in the subject supported my belief that the effort to achieve excellence in patient experience is not simply a phenomenon in the United States or one simply driven by policy. This is also reinforced by the fact that over 23 countries are represented as members and guests of The Beryl Institute itself. Patient experience is a without question a fundamental and global discussion.

Whether it is global perspective or political or policy motivations, those of us engaged in healthcare in whatever capacity need to consider the impact of our work on the experience of patients and families. As I discussed in my workshop, we are all touched by healthcare in some way either directly or indirectly through family or friends. More so we are aware of not just the outcomes, but also the stories we take from those encounters. Those stories are comprised of powerful and important interactions – as suggested by the Institute’s definition of patient experience as “the sum of all interactions…” In the workshop I posed the question of which interactions are most important in the healthcare encounter. After a long brainstorming effort the realization was that every interaction from the most critical clinical interventions to the almost unnoticeable or mundane encounters collectively equate to the experience people have and all are equally important.

At their core, each of those interactions is about a choice. As healthcare organizations you choose how to structure processes or determine what behaviors and expectations to establish and reinforce. With this, healthcare organizations are also held to the individual choices their people make at every touch point across the care continuum. It is here where you may be making things more complicated then necessary. By focusing on policy or political constraints you overlook the simplest of human factors; that people most often want to do the right thing. What must be done as leaders is to provide the support, the environment, the culture in which the right choices can be made, the right interactions provided and the best of experiences ensured.

I hope we can shift the discussion on experience from “why” and “what”, from policy or politics, to understanding there is a fundamental choice to provide the best experience possible for our patients, families and guests. In the desire to engineer this process we overlook the basic fact that healthcare at its core is human beings caring for human beings. In recognizing this, you ensure patient experience is a central and driving force to a continuously improving global healthcare system. It just starts with a simple choice.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Loyalty – The True Reward for Unparalleled Patient Experience

Last week I had the opportunity to attend a conference on Healthcare Experience Design. This is an incredibly important part of the work in providing a positive patient experience. In fact, experience design has been identified as one of the fourteen core domains in the Patient Experience Body of Knowledge (Have you provided your input yet?). The element of design focuses on possibility, not problems. I believe we need to ensure patient experience overall has that same intention.

The well-known design firm IDEO reinforces these principles in the way they work with partner organizations. They describe this as design thinking, “a deeply human process that taps into abilities we all have but get overlooked by more conventional problem-solving practices.” This is a powerful statement in that patient experience in many ways is just that, the ability to move beyond problems to something more meaningful, and beyond standard processes, to those that have real and lasting impact. In this shift from a problem solving to a design mindset, the potential power of a positive patient experience is unleashed.

This idea was reinforced by Gary Hirshberg, President and CE-Yo of Stonyfield Farm, who talked about the potential intersection of design and business function. He shared that while some organizations manage their priorities to reduce production costs and then direct significant dollars towards promotion and advertising, there is another opportunity. If we invest in our products and services to ensure the greatest quality experience, we can change the equation. This shift in focus is from one of awareness through advertising to one of attraction and engagement through loyalty. Hirshberg reinforced that you get to loyalty by doing what is right for your consumer, not by telling them how great you are. As I listened to this argument in the consumer product world, I found myself thinking about how this applies to healthcare.

In an era where patients and family members are becoming more consumer-savvy and the system is set up to provide for greater ways to actually comparison shop in the healthcare marketplace, how has healthcare responded? Have efforts in healthcare focused on awareness through advertising and promotion or have opportunities for loyalty been created and sustained? Has a system been built based on solving the problem of driving healthcare volume or has the industry shifted to the thoughts of possibility in designing for an unparalleled experience?

It is clear in healthcare reputation carries great weight, but how that reputation is presented also has an impact.  Advertisements for awards, recognitions or even wait times can only carry an organization so far. They are the perceived, not lived experience. Rather it is in designing and enacting the actual experience through which reputation is solidified and loyalty gained. This suggests the importance of investing in what it takes to ensure the best patient experience versus simply the messages to convey value. In doing so the conversation shifts from awareness which will need to reinforced again and again via the next print ad, billboard or TV spot, to that of experience that will reach well beyond the walls of a facility or practice, through the words of those that have walked your halls, engaged with your staff and had the chance to be impacted by the experience overall. Loyalty does come by doing right. This is making the right investments in your overall patient experience. In doing so you move beyond solving the problems for your organization and instead reinforce what is possible for your patients, their families and your team.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Creating a Body of Knowledge for Patient Experience Leaders

In The Beryl Institute paper, “The Four Cornerstones of Patient Experience”, we discovered that when organizations choose to have a leader with committed time to guide patient experience efforts, those organizations outperform their peers in both HCAHPS performance as well as patient satisfaction results. Finding that intentional focus on an issue leads to better results is not surprising, but it is important to note that a focused individual made the difference.

This led us to ask, if we can show that having an identified patient experience leader is a critical component of success, and specifically in driving measures that have service, quality and financial implications for healthcare organizations, can we define what it is that this individual does?

We started with a small steering team of healthcare professionals from hospitals and organizations across the United States on a mind-mapping exercise to identify key areas of knowledge critical to patient experience leaders. This exercise led to the development of domains that started to frame a core body of knowledge. Job descriptions were explored from roles around the world, competency models were examined from related fields and organizations, and then broader input was sought engaging patient experience and healthcare leaders from the US, the UK, Australia and Canada. The feedback led to hundreds of pages of thoughts on the critical nature and true complexity of patient experience and of the knowledge needed to effectively address it.

The discovery was powerful; a body of knowledge for patient experience leaders that began to shape an identifiable field of practice. It also brought greater clarity to the findings in the “Four Cornerstones” paper. While a focused individual was critical, this alone would not drive patient experience success. Rather an individual needs the skill set and “know-how” to truly impact this central component of the healthcare world.

That leads us to today, where the input and work of over one hundred volunteer leaders and contributors provides an initial framework to explore and a new possibility for shaping the field of patient experience. On Monday, March 5 we unveiled the Patient Experience Body of Knowledge and the 14 domains of knowledge key to an effective patient experience leader. With all the work that has led to this point, it is now that a much broader conversation gets underway.

We invite individuals from all corners of the healthcare system, including patient experience practitioners, healthcare leaders and staff, physicians, patients, families and community members to contribute their voices to the process. For the next 6 weeks, through Monday, April 16, we will be gathering your input to further polish this work. We will share the results of this effort to start Patient Experience Conference 2012. At The Beryl Institute, we believe the patient experience is about every player in the healthcare process and should encompass the voices of all those it impacts.

In healthcare, experience is truly central to all we do. The opportunity to provide a framework for the important work taking place every day in healthcare organizations is a critical global dialogue. I invite and encourage you to join the conversation.

Jason A. Wolf, Ph.D.
Executive Director
The Beryl Institute

Whose experience is it anyway?

During two of my recent On the Road visits (one with Children’s National Medical Center and another for an upcoming story on Banner Health) what I observed and what came up in conversation caused me to pause and ask the question – whose experience is it anyway?

In one example, Kelli Shepherd, the Director of Service Excellence at Banner Good Samaritan Hospital, shared a subtle, but profound change in the language they were using. The shift was one in perspective – from “our” beds to “their” beds. A simple change, but one I believe challenges one of the central mental models I have seen in healthcare. We have often viewed patients as individuals that things are done TO, not necessarily done FOR.

I would not say we have turned healthcare into a heartless, mechanical process. Rather, I caution that what we may have done in not recognizing “ours” versus “theirs” is to design processes and systems and implement requirements and standards made to work best for us, not our patients and families. So what can we do to address this?

1. Clarify perspective. Are we building our programs, and even our patient experience efforts, from what we believe will best fit our needs? Or are we considering the perspective of patients and families as our guests? Stop and ask yourself, especially as you consider developing your patient experience effort, if the process is based on what is easiest for you or what is best for the patient?

2. Build an active process to engage patients, families and the community at large in how we can provide the best experience possible. Many organizations are now using patient focus groups not only to gather feedback post experience, but also to design processes and programs. At Children’s National, Patient Family Advisory Council members are embedded in many departments. They review and offer feedback on processes and provide an open avenue to ensure a broader perspective is available in all planning; they have even participated in the redesign of units.

3. Find ways to show you “listened”. The biggest return on experience investment is ensuring that patients and families not only feel heard in the moment, but also that the experience they are having overall reflects their wants and needs. Find avenues to show you are listening; be transparent about the input you seek and when and how you can (or cannot) use it.

As many of us in healthcare call hospitals the “house”, we must acknowledge that we are welcoming patients and their families into “our” house as guests. Our efforts should be focused on ensuring we provide the best experience possible. To do so we must recognize whose experience it is in the first place.

Jason. A Wolf, Ph.D.
Executive Director
The Beryl Institute