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

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 Importance of Voice in Improving Patient Experience

As The Beryl Institute has grown from a small group of committed individuals to a true global community, I have learned something very important. There is tremendous power in giving voice to ideas. Voice is not just the spoken word, but also the expression of opinion and thought, of creativity and passion, through multiple avenues. It is this essence of giving voice that rests at the core of excellence in patient experience itself.

My hope is that the Institute has reinforced that very fact. More than just a membership association or a research organization, the Institute’s strength in supporting those working to improve the patient experience has been in giving voice to the over 15,000 members and guests that engage in our community of practice. It was members and guests that provided input on the largest patient experience benchmarking study to date, it was members and guests who over 400 strong have contributed to creating the Patient Experience Body of Knowledge, it was members and guests who came together to author the definition of patient experience.

Why is this important? Because we have been built by and for our members in the way I have seen the most successful organizations address the patient experience itself. Those organizations have created the means to engage the range of voices they encompass. Those successful facilities and practices, systems and centers have made a commitment to intentionally listen and actively engage the voices of their community. They did this by:

  • Creating the opportunity for the voice of patients and families to be heard, not just in formal advisory roles, but also in common interactions. Those organizations that have incorporated patients and families as critical partners in the care experience excel at ensuring the best in service, quality and safety.
  • Providing the means for the voice of staff to be heard, not just through engagement surveys, but also as active contributors to an environment of continuous improvement. The ability to speak-up, offer ideas and even challenge the status quo without fear of repercussion has led to great improvements and important changes in the delivery of care.
  • Offering the chance for the voice of the community to be heard, more than just asking for contributions to foundations or causes. The engagement of community through strong presence and focused outreach shapes the nature of a healthcare organization, be it a rural community health center or a major urban hospital. In healthcare we hold a unique place in the communities we serve and play a role no other service provider can.

The importance of voice plays a central role in improving patient experience in healthcare settings around the world. In fact, in our most recent paper, Voices from the C-Suite: Perspectives on the Patient Experience, the executives we interviewed consistently talked about the importance of engaging the voice of patients, family and staff.

In no small part then is the importance of continuing to ensure the power of voice is included in all we do at the Institute. We have opened the year with a series of papers, including the Voices from the C-Suite mentioned above, that provide the opportunity for voices to be shared. This will be followed by Voices in Practice and ultimately Voices of Patients and Family, as we look to reinforce this simple, but significant tool and the lessons it offers in impacting patient experience.

Perhaps more importantly, we commit to ensuring the voice of the patient experience is heard. It is in our collective expression and sharing in which each individual and the organization they represent can learn and grow. It is ultimately in expressing our voice that we give the greatest gift to one another, it is in inviting that voice that we show the greatest of respect.

Improving the patient experience is not just an act, it is critical dialogue; one that we must foster and encourage. Its impact is greatest when all voices are heard. Our commitment is to provide the space for that to continue. My question now is how will you use your voice to impact the patient experience and how will you engage the voices of others? This is one conversation we must never let end.

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

Patient Experience: A Global Opportunity and a Local Solution

Last week we held the second call of the new Global Patient Experience Network supported by The Beryl Institute. The call included Institute members from eight countries and spread across 18 time zones. Despite our differences in location, time of day, native language or accent, when the conversation started, we discovered that the concepts at the core of improving patient experience are fundamentally the same. Providing the best in experience for patients, families and the communities (and countries) we serve is an unwavering focus for people across healthcare systems and functions around the world.

As I listened to the conversation and we dug deeper in identifying what posed the greatest challenges and offered significant opportunities for improving patient experience, I was struck by the recognition (and even relief) that participants showed in how similar their issues were. One participant offered, “It’s comforting to know we are all contending with the same challenges and questions moving forward,” with a second individual noting, “It is amazing that at the end of the day we are all working towards the same end and facing the same issues.” This realization drew agreement and raised the excitement of the group in understanding that even with great distances between us, there are great similarities and therefore possibilities.

The group identified the same top issues central to patient experience efforts that I have seen in my travels. They included:

  • The importance of organization culture and our ability to manage change in today’s healthcare environment
  • The understanding and effective implementation of patient (and team) interaction processes from patient, physician and staff engagement and involvement to service recovery, post care follow-up and building consumer loyalty
  • The implications of measuring our patient experience efforts to gauge perception and understand the impact of each effort
  • The value of the structure of patient experience practice itself, ensuring a clear focus, supportive leadership, aligned roles and right structures to deliver on the best experience possible

While these are not the extent of the issues faced in addressing patient experience, it was evident that among peers separated by great distance, they still had closely knit similarities. This was especially significant for our team at the Institute as we have always approached our work from the belief that while systems may operate differently and policies might be distinct, the very fundamentals that drive a positive patient experience – the power of interactions, the importance of culture, the reality that perceptions matter and the realization that experience covers the continuum of care – as framed by the definition of patient experience, continues to hold true.

With this great commonality and the excitement generated in the discussion, it was also evident that our members recognized that patient experience is a local, dare I say personal effort. Each and every individual that plays a role along the care continuum has some level of responsibility. It is based on the sum of all interactions, as we suggest, that a patient and their family members gauge their own experience. Therefore in building a patient experience effort, it requires an understanding of your own organization, the people that comprise it, and the community (and demographics) that you serve. Patient experience success is not driven by a one model fits all solution, it is and forever should be something that meets the need of your organization and your patients whether in San Diego or Sydney, New York or New Delhi. Ultimately, patient experience is a global issue, but it is and will continue to be up to each of us locally to bring these grand ideas, the critical practices, and the day-to-day needs to life in every encounter. There is a great opportunity we have been given to move beyond policy to true cause, beyond process to effective practice and beyond “have tos” to “always dos”, that will impact the lives of patients and families globally. I have always suggested it is a choice…I maintain that and hope it is part of all our resolutions for positive and healthy New Year!

In reflecting on the launch of the Global Network and other Institute efforts in 2012, it is clear that this has been an amazing year for our growing global community, with now over 11,000 members and guests in 28 countries focused on improving the patient experience. We have all committed to something noble and important, the best possible experience and the health and well being for our fellow man. And we have been given a great opportunity, to turn a global need into something each and every one of us can impact directly. Happy Holidays to you all and I look forward to continuing to learn and grow together in the year ahead.

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

Creating a Field of Patient Experience – A Call to Action

Something powerful took place at this year’s Patient Experience Conference and it took some time in reflection for me to sort it out. We opened the conference with the powerful video “I am the Patient Experience” showing the faces of the many individuals key to the Patient Experience. We then reviewed the efforts underway to create a Body of Knowledge, shaping a model for ongoing development of patient experience leaders, and the potential for formal certification. The days together were filled with the connections and learning central to the vision of The Beryl Institute (see the pictures and review the lessons learned).

It culminated with our closing speaker, Tiffany Christensen who brought us the voice of the patient and suggested something profound. She noted that our work in patient experience is truly a movement. In fact, what we are doing together is shaping a field. As the faces of participants declaring “I am the Patient Experience” flashed on the screen to close the time together, it was evident something bigger was happening than a conference or even the growth of a global community of practice.

Captured in the energy and spirit that filled those three days in April, was the same commitment and possibility that was shared by the over 300 individuals from 8 countries that have contributed to framing the 15 domains in the Patient Experience Body of Knowledge or even the over 8,000 members and guests that engage with the Institute community every month. The Body of Knowledge now stands for something bigger than just things we “need to know” to be effective practitioners in patient experience. It represents the foundation of a field grounded in knowledge and experience that can have lasting and profound impact on how those in healthcare work and how patients and families are ultimately cared for.

Creating a field is no small task and will not emerge from any one individual or organization. It must result from the voices of many, which is why I encourage your continued involvement in the Body of Knowledge effort. At The Beryl Institute, we look to be the catalyst, convener and coordinator of this important work. The next steps in the process will be the creation of work teams that will outline the key content for each of the domains of knowledge. Together with respected subject matter experts these outlines will help shape the learning needed to sharpen the skills of current practitioners and create a path to develop future leaders for the field. I invite you to learn more about the process and consider contributing to the work of these teams

I mentioned in a recent Hospital Impact blog that patient experience is not a fad, but is now a critical component of healthcare overall. We must work together to solidify the knowledge needed to lead, continue to support the research that will stretch our ideas and practice and come together as a global community that will take a stand for what we know is right in ensuring the best of experiences for our patients and their families. If we do this with the passion that I saw during our three days together at Patient Experience Conference 2012, there is no doubt that what we are doing is truly creating a field of patient experience.

Jason A. Wolf
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