Reframing Patient & Family Experience

experienceBWAs the experience conversation grows and more voices enter the discussion, I have come to recognize a need to reframe how we think about experience overall. In much of what I have written and shared in my talks, I have stressed an important point, that experience at its broadest point is all a patient, long-term care resident and/or family member encounters while they are engaged in our healthcare system. Critical to this idea is that, as outlined in our stand at The Beryl Institute, experience also reaches across all segments of the continuum and the spaces in between.

I raise this again now for as recently as this week I have been asked about how experience fits with quality and safety efforts or compares to patient engagement. My concern and therefore my desire to align our conversation is that many in the experience discussion have become trapped by our own warnings – that we continue to address experience from the perspective of providers rather than what the actual experience is for those in our systems.

I start by reinforcing what patient experience is not, in order to build a framework and encourage a discussion of what experience truly must be. For a long while experience was simply aligned with service or service excellence or even more simply satisfaction. For many it still is. Service in healthcare is critical, as it is the domain through which we find ourselves engaging people with dignity and respect, as one human being to another. Yet service is also not the full extent of what the users in our healthcare systems experience. It is but one piece of a complex pie inclusive of quality, safety, service, cost, outcomes and influenced by caregiver engagement, in which we must work diligently to drive integrated actions.

This leads to the question is experience engagement? There has been incredible work around the processes and tools to drive patient and family engagement and in their very creation believe our answer is provided. If engaging patients and families in care encounters is of value, which it has proven to be, this too becomes a critical practice in positively impacting experience. Engagement tools, and in similar light the concepts of patient and family, or person centered care, all provide an incredibly important set of resources for ensuring the critical positioning and involvement of patients and families as partners in their care. These ideas too then are not experience in total, but rather are central to ensuring a positive experience overall.

I continue to raise this issue for one central reason. That in all we do to ensure the best in healthcare as I note, from quality, safety and service, to driving outcomes or addressing cost, to implementing processes of engagement or person-centeredness, these ideas are OUR language inside healthcare looking out. Yet when looking from the outside in, they are all but parts of one experience.

With this mindful integration I do not suggest we eliminate all distinct efforts to drive results in these various segments of experience. In fact in order to manage the dynamic nature of healthcare today, we need to focus our work on each of these critical efforts to ensure directional progress and continuous improvement. Rather, I do suggest we MUST NOT tackle each of these efforts in isolation, or under the false pretense that they are not part of the broader experience for patients and families.

So what is the opportunity we then have in reframing patient and family experience? I believe we must:

  1. Look beyond experience as just satisfaction or service to the reality of what our patients and families see every day. We do them great disservice by simplifying this idea in a way it becomes tangential or even “soft” to the hard work we do in healthcare every day.
  2. Align and coordinate our divided efforts, and in doing so, our collective language, to reinforce a commitment to the perspective of the end user in healthcare today. We can still segment our work efforts and improvement opportunities to tackle these often complex opportunities and problems, but we cannot and must not do so to the detriment of providing a coordinated and comprehensive experience.
  3. Work together to address experience from the broadest perspective across and at all touch points and the moments of truth we create clinically, interpersonally, virtually, etc. and include the voices of those we care for and serve to ensure an integrated and experience focused effort overall.

Yes we must focus on the basics – the blocking and tacking of what impacts experience everyday on the front lines of care, at points of transition and in the many seams we have created in between, but if we lose perspective on the broader opportunity, our smaller steps may not help us realize our greater goal. If we are committed to providing the best in experience for all in our healthcare systems – quality, safe, service-oriented, cost efficient, outcomes driven, inclusive, coordinated and compassionate – like I know most in healthcare are, then we still have great opportunities ahead. I challenge us to think about reframing our view of experience. In doing so I believe we will identify and achieve all we know is truly possible for all those touched by healthcare every day.

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

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

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

 

Patients are Partners in Experience, Not Just Recipients of One

JWBlog6.13In my most recent Hospital Impact blog I noted that “how” we choose to do things in healthcare will and should trump the “what”. This is supported by my travels through numerous healthcare organizations where it is becoming evident that the core practices organizations are using to drive patient experience success are more and more consistent. While some might see this as limiting, I see it as encouraging.

Why is that? It means we are listening to one another, learning from each other and showing an incredible willingness to “steal ideas shamelessly” as a well respected CEO once shared with me in describing a component of their organizational success. That means the ‘what’ we do is not very different location to location. The distinguishing characteristic in experience is not the things you do, but the way in which your deliver. This is at the core of the very definition of patient experience as “the sum of all interactions, shaped by an organization’s culture”.

This ability to listen and learn from one another is a central value of all we do at The Beryl Institute. As a global community of practice we can (and must) learn from all edges of the community – those Institutions rated the “best” or seen as the “biggest” do not represent the only expertise. Rather it is in trying and executing of ideas in organizations of all shapes, sizes and focus through which excellence is supported and shared. It is based on this premise that the idea of a broad and inclusive range of voices has been so central to our work.

In returning to the conversation of “how”, I reflect on the recent conversations I had with 18 incredible patient and family advocates committed to the work of improving quality, safety and service for patients and families around the world in preparing the most recent paper from The Beryl Institute – Voices of Patients and Families: Partners in the Patient Experience. The stories these individual’s shared of compassion personified and at times the uglier side of care help us realize that there is power in how we choose to manage the interactions we have in healthcare every day. That it is truly more than the tactics, and rather the execution that matters.

The point I make here is all the tactics in the world amount to very little if all they are is something we do TO people in our care. The old language of provider and recipient may well still be used in healthcare, but its use is outdated and indicative of a system in need of change. Patients – yes, you and I, our children and parents, family and friends – are active parts of the healthcare equation, not passive recipients of it. We need to ensure we start acting this way. This perspective is exemplified through the work of such great organizations as the Society for Participatory Medicine.

While there are countless lessons shared by the individuals interviewed in the Voices paper, we inherently know many of them ourselves. Our contributors helped frame three central ideas in ensuring partnership in the care environment:

1. Acknowledge patients are not subjects in the healthcare process or “something” you should talk about or plan for in third person.

2. Recognize patients are not necessarily wired to actively engage in the healthcare process, due both to the complexity of healthcare and the nature of the system itself (that potentially diminishes the role of the patient in an unspoken hierarchy of expertise). You must ask, encourage, and act on the patient’s voice.

3. Consider coordinating efforts to identify and incorporate patient perceptions into the overall planning of care.

Personally, as I continue the journey of new fatherhood, I saw this play out in the very interactions we have had with our pediatrician. At our stage as new parents, we could be scolded, challenged or even talked down to about how we handle situations. Instead our doc engages us based on our questions, our hopes and fears. I know she is getting all the needed clinical work done, but she is including us as patients and family, as partners in the process. This is an active decision on her part, it is one that engages us in the care of our son and ensures a positive experience with every visit. “How” is a choice we can all make in healthcare and is one I believe will make all the difference.

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

Why Community Matters in Improving Patient Experience

CommunityBlogThey say when someone mentions a Red Beetle – the automobile version from Volkswagenor “bug” – you go from not seeing them at all to seeing them everywhere you look. In a similar fashion my recent conversations on the patient experience have raised this sense of “everywhere” awareness to the idea of community. From as recently as our March 5 webinar on patient engagement to the final interviews I just conducted for our pending paper on the Voices of Patients & Families on Patient Experience, there is a recognition that while patient experience is built on the foundation of countless personal interactions, when pulled together it is a true community issue and, I would suggest, opportunity.

The idea of community aligns strongly with the definition of patient experience that asserts patient experience crosses the entire continuum of care. I need to reinforce from the perspective we hold at the Institute this is not just the continuum within the four walls of the clinical experience, but from the very first encounters someone has with your organization to the stories they share well after their departure or discharge. Where are these stories told and where do they live beyond the boundaries of what you can control? In your communities, in the voices of people that have either had encounters with your organization or who have heard the stories, true or embellished, about what happened within your walls.

This means to provide a true experience, you must think well beyond the physical nature of your facilities or practices to recognize the experience resides in the network of people that surround and are connected to your organization, both near and far. This is at its heart, the essence of experience. As defined, experience is all that is perceived, understood and remembered. Those perceptions and memories and the stories through which they are shared are not collected at your doors, but rather they flourish in the sunlight and in the air of the streets, towns, and cities around you. The experience you provide is a community story and one you must be willing to acknowledge and address.

But I want to suggest another angle on community as well that is as equally important in all I have seen. That accomplishing the greatest in experience is a true community effort. It is not just something that can happen at admissions or discharge, or in your top performing units or departments. It must happen across the organization or system. More so I strongly believe the essence of patient experience thrives in much bigger ideas of community, which is why we have worked so hard in creating a true community of practice in The Beryl Institute itself.

I continue to be amazed by the generosity of spirit and sharing that has been afforded by the safe framework of our community. The realization that in healthcare if we are to be about the patient experience, holding our cards close to our chest or believing our “secret” process is our competitive advantage, is counter to what we are all trying to achieve. As much as I admire systems and organizations big and small for what they accomplish, I can tell you from my travels and encounters around the world, there is no one secret to success. What I have seen as the greatest resource comes back to the idea of that red beetle – community. It is in our willingness to share ideas and practice, to be open to exposing where we may have been challenged and celebrate and disseminate that which drove success, through which we can all impact patient experience.

This is not just a lesson for those in the delivery of care, but for those that support it; the resource providers and vendors, from survey companies to technology tools. It is their willingness to collaborate and share in community through which even greater things can happen. While their distinctions may be in variations of a theme in process and clearly more on level of service and the personalities involved, the reality is that they too play a part in this critical community conversation. From leadership to the frontline, from the future to patients and families themselves, it is the spirit of community and through the action of community that we can ensure the greatest in patient experience for all the patients, families and yes the very communities we serve.

As we approach Patient Experience Conference 2013, and we bring our virtual global community together physically for a few days this April, we hope that we are all reminded that it is through our connections that we have the opportunity for greatest impact. It is in our collective efforts and shared learning that we have the clearest path to success. My hope, and my vigorous invitation, is to join us, join this community and our efforts at The Beryl Institute as member or guest; as caregiver, physician, administrator, resource provider, patient or family member and to be in conversation on what we can accomplish as a community, together. The greatest of opportunities will emerge when we find our collective voice and there is so much yet to learn from one another.

Jason A. Wolf, Ph.D.
President
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

7 Steps to Accountability: A Key Ingredient in Improving Patient Experience

As I continue to visit healthcare organizations and engage with leaders globally there are clear emerging trends at the heart of effective efforts to address the patient and family experience. In my recent series of blogs I suggest we must recognize the implications of patient perceptions as a focus of our patient experience efforts. I support this by reinforcing that culture is a critical choice for organizations to consider in terms of how they look to shape those perceptions. In fact we cannot overlook the centrality of culture to the very definition of patient experience overall. I add that it is on a strong cultural foundation that we can then ensure a sense of engagement for our staff and patients.

The missing piece in this important dialogue is that of building a foundation of accountability in our healthcare organizations. It has been identified as a top issue for healthcare leaders during my On the Road visits and at our Regional Roundtable gatherings. In looking at all the suggested paths and plans to accountability some general themes emerge.

Building a basis for accountability in organizations requires a number of committed actions. Without these organizations run the risk of falling short on their defined patient experience objectives. They include:

1. Establish focused standards/expectations – Determine and clearly define what you expect in behaviors and actions as you create a culture of accountability.

2. Set clear consequences for inaction and rewards and recognition for action – Be willing to reinforce expectations consistently and use as opportunities for learning.

3. Provide learning opportunities to understand and see expectations in action – Ensure staff at all levels are clear on expected behaviors and consequences.

4. Communicate expectations, reinforcing what and why consistently and continuously – Keep expectations top of mind and be clear that these are part of who you are as an organization in every encounter.

5. Observe and evaluate staff at all levels providing feedback and/or coaching as needed – Turn actual encounters, good or bad, into learning moments and opportunities to ensure people are clear on expected behaviors and actions.

6. Execute on consequences immediately and thoughtfully – Respond rapidly when people miss the mark (or when people excel) to ensure people are aware of the importance of your expectations.

7. Revisit expectations often to ensure they meet the needs and objectives of the organization – Remember standard and expectations are dynamic and change with your organization’s needs. They must stay in tune with who you are as an organization (your values) and where you intend to go (your vision).

Accountability has been tossed around more and more in conversations today in healthcare organizations as something that leaders want to see more of. The reality is that accountability is not just something you simply expect and it just miraculously appears, it is something you must intentionally create expectations for and reinforce. As with patient experience itself, accountability needs a plan in order to ensure effective execution.

I often speak of patient experience efforts as a choice; one that requires rigorous work. This is overcoming something I call the performance paradox, which helps us recognize that many things we see as simple, clear and understandable are not always easy, trouble-free and painless to do. Yet I would suggest we have no other choice. As a positive patient experience is something we owe to our patients and their families in our healthcare settings, creating and sustaining a culture of accountability is something we actually owe to our staff in supporting their ability to create unparalleled experience.

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

The Power of Celebration: A Simple Secret in Improving The Patient Experience

Last week I had the privilege of attending an award ceremony designed to recognize the accomplishments of healthcare organizations for performance on patient experience measures, HCAHPS scores and service innovations. The recipients came from across the spectrum of care settings including acute care, critical access, physician practices, outpatient and home health. I have had the chance to attend a number of events like this in the past and have always been moved by the enthusiasm and excitement generated by this type of recognition. Yet at this event, I was struck by something I may have been missing all along.

Whether a large national event of this type or a recognition event in a single healthcare organization, what I discovered is that there is something significant hiding just beyond our efforts at recognition. Recognition is a powerful tool in organizational settings. It has been shown to bolster engagement of staff, increase satisfaction and even boost motivation. Yet, what I suggest is often missed is taking one more step beyond acknowledgement and recognition. It is a magic opportunity we often fall short of in healthcare, the power of celebration.

I am not talking about hanging a sign on a unit to say congratulations for a performance achievement or even singing happy birthday at monthly staff forums. All these activities are important, but remain the rational part of creating cultures of engagement. One could argue these are celebrations, and while I would not disagree, they seem more often to be a thoughtful acknowledgement of accomplishment. By celebration I also don’t suggest the need for costly or even lavish events, I am talking about the emotional connection we have to our success. Celebration is not a certificate or sign, it is the true expression of appreciation from the heart and shared with colleagues and peers.

So how can you use celebration? It may be the attendance of a senior leader at a unit huddle to express why the service efforts of a staff member had a positive impact on the experience of a patient or family member. It could be bringing the prom or an anniversary or birthday party to a patient’s room. It could be a red carpet welcome in the lobby for a volunteer on her 20 years of service or a thoughtful send off for a long time patient who healed and is now leaving your facility. So how do you know that you are celebrating versus recognizing? You feel it on the inside.  Versus a virtual handshake, it is a virtual hug. Recognition is something you do; it is rational and thoughtful. Celebration is something you experience; it is emotional and heart-felt.

In a work environment where stress can run high and emotion sits just below (and at times above) the surface in every encounter, by moving beyond recognition (not leaving it behind) and ensuring true celebration, we intentionally provide an experience for our team, our patients, our families and our communities. The reality is they are having an experience whether we design one or not. In celebration we create lasting memories, the very essence of experience itself – that which is remembered. In doing so we unleash the potential of our people, acknowledge the humanity of our patients and allow the true purpose and passion in our work to emerge. Through celebration we enliven and enrich our organizations and we create new opportunities to positively impact the patient experience.

At The Beryl Institute we work tirelessly to ensure we celebrate the amazing work taking place in healthcare every day. I invite you to share your story. How do use celebration to enliven the patient experience in your organization?

Jason A. Wolf
Executive Director
The Beryl Institute