Silence: The Invisible Tool for Patient Experience Excellence

2016-02I must start my comments with a disclaimer that this blog is not about noise reduction, though I still have yet to find an organization that has conquered this great challenge in healthcare today. In fact our own research at The Beryl Institute continues to show noise reduction to be a leading area of focus, public survey results continue to highlight it as a challenge and a simple walk around most healthcare facilities reinforces the opportunity this issue represents.

Interesting enough was that in our own work on the issue of noise and hearing from recognized efforts in the field of healthcare acoustics that we will never and in actually should never strive for perfect silence. Not only would it be unachievable, it would not meet the true needs of so many in our care. Rather what I mean by silence as we look to patient experience excellence is a much different idea. I wish to frame this not as a negative – i.e., the result of suppressing noise, but rather in the appreciative, as the art of creating a space in which we can hear.

I spent the last week traveling the halls of healthcare organizations and was warmed by the buzz of humanity, and embraced by the rhythmic symphony of conversations and footsteps, beeps and clicks all symbolizing the living nature of healthcare. But what was most moving and perhaps most powerful was a lesson hiding invisibly in front of all us in healthcare trying to have a positive impact…it was those subtle moments between the beats that have incredible power.

In providing a sense of silence for those we work with, care for and serve we create a space for their voices to be heard, their ideas to find opportunities to grow. In affording the gift of silence – that is the space of silence – we enable people to feel acknowledged and listened too. Yet we must also admit that of all places healthcare may be the hardest place to provide this space of silence.

What I mean by this is our ability to be with someone so they can express themselves, providing time to think and reply, to open our eyes or inform us even in the face of the great expertise so many bring in this work. In the space of silence we do more to offer a sense of dignity and respect, of care, compassion, and commitment than we almost ever do in providing a monologue pertaining to our expertise. There is a time and a place for that as well.

In a world where speed so often matters and chaos is the foundation of normality, the ability to sit with someone and allow them to be heard is profound. So how can we proceed in this way for better outcomes in all we do? It may be the most simple, yet difficult concept I have yet proposed in tacking patient experience opportunities. Yet I see it over and over, when we take the time to listen for needs, understand pains, work to connect with the human standing across from us that most of all wants to be heard, great things can and do happen.

As an extrovert I am guilty of violating this trust more often that I would like to admit, so I feel comfortable challenging us all in how we can proceed. How often do we provide the space for a reply, invite a comment or simply choose to be with someone by sitting at their bedside, holding their hand. Words at times do more to create our noise problems than anything else. More so we hear from many that in their attempt to be heard we in healthcare often miss their voices…our lack of silence being the very liability we look to avoid.

This was no more apparent to me than in the moving story shared by a brave colleague Tanya Lord who in all she tried to raise about the care of her son in a mishandled post operative situation was simply given the typical responses and they were eventually discharged from care. In many ways to me her story, and the tragic and painful loss of her son, was a bold splash of our cold reality in healthcare. We must find the time for silence and to listen…in those moments we have the greatest chance to change, if not save, lives. We must also acknowledge this is about much more then the act of listening. I am sure many of the folks with whom Tanya engaged listened, they just did not hear. They too missed the art of silence. To be clear, I am not suggesting a silence in which people are not heard, but rather in creating the space in which we actually allow hearing to happen.

If we are to achieve the best in experience for all in healthcare it cannot simply be about what we say or know, the strategies we shape or the tactics we employ. At its very essence it must be about how we as humans choose to address this sacred and critical work. In all that is sacred I maintain the most transforming moments are less often found in the words and more in the silent moments and what they contain in between. If we can intentionally bring silence to our work in patient experience it may be the boldest and I dare say loudest statement of our humanity and all we strive to achieve in caring for one another. I am willing to give it a try…are you?

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

Considerations for Patient Experience Excellence: 2016

2016-01 jan2016blogAs we have watched the patient experience movement grow in the last five years of our journey at The Beryl Institute, we have seen increasing levels of commitment to this effort and a refocusing on what matters versus simply what is measured. Many began their involvement in patient experience efforts purely due to motivation by policy, measurement and then eventually financial implications for outcomes. These dynamic shifts driven by policy in the United States were not unique to the country, but rather we have experienced a global wave of acknowledgement of and commitment to action around addressing the experience in healthcare.

What has stirred this broader global movement and created a dynamic shift in how healthcare operates regardless of system or policy? I offer it is connectivity and proximity – not necessarily physical proximity, but what I would call “social proximity”. Social proximity, driven by connectivity, access to information, an open willingness to share ideas, constant access to research, news and even rumors all contribute to an environment for humankind that has dramatically shifted in the last decade and with increasing speed in the last few years.

So what are the implications for this on patient experience? We are now at a critical turning point where one can no longer diminish or downplay that experience matters. In fact, I would warn those that do or more so resist or fight this shift, that you will soon be swallowed up by the tides if you choose not to climb aboard. We are at a pivotal time in the journey due to these and many other dynamics changing how we deliver care and how consumers of care perceive and expect it.

2016 provides an interesting transition point now 15 years into this rapidly flowing century. In thinking about the year ahead, I offer some considerations whether patient and family member, healthcare provider or a company providing services and resources to healthcare – we are now all in this together.

  • Experience is a MACRO issue. We are no longer talking about “experience of care” as first portrayed in the Triple Aim. Rather we are now readily acknowledging and acting to encompass quality, safety, service, cost, environment, transitions and all the spaces in between in the experience equation
  • Patient and family (consumer) voice is stronger than it has ever been (and won’t be quieting down any time soon). Patients have found their voices in new ways and are showing a fearless willingness to challenge what was once a paternalistic model to raise their own wants and needs.
  • Technology is no longer a differentiator, i.e., specifically saying you are engaging in technology solutions. It will be how you use technology, the information it can provide and the way it impacts your ability to provide care and more positive experiences that will matter most.
  • Tactics, even strong ones may move you forward, but will not support you in achieving ultimate success. There is now a clear recognition that experience efforts are no longer driven simply by a list of tactics, but rather by comprehensive strategies with unwavering focus and committed investment.
  • The “soft stuff” matters and all engaged in healthcare are expressing this in their own ways. Our latest State of Patient Experience study reinforced this very point; that culture, leadership and the people in your organization are the primary keys to driving strong outcomes and overall success.
  • We need to stop calling the “soft stuff” soft. It is perhaps the most challenging and intense area of focus we can and should have in organizational life. Culture change, aligning leadership, ensuring actively engaged people is perhaps the hardest work we can take on. So while deemed soft (perhaps even as an excuse for an inability to affect them), we cannot relent in a commitment to make these efforts central to any plan.
  • “Sharing is cool” – yes for you parents out there I just quoted Pete the Cat (Pete’s Big Lunch to be exact). It remains astonishing to me how so much of what we espouse to our children as critical skills, we lose as we move forward in our careers. Experience excellence is driven not by how much you know as an organization, but rather how much you are willing to share. A value-based world competes on the execution to excellence not simply volume and we should not be hypnotized by one “way” as sacred. It is in our willingness so share broadly and openly that we collectively win. The new healthcare environment calls on us to do this.
  • The global dialogue on experience excellence is emerging as boundary-less and systems will look beyond organizational constraints to the commonalities they can find in driving the best in outcomes for all being cared for or caring for others.

I conclude with one more consideration:

  • Aim high, but start where you have solid ground. I remain resolute that we all have a commitment, whether we have yet acknowledged it or not, to provide the best in experience in healthcare (and must be willing to fully engage in what experience encompasses). Change will increasingly be transformational in healthcare and in simple choices great shifts can occur, but it will take the building blocks of success on which to reach the greatest heights.

Icarus, who in an act of great hubris and in an attempt to achieve it all, flew too close to the sun with his wax wings and fell to the sea. As we look to 2016, we must never let the big ideas fade from view or the small ideas impede our progress. It will be finding a way in which to move each of our organizations forward from where they are, with an understanding that the world is dramatically shifting all around us with increasing speed, where success can be achieved. This is our new world in healthcare and in the patient experience movement that now churns at its core. I believe if we are clear in our efforts and intent, we can and will achieve the best in outcomes for all. Here is to a great year ahead.

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

Reframing the Core Values for Patient Experience

2015-11 blockbwWhen we began the patient experience journey at The Beryl Institute just five years ago, we were surprised to find that in a healthcare landscape peppered with talk of patient centeredness and an expanding dialogue on patient engagement and grounded in the fundamental principles of quality and patient safety, there was not an overarching discussion on the broader experience of patients and families – beyond that is what was dubbed the patient experience of care. I believe we have from and through that time to today come to recognize that when we talk about experience – the healthcare experience – it encompasses all those ideas. We can also acknowledge that in its simplest of forms, patients, family members and loved ones and individuals serving as care providers or in support services all have an experience in healthcare every day – whether it is strategically planned or just left to fate.

For this reason, in our first steps at the Institute, we gathered a team of individuals to wrap our arms around what we meant in discussing the patient experience. From the contributions of many voices, we found a broad and encompassing idea. That patient experience is the sum of all interactions shaped by an organizations’ culture that influences patient perceptions across the continuum of care. The simplicity of these words was meant, and still does mean, to reflect much more. Experience is about interactions across the continuum, in the spaces in between, grounded in who we are as organizations in our actions and engagement with both those who encounter and work within them. Ultimately, it is about the partnership we establish with patients and the perceptions they take away. These are the lasting ripples of personal and quality care that represents the dimensionality of any human journey across the healthcare continuum today.

This need for definition was reinforced by the rapid focus on these core ideas in the experience conversation and was supported by an integrated and broad conversation on what the patient experience, and the healthcare experience, truly means today. In continuing to watch these ideas in action, I also saw a pattern emerging in those organizations with a commitment and focus on positive outcomes. Interestingly enough, these same ideas were evolving as fundamental to who we were at The Beryl Institute ourselves, as a collective community of front line caregivers and healthcare executives, resources providers and consultants, physicians, patients and families alike. What we saw emerging was a core set of values fundamental to community and experience success overall.

In this, we came to offer the following ideas as core values for our work at The Beryl Institute. I, too, believe in traveling the experience journey over the last five years and seeing all the good being done in providing the best in experience that these values, whether made explicit or not, are central to experience excellence overall. They include:

  • Accessibility: A commitment to open access, a spirit of generosity and the active invitation to engage and contribute that continuously expands reach and sustains growth
  • Agility: The ability to rapidly reconfigure and realign resources to lead new directions and respond as needed within the industry
  • Innovation: A vigilance in continuously searching for new ways of thinking, doing and disseminating ideas
  • Inclusivity: The purposeful consideration of expansive ideas and the engagement of all voices to ensure the broadest perspective and awareness
  • Collaboration: A recognition that overall success is driven by a willingness to partner with others in the sharing of ideas, information and action that ensures better outcomes for all involved

In a healthcare marketplace now expanding its efforts to get at not just the science of healthcare, but the humanity on which it is built, reframing and aligning around a set of core values becomes a fundamental opportunity. As we see efforts now to broaden the conversation, just years ago grounded in clinical checklists alone to now purposefully engaging in not just how patients and families are cared for, but also the fulfillment and well-being of those providing care, we are experiencing a fundamental shift.

I do not believe we ever forgot that this was a caring industry; rather, our caring came in appropriate models. In reframing our efforts around shared values – on a sense of openness and a mindset of abundance; on the capacity of agility, not just a willingness to change; on the acknowledgement that the status quo leaves us slipping behind in the face of a world of innovation; that all voices matter and must be sought with intention; and that in a world of value, competition is now driven in how we execute and in the sharing, not in the secreting of ideas – we are setting a foundation for perhaps one of the most revolutionary periods in healthcare. A focus on experience, on what it represents and the values on which it is built is not a soft idea. Rather it is the bedrock on which the best in outcomes will be built for years to come. It is quality, safety and service, it is cost and the health of our populations globally, it is about the well-being of those delivering care and it is represented in an integrated perspective of bringing ideas together. That is the opportunity we have been presented with today. Our choice now is a simple one: take the first step and act.

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

A Research Agenda for Patient Experience Excellence

penpicAs we continue our work at The Beryl Institute in moving the patient experience conversation from one at the fringes of healthcare just a few years ago to a central discussion point in healthcare globally today, we remain committed to developing a true field of practice for this work. This idea, of building a field and framing a profession, requires some fundamental cornerstones be put in place. This includes a professional community from which ideas are percolated and connections are made, a foundational and widely supported body of knowledge that drives professional alignment, a process for identifying and certifying those formal professionals in the field and a solid grounding in research from both an academic and practitioner perspective.

The community is represented by the over 35,000 of you around the world actively involved in accessing and engaging with resources of The Beryl Institute. The Body of Knowledge continues to find great value and expanding reach now through not only a conceptual framework, but also 15 full courses and the ability to achieve certificates of completion for coursework in Patient Experience Leadership and Patient Advocacy. Formal certification is now available through The Beryl Institute’s sister organization – Patient Experience Institute (PXI) – with the inaugural offering of the Certified Patient Experience Professional exam later this year. The first class of CPXPs, our profession’s pioneers, will be announced early next year. All of these efforts have been born from the contributions of hundreds of voices across our global community.

The last cornerstone builds on this idea of community contribution. It is a focus on rigorous research, and the importance of expanding the research agenda for patient experience. This has been building over the 5-year history of The Beryl Institute; first with the establishment of thePatient Experience Grant Program in June of 2010 (applications for the 2015 Grant and Scholar programs are open now), followed by the launch of the open access, peer-reviewed, Patient Experience Journal (PXJ) in April of 2014 (the next call for submissions closes January 2016), and lastly through PXI’s expanding philanthropic outreach to establish even greater support of research efforts (opportunities to donate will soon be available).

This type of reflective thinking, is seen in such government-supported programs as the groundbreaking comparative effectiveness work found at The Patient-Centered Outcomes Research Institute (PCORI), whose mandate is specifically “to improve the quality and relevance of evidence available to help patients, caregivers, clinicians, employers, insurers, and policy makers make informed health decisions.” It is also seen in many of the recent efforts supported by the Gordon and Betty Moore Foundation, and their focus on patient and family engagement.

And while there are even other efforts taking place, I still believe we have a significant opportunity to tackle the real tangible nature of the human experience in healthcare itself. The essence of these opportunities is reflected in the patient experience grants, in recent journal articles found in PXJ and elsewhere. When I look to the definition of patient experience itself and the simple, yet intricate nature of the key concepts such as interactions, organization culture, perceptions and cross continuum issues, all linked to outcomes and driven by safe, quality-focused, high reliability, service-driven efforts, there are incredible variables to explore at each point on the continuum of care and across all segments of the healthcare experience. This reaches from chronic illnesses to primary care encounters, long-term residential issues to rural settings or underserved populations. Underlying it all is the nature of human dignity and respect we all know is central to providing the best in healthcare overall.

To drive these ideas, we need to continue to frame, refresh and execute on a robust, thoughtful and I dare say edgy research agenda for patient experience. This is not research to just validate the usefulness of new solutions, but rigorous explorations of what practices, processes, systems, behaviors, communication styles, engagement efforts, tactics and tools not only show promise, but lead to lasting and sustained positive outcomes.

I ask you as the patient experience community what it is that we need to be asking, exploring and proving on we move forward. Are there practices you have taken for granted we could test? How can we explore key elements of the Guiding Principles for Patient Experience Excellence and determine which have the greatest impact, what that looks like and where we should focus our efforts first? How can you partner with your own vendors and resource providers to test new solutions? Or perhaps I will push you even further…how can we as a community come together to provide global insights into many other questions. Our biennial Benchmarking Study represents the kind of opportunity we have at hand to explore ideas both locally and around the world in identifying new concepts that can and should push our thinking in the realm of patient experience overall.

If we are to continue our endeavor in not just shaping, but solidifying and expanding a true field of practice and a profession that can positively influence outcomes for years to come, what questions should we be asking? What should we include in our PX research agenda? I look forward to your thoughts and commit to pulling together these ideas so we can collectively engage and continue to push the patient experience movement forward together. We now just need the right questions to ask.

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

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

Taking a Stand for Patient Experience Excellence

The last month saw an incredible amount of activity for the patient experience movement, from Patient Experience Conference 2015 and its broad opportunity for learning and connection to last week’s Patient Experience Week, that had organizations around the world acknowledging and celebrating the work of so many and the voices of all in ensuring the best in patient experience. Underneath these efforts that are representative of the work taking place each and every day in healthcare, we at The Beryl Institute and through our global community believed it was time to move beyond just action to true commitment in our collective focus on experience excellence.

What does this look like? Beyond the incredible range of resources developed and shared through our global community of practice that can inform and guide each of our journeys, there was a realization that we had a much greater opportunity and I dare say responsibility in aligning our focus and intent on the true importance of patient experience in healthcare today. As a community we have focused every day to reinforce an important point – that patient experience encompasses all that a patient or family member encounters, be it quality, safety, service, cost or outcomes; it is impacted by the engagement of the very people providing and supporting the provision of care; it is driven by a recognition thatpeople, process and place are all fundamental considerations; and it is not a passing fad or simply a measure of satisfaction. Rather, it is a central construct that impacts healthcare organizations and their efforts around the world each and every day. Simply stated, patient experience matters!

We too have recognized that patient experience is more than just an idea; it is an emerging field of research and practice. So in conjunction with the incredibly powerful and energized community of practice that exists, we also framed a foundational body of knowledge, have pushed to expand the boundaries of research via Patient Experience Journal and solidified a professional designation and process for development with the new Certified Patient Experience Professional (CPXP) designation via Patient Experience Institute.

The last piece in all this – from philosophical and strategic alignment, to the physical framework of a vibrant, strong and lasting field of practice – was to identify and underline the critical actions that have emerged as central to achieving excellence in patient experience. We often are asked the question and see it in the conversation throughout the community, “what can we do to achieve the best in experience?” In our work and through the incredible examples of so many doing this critical work each day, we have come to identify what we believe are the guiding principles for patient experience excellence.

As we introduced these ideas last week – our stand for patient experience excellence – we reinforced an important point. These eight essential actions should serve as aspirational and affirmative statements about where we as individuals, organizations and collectively as the patient experience movement should focus our efforts. We offer these as aspirational – as ‘wills’, not ‘shoulds’ – for as the data show so many of us are just starting or are in the midst of our patient experience journey. In fact, if we believe experience is a continuous effort than the journey truly never ends. With that we warmly invite and strongly encourage healthcare organizations globally to consider and commit to theseguiding principles:

We believe organizations and systems committed to providing the best in experience WILL:

  • Identify and support accountable leadership with committed time and focused intent to shape and guide experience strategy
  • Establish and reinforce a strong, vibrant and positive organizational culture and all it comprises
  • Develop a formal definition for what experience is to their organization
  • Implement a defined process for continuous patient and family input and engagement
  • Engage all voices in driving comprehensive, systemic and lasting solutions
  • Look beyond clinical experience of care to all interactions and touch points
  • Focus on alignment across all segments of the continuum and the spaces in between
  • Encompass both a focus on healing and a commitment to well-being

As we look at the potential we have in our focus on excellence in patient experience, there is boundless possibility. More so, at its core we find an unquestionable opportunity to reinforce the great value of all who participate in the healthcare conversation and all who are touched by it. Commitments as strong as they may seem, or as aspirational as they may be, are only of impact if they are moved from words to action. That is my ultimate challenge to you as the patient experience community and as the healthcare community as a whole.

These are not just concepts, but rather they are commitments to action – for our organizations, for our people, for all those we care for and serve and for the kind of healthcare world we have the desire to, and I know we have the capability, to create. I invite you, encourage you and call on you to join us in taking a stand for all we can do for experience excellence. Only good things can come of these actions if we take them together.

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

Patient Experience Matters

As the final hours before Patient Experience Conference 2015 count down, I am reminded of the importance of the journey we have set out upon. When we work, as one community, encompassing a diversity of thought and experiences, on a cause so central to healthcare – the experience of all in our global system of care – only good things can happen. For so many committed to the best in experience for the patients, residents and families they serve – be they the almost 35,000 members and guests of The Beryl Institute Community, the readership of Patient Experience Journal from over 100 countries, the volunteer leaders and content contributors, writers, tweeters, caregivers and support staff around the globe – we often find ourselves in small pockets of people, likeminded in purpose and focus. Tackling this work in small bands spread far can at times be exhausting, even knowing you have the support of the thousands in our virtual community.

I, too, know that there is power in the ability to come together and recall the words shared by a participant in the closing conference discussion session we held at the end of our first patient experience conference now five years ago. (Yes, it was intimate enough we could all have one discussion.) That person stood, with the polished, but worn glean of a conference well spent, of learning gained and new connections made, and said “I now know I am not alone.” It was a profound and awakening statement that has been a fundamental root of our last five years in growing the Institute community. First, that you, as professionals or as patient or family members, are not alone on this journey and second, there is a place you can come to connect, find support, contribute, be vulnerable, breathe, smile and grow. But more so, there is a special moment when you can do that with one another together at Patient Experience Conference.

I have heard some call the event a family reunion and others call it the recharge they needed from a year of draining work. In all descriptions, I have heard something underlying it all – Patient Experience Conference, while a “conference” in title, is nothing like any other healthcare conference experience you can or will have. Others may have summits, conferences or symposiums with the requisite healthcare structures, protocols and learning. From that we do not differ, but what you do find are the people and the connections that last well beyond just three days a year.

Since our first Patient Experience Conference, I have opened reinforcing that important point – that in looking around the room, the power of our time together is in more than lessons shared, PowerPoints projected or even compelling stories told. It is in the gift of being together, of those around you, and all you and they have to offer. When we spend the next three days in Dallas, that will happen once again. Together, we will create a gathering not meant to highlight one organization or a specific product, but rather bring life to an event that is committed to the very idea that is at the heart of the importance I mention above. Simply stated, patient experience matters.

It matters because it touches the lives of so many leading to quality, safe, service-focused encounters conscious of cost, committed to outcomes, open to all voices and intent on nothing but the best for all we care for from healing to the fate of spending one’s last days in dignity. You see, we are all the patient experience. So I, too, look forward to the next few days ahead, but in highlighting their importance, return to a point so central to our work. We are not in this alone, and there is a community to support you every day of the year. I am proud of what we – our community of committed leaders around the world – have created, humbled by the cause we have taken on and inspired by all I know we have yet to do together.

Jason A. Wolf, PhD
President
The Beryl Institute

Why We are ALL the Patient Experience!

“We are ALL the patient experience” is not just the theme that underlined Patient Experience Conference 2014; I would offer it is an idea that must be central to patient experience improvement and the patient experience movement overall. I am encouraged by the increasing acknowledgement that it takes all players in the healthcare marketplace, across the continuum, through the established hierarchies, and from patient & family, to caregiver, to community to ensure the best in experience.

This was exemplified during my On the Road visit just last week to Cape Regional Medical Center that will be published later this month. What I found was an institution that understood and acted fully on what community meant and, in doing so, engaged staff, physicians, leadership, patients and families in collective efforts to provide the best in experience.

I am often asked for the quick list of solutions to drive patient experience excellence or the checklist of actions that will lead straight to success. What my visit to Cape Regional reinforced, and what I have learned from so many other institutions, is that there is no one path to patient experience nirvana. Actually, I think we could all identify many core tactics that would help support improvement efforts. There are truly no secrets in this work (or at least there should not be). In fact I would challenge any organization that claims to have the secret recipe, be they provider or consultant, to examine what is truly distinct or unique about their efforts, and highlight, market and sell around that premise – not as an ultimate solution, but as a piece of an intricate puzzle. I believe there are practical ideas and innovative solutions we can learn from one another and, in fact, that is what I hope to reinforce.

A strong patient experience effort must be built on a patchwork of ideas, with a foundation of commitment across roles and responsibilities. While patient experience may be (and we encourage it should be) led by an individual or partnership of leaders, it can never be fully executed in isolation. In fact if we believe that at its core, experience is about the interactions that take place between two human beings around issues related to quality, safety, service and even improvement, then we must acknowledge the simple, yet powerful point that we are all the patient experience.

The implications for this understanding are significant and the imperative for supporting action is clear. Successful organizations driving patient experience improvement, and sustaining it, have worked hard to:

  • Develop and support leaders at all levels, in all roles, across all functions
  • Equip people with direct and easy access to the broadest amount of relevant and actionable information possible
  • Build solid partnerships with those they serve through active patient and community engagement
  • Build recognition and performance plans in direct alignment with experience objectives
  • Create a sense of shared ownership and reinforce accountability for ideas developed and actions taken

And the list could go on as you build an integrated effort.

You see, improving patient experience and the effort it requires must be owned by all and every individual most often impacts experience at the moment of a simple encounter. This means we must prepare these individuals to act. It is for this very reason that we introduced a simple, but comprehensive Institutional membership access to The Beryl Institute this year. This membership offers healthcare facilities of all sizes and purposes the broadest access for the most individuals in their organization. It provides information, education and accountability across the organization’s community. We have seen organizations with front line nurses to senior leaders and patient and family advisory council members to physicians engaged in accessing community resources and, in doing so, contributing strong ideas as well.

It is in our ability to engage the broadest range of voices through which we can find the best in experience outcomes. I encourage you to provide the opportunity for leadership to emerge, for new ideas to be fostered and for proven concepts to be shared. I know at the Institute we are committed to ensure you have the platform on which to build those efforts every day. Here is to all each individual contributes to the best in experience and for the rallying cry that moves us forward: We are ALL the Patient Experience!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Collaboration-v2

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