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

The importance of invitation in patient experience excellence

I was talking to a member recently who asked what has been the key to our growth at The Beryl Institute over the last few years from an idea to a global community now engaging over 30,000 members and guests from around the world. My response came quickly. It is the willingness to ask – that is to invite people to participate, to get involved, to offer ideas, to provide input, ultimately to engage in our efforts and in this movement.

It was for both of us, a subtle, but profound moment, as the individual was struggling with how to move from mandating compliance to experience efforts in their organization to creating a sense of involvement and ownership for action. For me, I realized it has been a sense of openness to all ideas, perspectives and voices, the value of abundance I challenged us all to consider in starting this year, that has supported our own ongoing efforts to invite the engagement of so many of this journey. I too recognized in our conversation that invitation was not only an opportunity for growth, it provided a powerful idea for patient, resident and family experience excellence itself.

Invitation is a simple, yet profound act. It requires a strong sense of self-understanding, a willingness to be vulnerable and open to new discoveries. In offering an invitation we acknowledge the value of others and express our respect for and trust in their presence. More so invitations themselves are the seeds of new possibilities.

When I think about what organizations work to accomplish for those in their care at all points of interaction across the continuum, the greatest opportunity we may have is to invite. If we believe experience excellence is driven by both the engagement of the people in our organizations and those we care for, why just create opportunities for engagement and hope others respond? Rather we must create them and invite people to act.

How can we do this in healthcare today? For our own teams we can invite input on new ideas or participation in strategic efforts or even tactical planning. For patients, residents and families we can invite their participation in both personal and organizational opportunities. As individuals, we can engage them in their care planning, involve them in shift transition conversations or even post care decisions. Organizationally we can invite involvement in patient, resident and/or family advisory councils, we can engage people in strategic planning sessions or on operating councils or boards.

I believe there is a significant difference in hearing “people are just not engaged” if we simply work to create opportunities we hope people will take advantage of versus creating those opportunities and actively inviting participation. Yes, it is through inviting that we have the greatest of opportunities in creating cultures and interactions that will drive the best in experiences. How will you create opportunities for invitation in your own organizations for both whom you work with and those you serve?

In that spirit of invitation then I would be remiss in not living up to the response I offered my colleague. While there are so many ways to engage in the patient experience movement, first I invite you to consider joining us for Patient Experience Conference 2015. As a central community gathering for people committed to experience excellence at points all across the continuum of care and supporting those efforts, this event provides for a coming home and/or a recharging for some, and an awakening and/or learning opportunity for many others. More importantly it connects you with fellow travelers on this journey and committed to this cause from which to build lasting connections.

With that I too must invite you and your organizations to consider our most rapidly growing opportunity in the Institute itself, Institutional Memberships. These incredible connections have stretched the boundaries of the experience conversation in ways we could not anticipate and to corners of the world we could not imagine. It also reinforces the fact that the experience of those in our care is an ongoing and relentless pursuit and connecting to a broader community and support network can only help each of us be stronger. That is it, the power of invitation exemplified.

Many of you may have heard of Shel Silverstein, one of the earliest poets I digested as a child. And while seemingly focused on children in his writings, his message resonates for all of us. He wrote a wonderful piece called “Invitation”:

If you are a dreamer, come in
If you are a dreamer, a wisher, a liar,
A hope-er, a pray-er, a magic bean buyer…
If you’re a pretender, come sit by the fire
For we have some flax-golden tales to spin.
Come in!
Come in!
– Shel Silverstein

There is incredible simplicity in the art of invitation, and yet it has the opportunity for unparalleled impact on all we do in healthcare today. I invite you to join us. Come in!

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

The Importance of Voice in Improving Patient Experience

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

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

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

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

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

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

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

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

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

All Voices Matter in Improving Patient Experience – A Reflection on Election Day

In some of my most recent blogs and in current publications from The Beryl Institute we have expanded the dialogue on the importance and power of voice in driving towards a positive patient experience. It is only fitting to take pause of this, as today – November 6, 2012 – in the United States represents one of the most powerful examples of the expression of voice to be found. In electing a President, citizens of the U.S. of all backgrounds and beliefs have the opportunity to be heard. The intention is that every voice regardless of how young or old, soft or loud, rich or poor has value in a broader dialogue about the greater good and direction of the country.

As I travel to healthcare organizations and engage with patients and families, caregivers and leaders, one thing stands out. It is the great alignment these individuals have in desiring and working to ensure the best care outcomes and overall experience possible. The recognition in this expanding dialogue on experience is not one of cynicism or even submission to simple performance on surveys, but one driven on the same passion and commitment to the wellbeing of our fellow human beings as those that vote to support the best in what they believe.

The common denominator in these ideas is the most critical component of all we do in healthcare, in our world of human beings caring for human beings. The power is that of voice and the voice of all, be it spoken, written, sung or signed. Healthcare organizations around the world bring people together at the most critical times of our lives – from the joys of birth, to the tears of a last breath – and this is not something any of us do alone. It takes the hearts, minds and yes, voices of many to make it work. It is the voices of patients and families in expressing their needs, but also sharing their fears and pains. It is the voices of caregivers who contribute to the best processes of care and support for one another. It is the voices of physicians who bring great insight and education along with the powerful ability to heal. It is the voices of staff that in basements, back rooms, and labs sew together the web through which the paths of care are supported. It is the voices of leaders who set visions and inspire and hold the space for all voices to truly make a difference in how we care for one another.

I had someone suggest to me once that if we allow room for all these voices, we give in to chaos at the cost of processes of care; that the input from all corners of a healthcare experience, be it acute or pediatric, ambulatory or practice-based, cause a murkiness that only leads to confusion. My response was simple, and my experiences have proven it to be true more and more each day. The chaos only exists if we fail to listen. When we get beneath what some may perceive to be noise, we realize there is a great commitment to the idea that every one is working towards the health and well being of those in care. By bringing together a symphony of voices we not only engage people, but we also expand the potential of what we can accomplish.

There is no magic formula or process for the gathering of voices. The methods and processes are rather clear, be they surveys, focus groups, advisory councils or committees for patients, staff, physicians and leadership. More important is the fact that we choose to acknowledge that all of these individuals have a voice to share and it may be in the most unsuspecting moment that the most impactful idea emerges. Perhaps in the end it is simple, that improving the patient experience is nothing more than a critical dialogue that must be fostered, nurtured and supported in ensuring that we listen and understand that each and every voice matters.

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

Engagement: A Cornerstone of an Unparalleled Patient Experience

Over the last decade, engagement has been a consistently evolving strategic management term, first from the perspective of employees and more recently in healthcare with a line of sight on patients and families. In the simplest of terms, I see engagement as the involvement that someone has in a process or effort. Common discourse has had it tend to the positive by asserting employee engagement is a desired state versus just an action or behavior. Recent research (Shuck and Wollard, 2009) on the term employee engagement noted that with its rapid increase in use the definition of engagement has become muddied. Yet across the descriptions of this phenomenon there was consistency in describing engagement as a personal decision (not an organizational one) and one grounded in individual behaviors (as they relate to organizational goals).

This has significant implications for both employee and patient engagement.  In the end it is about creating the environment in which individuals can choose to actively engage. Organizations cannot create engagement. Rather they can create the environment and reinforce the behaviors in which engagement can grow and thrive. This has significant implications for our work in healthcare overall.

Some have said that patient engagement is the latest buzzword for how we work to involve patients and families in the overall care experience. As a concept it has ties to safety and quality and links to the discussions on the application of meaningful use. Patient engagement is focused on ensuring patients take actions in order to obtain the greatest benefits of the healthcare services available to them.

The Nursing Alliance for Quality Care (NAQC) has deemed patient engagement “a critical cornerstone of patient safety and quality”. Their efforts have outlined a comprehensive set of nine principles to consider when engaging patients in their care. They stress “the primary importance of relationships” between patients, families and providers of care as key to effective engagement overall. This work stresses the foundation of relationship and partnership as central to the care experience.

These ideas are essential elements in how we identify experience overall at The Beryl Institute. At the very heart of the definition of patient experience is every interaction that occurs between a patient, family and the healthcare system in which they find themselves, from the deepest of relationships to the briefest of encounters. I believe we need to consider engagement more broadly and link its contributing values to the cornerstones of quality, safety and service. Together, quality, safety, engagement and service establish the legs on which the most comprehensive and positive patient experience can be built.

The same perspective can be taken when looking at the employee aspect of engagement. If engaging employees is around the behaviors of individuals that contribute to the goals of an organization, there is truly one means by which we can influence this action – the culture on which we build our very organizational existence. This leads us again to how we define experience at The Beryl Institute.

In reinforcing that the patient experience is “the sum of all interactions”, as we noted above, “based on an organization’s culture”, then healthcare organizations must have a strong commitment to not only create a positive environment for our patients and families, but one that supports the efforts of our staff, employees, and associates as well. In my travels to hospitals on behalf of the Institute both in the U.S. and abroad, I am continuously reminded that there is great power in the culture of an organization to drive excellence in experience. It is the foundation on which care givers and those that support them act and it shapes the environment in which care is delivered.

In considering engagement, I encourage us to move beyond the concept as a “nice to have” in our organizations, to a “must have” if we are to provide the best experience for patients and families alike.  Engagement is not what we directly create, it is the result of doing the rest right – of creating vibrant and supportive cultures of service, quality and safety – of care at the highest order at every touch point across the continuum of care. If we do so and do so well we ensure the greatest of perceptions from our patients and the unparalleled experience we would want for our families and ourselves and we know they undoubtedly deserve.

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