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

Community Matters in Patient Experience

Earlier this year at Patient Experience Conference we introduced our latest video,What really matters in Patient Experience?, which called us, through the voices of patients and family members, to consider “all voices matter”, “every interaction matters” and “you matter” in patient experience performance. The subtle message in this video was that for as much as there is clear and recognized individuality in each patient experience story, the needs identified and the outcomes achieved, there are also strong and important commonalities of which we should be aware and on which we must be ready to act.

community1015This same consideration of the value of individuality, yet the power of commonality has arisen with the recent emergence of special interest communities in The Beryl Institute. These groups of individuals focus on key areas of healthcare including patient advocacy, physicians, pediatrics and now patient and family advisors, represent an interesting and critical dichotomy and a balancing we see is needed as we address patient experience. In fact we are encouraged by the interest from all corners of the community to look at other opportunities of focus, such as behavioral health, emergency departments, post acute care, home health and others.

It is clear then that there is a definitive need, one asked for by members of The Beryl Institute, in focusing conversations around shared and special interests. This provides an important opportunity for learning, the collection and dissemination of ideas and the connection among peers. Yet we must also be aware that in doing this, we run the risk of missing opportunities for broader learning and collective focus. While we believe and fully support these independent conversations for all they represent, we too reinforce that there is power in the greater community in which these groups exist. More importantly we cannot lose sight of the opportunity for these communities to learn and share with one another, cross fertilize ideas and grow stronger together as a result.

This idea of creating distinction, or as often seen in healthcare, the delineation of our work in silos, provides us an opportunity to seize, especially as it related to the idea of patient experience. While we might distinguish our efforts and even establish infrastructure and resources in areas such as quality, safety, and service, we too must recognize that these investments collectively are part of our overall experience effort. The question we then should ask, is how are we framing our broader investment in experience excellence overall.

Our recent State of Patient Experience Benchmarking Study revealed that people identified clinical outcomes as the top result of effective experience efforts. This trumped consumer loyalty, customer service and others. Outcomes are what we strive for in healthcare – be they healing and recovery or managing the remaining days of life or be they financial imperatives to create a healthy, vibrant and sustained system of healthcare services. This is the very opportunity we then have in creating alignment among our efforts; weaving together quality, safety, and service, a focus on cost and outcomes, honoring the individuality of all we care for and serve while finding strength in our common actions and purpose; identifying special areas of interest and learning, while striving for collective understanding.

These ideas all come down to one core idea – community matters. In the bringing together of ideas or functions, we do two things – honor and address individual needs, while strengthening our collective stand. This captures the unspoken essence of patient experience itself. As we learned from the voices of the patient and family members so gracious in sharing their stories, while each unique, they too have common desires – to have voice, to be heard, to be treated with dignity and respect, to feel compassion and to receive clinical expertise, to be understood and cared for.

As no two people and in the same light, no two healthcare organizations can or should be alike. We must respect that distinction, while honoring all that brings us together. In balancing this intention in every encounter and every moment we create the opportunity for the best interactions and the most positive of experience. Community matters in patient experience and we must ensure it does for the power of the collection of voices in our movement and in the work it calls us to do every day. We must remain vigilant in ensuring the critical balance of individuality and community. In doing so, we reinforce our call to action – we are all the patient experience.

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

Patients and Families Included

patients_included.001Just a short, but incredibly exciting 5 years ago, I was writing my fourth patient experience blog in what has become a monthly occurrence. In that blog I introduced the definition of patient experience created by early contributors to The Beryl Institute community. In those first months of our work we were focused on reinforcing some fundamental ideas and values that have remained at the core of our work at the Institute since that summer we got underway.

In introducing the definition we offered,

“A positive patient experience is created by partnering with patients and their support network (i.e., families or caregivers) to anticipate needs and exceed expectations, recognize the individuality of each patient as a decision maker, form a caring, compassionate and lasting relationship.”

From those very roots we have operated, not from the perspective of providers only, or espoused a singular model or organizational perspective. Rather, we have comfortably left that to those with personal or business interests in what they saw and see as the potential of the patient experience marketplace. Our belief was and remains that the ability to improve the patient experience at a global level is grounded in collaboration and partnership, a welcoming of all perspectives and encouraging open sharing of ideas across segments of healthcare, organizational boundaries and even national borders. This philosophy has led to the largest community of practice dedicated to patient experience improvement, now almost 35,000 people strong representing almost 50 countries around the globe.

The significance here is that from the very beginning of our work we have operated from the mindset that patients and families are partners in the overall experience conversation, or simply stated, patients must be included. I offered this perspective as recently as my Hospital Impact Blog last week, but perhaps more importantly have lived it through our work as we have continued to learn and grow as a community. These efforts have been realized through the inclusion of patient and family voice on our boards from the outset, in our establishment of our Global Patient and Family Advisory Council (GPFAC) and the cutting edge work they continue to push us to explore (including some exciting news to be announced later this month), and they have been seen in our provision of learning and content from webinars and papers, to Patient Experience Conference itself, which has included patient and family voice on stage, in breakouts and in participation for the past few years.

It is for these reasons and grounded in our founding values that we are excited to also reinforce our commitment to the formal efforts around having patients included in healthcare gatherings. The phrase “nothing about me without me” is not new to healthcare, but what is emerging is a more critical intent on ensuring the consumer voice is engaged and included in the broader healthcare conversation – not simply around individual episodes of care, but in the very discussion of policy, procedures and processes that impact all engaging in healthcare globally.

For this reason, “patients included”, is much more than a nice phrase, it is our commitment and should be the commitment of so many other organizations espousing to include or more significantly represent the patient and family voice in healthcare. As a community comprised of all voices, we believed it was important to reinforce this important point.

The “patients included” movement was inspired by an experience and subsequent blog authored by a virtual colleague and thoughtful healthcare leader Lucien Engelen. He offers in recounting the roots of this effort, “When it was my turn to deliver my keynote, I asked the audience ‘How many patients are present here?’ Not one, it appeared. That there should be so much talk about what patients need and want without them being present prompted me to take action.”

The action resulted in the “Patients Included” movement and most recently a full charter guiding a true patients included effort around healthcare events. The charter, created by the voices of patients, caregivers and healthcare leaders in Spring 2015, calls on healthcare events to commit to the following:

  1. Patients or caregivers with experience relevant to the conference’s central theme actively participate in the design and planning of the event, including the selection of themes, topics and speakers.
  2. Patients or caregivers with experience of the issues addressed by the event participate in its delivery, and appear in its physical audience.
    • The Beryl Institute Patient Experience Conference 2016 keynote speakers includes patient and family voice and perspective. In addition, when sessions are selected late August, they will also reflect patient and family representation.
  3. Travel and accommodation expenses for patients or carers participating in the advertised programme are paid in full, in advance. Scholarships are provided by the conference organisers to allow patients or carers affected by the relevant issues to attend as delegates.
    • The Beryl Institute Patient Experience Conference 2016 offers patient and family scholarships to conference participants to support engaging more patients and family members in the overall patient experience conversation. In addition, patient and family voice throughout our conference keynote speakers are fully covered for fees, travel and accommodation.
  4. The disability requirements of participants are accommodated. All applicable sessions, breakouts, ancillary meetings, and other programme elements are open to patient delegates.
    • The Beryl Institute Patient Experience Conference 2016 will accommodate all disability requirements of conference participants for all parts of the program elements.
  5. Access for virtual participants is facilitated, with free streaming video provided online wherever possible.
    • The Beryl Institute Patient Experience Conference 2016 will provide conference access and updates to virtual participants through social media and the #PX2016 hashtag. Conference participants actively engage online via social media and conference presentations are made available to participants after the event.

While not every organization may be able to accommodate these commitments due to constraints or other considerations, they reinforce a powerful statement on what including all voices and providing the access to do so truly means. At The Beryl Institute, we ourselves have met these very commitments for our own Patient Experience Conference. Patients and families contribute to program development and review and are critical voices on stage and in breakouts. Scholarships, though modest are provided and accessibility, one of our core operating values, is reinforced, including virtual access to the extent possible via social media and other means.

We do this for more than it being the right thing to do. As a community of practice committed to experience improvement, we also believe that which we espouse and encourage in organizations behavior, we must be willing to do and model ourselves.

Patients included is more than a nice slogan or a feel good effort, it is a fundamental premise to executing on the best in patient experience efforts in healthcare today. We welcome the opportunity as we continue to grow to ensure we maintain this perspective and challenge and encourage the patient experience community and the broader healthcare community to take note. Patient and family voice matters in our ability to provide the best in outcomes, it has and always will.

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

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

Understanding expectations matters to experience excellence

In a recent personal encounter shared by our Director, Member Experience, Michelle Garrison, she told a story of her own healthcare experience related to a surgical procedure and how it made her feel as a patient in the process. Her experience and insights reinforced a critical point central to the conversation on experience excellence – expectations matter.

I first addressed this issue in the Patient Experience Blog two years ago when I wrote:

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

As Michelle shared her story, she reinforced an important point from her personal experience. She noted, “We are continually looking for the best methods to help prepare patients and family members by ensuring they know what they are likely to face when they visit with a doctor, arrive at the hospital, leave a healthcare encounter and beyond. By setting their expectations ahead of time, we help prepare them and give them the opportunity for the best patient experience. However, even with the most comprehensive of processes in place, there are going to be times when expectations are not met and the patient experience will fall short.”

This was a profound statement for me as I realized in Michelle’s words reflecting on her encounter that she felt the provider would have provided expectations. It also raised an important point, and I dare say an opportunity. That in providing the best in experience we must also be willing to ask the questions and take the steps necessary to understand the expectations of those we are caring for.

In talking about her experience Michelle said “I was not the best of patients. Though, I am pretty sure if you were to ask my doctor, the nurses, anesthesiologist and the others who took care of me, they would not have anything bad to say about my behavior or me.” In asking why she felt that way, she added,

“Here is where I fell short. I did not ask enough questions and the questions that I did ask were not the right ones. I was not as informed as I could have been about what was going to take place and how I would feel after the procedure, and so my expectations did not match the reality of what occurred. I was given instructions both before and after, on the procedure and what to do if there was a problem, but there was nothing about how to deal with the lingering after effects and how I might feel. I mistakenly thought all of the information I needed would be given to me without my having to ask for it, but it was not. Of course, I could have reached out to my doctor, but instead I did what I am sure a lot of patients do, I turned to the internet to see if what I was experiencing was normal.”

This statement is powerful and eye opening in its potential reflection of the way many other patients or family members may feel in the midst of the healthcare system and their own experiences. This is a significant realization we may often miss, that while patients want to engage, they are not sure how to participate or what to ask. Or they believe what they need to know will be provided so don’t think they even need to ask. In concluding her story, Michelle shared, “It is important to understand that patients and family members are not always going to ask all the questions they should or even the right ones. They may not know what questions to ask because they will assume, like I did, that the answers will be in that packet of paperwork they were given.”

I think we would all agree Michelle was not a “bad” patient, but perhaps quite the opposite, a patient that was trusting in the system to take care of her. Michelle’s procedure was successful and the system did its job, but the realization here is that there is an opportunity for much more. In many ways creating a process for clarifying and understanding the expectations of all participants in the care encounter be they patients or family members, doctors, specialists or support services and in doing so together could be one the most clear, simple and impactful ways to create the best in outcomes overall. Thanks Michelle for helping us to see and understand this point with greater clarity. You are 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