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

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

The Patient Experience Must Be Owned By All: Welcoming the Society of Healthcare Consumer Advocacy

In The Beryl Institute’s recent research report – The State of Patient Experience in American Hospitals 2013 – I noted in conclusion that the state of patient experience is growing stronger every day because of the many voices committed to this work. I too reinforced my belief that a patient experience movement is afoot, one that requires continuous and focused efforts and one that should be grounded in and built upon collaboration and alignment versus competition or the desire to stake a claim.

This idea rests at the very core of the global community of practice we have built at The Beryl Institute. We do not claim to own the patient experience, but rather to be a place where people can gather together to share what is best in what they are working to accomplish. Our philosophy has been and will remain that through collaboration not just great, but greater things can happen.

It is in this very spirit of collaboration that I am excited to share the bridging of two great organizations to expand the alignment and dialogue on patient experience improvement. We have been in discussion with and will soon be welcoming the Society for Healthcare Consumer Advocacy (SHCA) into The Beryl Institute community. After an incredible 40 year history and supportive home with the American Hospital Association (AHA), our three organizations – The Beryl Institute, SCHA and AHA – saw great potential in supporting the next 40 years and beyond for SHCA within the Institute (You can read a letter from all of SHCA’s Past Board Presidents here). As of January 1, 2014, our communities will align to continue to expand the patient experience conversation and in doing so model the power of coming together in this critical dialogue.

More details will soon be available around this exciting next step in the history of focus on patient advocacy and more broadly patient experience improvement, but suffice it to say, the commitment to engaging all voices and growing those engaged in this important work is top of mind for us all. I am excited and proud to welcome the SHCA community to The Beryl Institute family as their new professional home and in doing so reiterate the very critical message I share here. That it is in coming together, not attempts at market distinction, in which the greatest outcomes are possible.

I have watched in recent years as patient experience has moved from an emerging term to an active conversation at the center of policy and now financial focus. I have also seen a great game of ownership being played out. Much like one might have experienced during the gold rush, claiming their small bit of mountain stream to pan for hours, days or more in search of that one bright speck, many organizations – some well established, and some quite new – have all worked on positioning for their piece of the pie.

While I am a true believer in free enterprise and recognize the great potential for market savvy in this new world of healthcare, I also believe we have something bigger we are attempting to do in working towards patient experience excellence. It is in the bringing together of disparate thoughts or competing ideas, be they those of resource providers of similar services or healthcare organizations occupying the same market, in which the greatest outcomes can be realized. You see no one organization owns the patient experience, yet we in healthcare must all take ownership of it.

For this reason we have worked to bring the many voices together, for as I asserted above, this is where the strength of our work and its impact rests. This idea has been realized in the Institute’s Regional Roundtables where market “competitors” join together in sharing thoughts and crafting shared plans focused on improvement. It has been realized at Patient Experience Conference where numerous resource providers join in and engage in support of a true, independent community dialogue. It is seen in the willingness of some of the largest players in experience measurement to come together to share ideas between the covers of our soon to be released paper on the Voices of Measurement.

If we are to make the greatest differences in the lives of our patients, families, peers and community we must be open to the idea that above all else through collaboration and coordinated effort profound possibility exists for improvement and sustained impact. And while by my very words, I cannot claim The Beryl Institute is the only place this can or will be done, I do hope and in fact commit that we will continue to stand for the bringing together of all ideas, of every voice and of each hope in each and everything we do. As a community of practice it is our calling, at The Beryl Institute it is our cause and we are so very excited to see (and hopefully be a catalyst in) the patient experience family continuing to grow.

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

Patient Experience and the Freedom of Choice

IPatient Experience and the Freedom of CHoice - The Beryl Instituten writing a blog for a US-based, global organization on the week of July 4th, I am hard pressed not to think about the concepts of independence, of freedom and of what those concepts provide for. To be independent, to be of free will, is something most, if not all, aspire to. It is ingrained in our human nature, for at its base is an idea so simple, yet at times so complex – the power of choice. For me this concept of choice is the essence of patient experience itself.

When I talk to people about the strategies and tactics of patient expedience improvement, I start with the simple recognition that what we do in healthcare – as human beings caring for human beings – is about the choices we make. From leaders guiding organizations on what priorities are set each day, to frontline caregivers across healthcare settings we are making choices in every moment, not just on what care to deliver, but how to deliver it as well.

This power of choice is profoundly important, and of increasing influence in our healthcare systems today. While we once may have gone directly to our local physician or hospital and listened intently with respect, following every word and instruction, the nature of healthcare itself has changed. I know to some this poses a great concern and others even disdain. For me, it reveals the true potential for excellence we have in healthcare systems around the world.

The debate has long simmered on if patients are customers of care. Using this term allows supporters of the historic healthcare hierarchy to diminish the very voice of patients, most often unintentionally. And you may be surprised to hear that I agree. Patients for the most part in healthcare today are not the customers of care. Customers are those individuals or organizations that choose to pay for a product of service. In fact following this logic, most often, insurance companies and/or government entities are the true customers of healthcare as they are the one’s directly funding services or paying the bill.

What does this mean then for our choice as patients? While many rightly make the argument, that as patients we do not choose to fall ill, have an accident, etc., that is we do not most often choose to be customers of healthcare, we overlook what I suggest above – that as human beings we still have choice. This distinguishes to me where patient experience plays it most significant role, especially economically. Patients are without question consumers of healthcare, regardless of systems, locality or structures. From an economic perspective it is the consumer who drives markets and influences business viability. Consumerism is the consideration that the free choice of individuals strongly influences what is offered to a market, what grows and what is overlooked. Therefore consumers and the choice they bring have strong economic impact.

The bottom line is that as patients have independence, even with some constraints based on insurance or in governmental healthcare systems, and therefore they have choice. Patients will note where the experience – the culmination of quality, safety and service – is best. And they wont keep it secret. Outside of the increasing use of government surveys globally to measure and publicly report performance, other consumer outlets are quickly booming – have you yelped your physician’s office lately, or seen the dialogue on Facebook about the care in your local hospital? This is consumerism at its finest and it is having great impact.

Patients have discovered they too have choice in the system, to not just expect, but to directly ask for and seek the best care they can find. Yes, patients do not choose a healthcare encounter like they would a hotel or an entertainment experience, they actually do so MORE significantly because this choice is about their own or a family member or friend’s well-being. A dear colleague, an inspiration for patients as true consumers of care, and a contributor to our Voices of Patients and Family paper – “e-Patient Dave” deBronkart clearly expresses the need for us as patients and family to choose to engage in our care, in ensuring we are fully informed and in doing so make the right choices.

I too am reminded about a story a gentlemen shared once with me about his 80-year old mother who when finding she needed hip replacement, scoured the internet for information on the procedure, recovery times, outcomes, etc. She discovered, that while scheduled for surgery at her local hospital (where she had gone for years), there was a better place for her to have her surgery in another state a plane ride away. She booked the ticket, made the trip and had her surgery. Now while all patients choices may not be that extreme, we must acknowledge that we all have choice – in some ways it is all we have – in how we decide to deliver care or on where we decide to receive it.

On a week where independence is held high, it is important that we remember it is not just a holiday in the United States, but a statement about the very freedom we have as individuals, as consumers: the freedom to choose. The Declaration of Independence declared that individuals “are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” There may be no stronger place for us to remember these choices than in the decisions affecting our health. As healthcare leaders we must remember this, as caregivers honor it, and as patients and families never forget – the choice is truly ours.

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

 

Patients are Partners in Experience, Not Just Recipients of One

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

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

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

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

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

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

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

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

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

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

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

You are the Patient Experience: A Reflection

2013-04BlogIn just two weeks, hundreds of healthcare leaders, resource providers, patients and family members from around the world will gather together at Patient Experience Conference 2013. This annual gathering continues to amaze me, for while I get to take part in the organization and preparation with an incredible team of planners and volunteers, what happens during these days together is still, in many ways, a surprise.

Why is that, you ask? It comes down to a simple philosophy we work hard to ensure permeates our community at The Beryl Institute each and every day. With as many resources as we continue to provide – from papers, to case studies, On the Roadvisits to research – and our commitment to be the global community of practice and premier thought leader on improving the patient experience, we fundamentally believe the greatest power in our community is the connection and sharing with one another. That is what makes the annual gathering of patient experience leaders so powerful; it is grounded in the learning from and connection with one another and provides a new level of support for what many can feel at times may be a very lonely and challenging adventure.

No one person, organization, provider or vendor “owns” the patient experience and they should not claim to; rather it is ALL of the people who live it, struggle with it, work to improve and yes experience it every day, who do. It is you who truly are keepers of this movement. You are the patient experience. I see our job to create the space for this to happen, provide the information from which you can learn and fundamentally encourage the connections that will help all of us ultimately improve.

In my March Patient Experience Blog, Why Community Matters in Improving Patient Experience, I suggested, “…to provide a true experience, you must think well beyond the physical nature of your facilities or practices to recognize that experience resides in the network of people that surround and are connected to your organization, both near and far.” I would suggest that in the call to action to address the patient experience we remember this fundamental point. This is what also has me encourage people to get engaged, be part of the community, contribute and learn from one another. It is why at the Institute we have launched our Voices of the Patient Experience series to start this year from the perspective of executives, the front line, healthcare students and patients and family members and why we are ensuring patients and family members can participate in Conference 2013 (#patientsincluded).

I also share these thoughts with a new perspective on this passion, from that of a patient and family member myself. Personal experience has led me to spend time (and as someone committed to patient experience, observe the experience) in an emergency department and primary care setting, and has blessed me with the chance to encounter the preparation and expectation setting that happens with both physician and hospital in anticipating the arrival of your first child. These personal encounters have reminded me that each and every one of us committed to this work are also (or will be) that patient or family member.

I share all of this to reiterate my central point, if we are committed to improving patient experience, to ensuring all voices are heard, to providing the best in quality, safety and service, then the opportunity we have and must take advantage of is to tackle this not alone, but as a true global community. Whether in person at Patient Experience Conference, on a call or via an electronic network, the impact that we can have is only heightened through our connections. I encourage your engagement and I urge your sharing. This is an effort worth every moment we spend. I most look forward to all that will still emerge as a surprise!

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