Silence: The Invisible Tool for Patient Experience Excellence

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

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

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

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

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

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

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

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

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

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

Considerations for Patient Experience Excellence: 2016

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

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

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

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

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

I conclude with one more consideration:

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

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

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

How Will You Invest in Patient Experience in 2016?

2015-12 BlogWe recently celebrated our first five years as a community of practice and looked back, somewhat in awe, at the incredible growth of this organization over such a short time. The Beryl Institute is now a global community of almost 40,000 individuals passionate about improving the healthcare experience for patients, families and caregivers.

The momentum continues, as does the realization that organizations are making significant investments in time, energy and dollars to ensure they are prepared to deliver the best possible patient experience. We see these investments in many forms from hiring teams to training leaders and staff to building and supporting cultures of excellence.

As we shared in the 2015 State of Patient Experience Benchmarking study, senior patient experience leadership and staff investment is growing with 42% of respondents having a Chief Experience Officer (or comparable position) compared to only 22% two years ago.  Along with that, the size of patient experience teams is growing; 33% of organizations reported having five or more staff members supporting patient experience efforts.

The Beryl Institute community reflects this trend as well. This year over 200 organizations will invest in institutional membership – meaning they provide unlimited access to the Institute’s white papers, webinars, topic calls, learning bites, etc. to everyone within their facility. They are making a statement that people in ALL roles impact the patient experience and should have access to research and collaboration that will assist their efforts.

We have also seen tremendous interest in learning and professional development programs intended to train patient experience leaders and other staff. We recently increased our virtual classroom offerings in the Patient Experience Body of Knowledge courses to support growing participation in the community-developed program that provides Certificates in Patient Experience Leadership and Patient Advocacy.

Patient Experience Conference had its largest attendance to date this year and we were honored to partner with member organizations to host sold out Regional Roundtable events in San Francisco, Charlotte and Minneapolis. Our community is eager to gain (and share) knowledge and to invest in their personal career growth. In fact, today our sister organization, Patient Experience Institute, will offer the first testing opportunity for those hoping to earn their CPXP, the professional certification for Patient Experience Leaders.

While we’re excited to celebrate the five-year milestone, we acknowledge how much work is still to be done. We imagine (and hope to help inspire) a world where all healthcare organizations appreciate the power and impact of patient experience efforts and make without hesitation the investments necessary to be the best they can be for patients and families.

Earlier this year we released Our Stand, a list of guiding principles we’ve identified in our five years of leading this work that can have significant impact on patient experience success. I share them again as a reminder as you evaluate your own efforts and consider what investment opportunities make sense to support your specific needs.

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

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

As you prepare for the coming year I challenge you to reflect on your organization’s commitment to experience improvement. Where are you exceling and where are your opportunities to do even more for your patients, families, caregivers and staff? Our patient experience community is here to support your journey and I encourage you to take full advantage of the incredible resources and knowledge available.

Wishing you a wonderful holiday season and a successful New Year!

Stacy Palmer
Vice President, Strategy and Member Experience
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

Reframing Patient & Family Experience

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

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

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

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

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

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

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

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

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

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

Taking a Stand for Patient Experience Excellence

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

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

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

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

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

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

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

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

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

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

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

Why We are ALL the Patient Experience!

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

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

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

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

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

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

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

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

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

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