Best practice improving the patient experience: An international - - PowerPoint PPT Presentation

Best practice improving the patient experience: An international perspective

Amy Maclean, Head of Patient Experience

Bit about me

• Lived and worked in USA until

2000—From Chicago most recently.

• Married a Brummie in 1999—

had been working in Chicago in Corporate Change Management.

• Own and run a healthcare

business since 2003 and trained and worked with as an Antenatal Educator from 2003.

• Service user since 2000 at BW

and came into post in 2014.

21 USA Site Visits since ‘15

Most recently:

• Providence Hospital - Burbank, California
• Emory University Healthcare System - Atlanta, Georgia
• Keck Medical Center, University of Southern California
• Cedars Sinai Hospital - Los Angeles, California
• 2015 - 17 other US Hospitals:

http://amymaclean.wordpress.com/ Work at Birmingham Women’s and Children’s NHS Foundation Trust and regularly visit other UK hospitals looking through the lens of Patient Experience

Patient Experience Hierarchy: Where to begin?

Patients as partners

Patient and family centred care WOWs - Harnessing Gratitude Outstanding customer service including service recovery Empathy

Technology driving Patient Experience

• Forced changes through legislation
• Challenge to creatively mirror expectations of patients with in-

house technology.

• Insight to improvement needs behind the data
• Rapid response ability to real or near time feedback—getting to

patients earlier in their journey.

• Using technology for appropriate transparency of data and

communication.

• Using technology for patient partnership throughout the

journey.

A few general principles

USA UK

326 million people 66 million people 50 governments 1 government The marketplace dominates, so consumers win. However, once into an health episode, it is difficult to exercise true choice. Reviews of facilities and individual clinicians is readily available, and hospitals are protective

• f reputational damage.

There is little to no ‘choice’ (market) in healthcare—offering choice quickly becomes a conversation about private healthcare. Spirit of people:

• Fiercely self-reliant: personal freedoms, individual responsibility,

resist someone telling them what to do or how to live.

• Rapidly embrace change, seeing progress as a good thing. Easily

mirror industry and take that as a model to comfortably adapt to.

• Government holds solutions
• More skeptical of change, more likely to

resist changes which might infringe on privacy.

• Ultimately do adapt to industry but it

takes longer. Voluntarism/Giving/Philanthropy deeply engrained from early on. Present but less developed. Needs a nudge! Obamacare centralised obligation to report on Pt Experience through monthly reporting via HCAHPS (Hospital Consumer Assessment of Healthcare Providers & Systems) FFT came about in 2012-13 as first centralised measure for Pt Experience

How they use data: What matters most

Rising tides: Biggest ‘bang for your buck!’

Statistics gives us insight into the following ‘rising tide’ measures: By improving ‘nurse/ midwife/ doctor communication’ we see improvement across the domains of:

• Safety
• Overall experience
• Reduced readmission
• Reduced pain

And two proven ways to improve nurse/ midwife communication:

• Purposeful rounds (preferably hourly)
• Bedside handover

The use of technology supports patients and families to access information they need and share feedback in ways they are most comfortable with. We have ability to control from a desktop and analyse data for insight.

Tech continues to inform: Closing the feedback loop

Tools to drive communication: Next tech solution?

Patient Experience Strategy in Action

Build and refine sustainable feedback to improvement loops Listen to feedback, identify themes and act Make it easy for users to feedback Empower staff through appropriate governance to be part

• f the conversation and

solution creation. Engage with future service users for inclusion and planning Develop a culture that supports continuous improvement of the patient experience Develop a culture where families, parents and patients are the centre of our service. Build the brand of the Trust: Excellent Service, Care, Quality and Experience for all our parents, patients and families Prevent poor experiences from

• ccurring or

getting worse. Parents/Patients/ Families

Create proactive mechanisms for identifying issues early in the parent / patient journey

• Easy from-App comms
• Ward-based PALS
• Easy-access to PALS

with extended hours

• After-Thoughts

Listening Service

Full Patient Experience and Engagement Strategy: http://www.bwnft.nhs.uk/wp-content/uploads/2015/03/Patient- Experience-and-Engagement-Strategy-2016-19-FINAL.pdf

A great place to start:

Introducing a “Listening Service”— bedside and beyond

Is there a pattern to your complaints? Go in early!

Technology helps us become a true Service Economy: Far more than ‘customer service’

• Look to industry - our patients do!

A focus on getting the ‘service right’ and attempting ‘service recovery.’ Intentional interventions: Memorial Sloan Kettering What do we do? Coffee cards!

Outstanding customer service including service recovery

Utter compliance with agreed Service Economy behaviours: Keck USC uses the KNOWN

K N O W N Kind Greeting:

Connect with the person

Notice Needs:

Observe

Own it:

Gain insight

Wow them:

Engagement

Next Steps:

Action planning

• Enter the

conversati

• n: How

is your day going? How may I help you?

• What is the

perceived issue?

• What is the body

language, tone of voice, urgency of conversation?

• What can you

learn from

• bservation or

asking to notice their needs?

• Ask clarifying questions:

seek to understand

• Open-ended questions—

How, what Why, Who, When

• Actively listen with

empathy—listen from THEIR perspective

• Build self-esteem through

process AND

• Make it happen
• Find solutions
• Embrace it
• Don’t pass the buck!
• See

involvement

• Be present

in the moment

• Ask for their

recommende d solutions

• Define

solutions together

• Explore
• ptions and

benefits of each

• End the

conversation with a commitment moving forward

Expected behaviours UCLA:

• Connect with Compassion

By addressing patients by the name they prefer. Smile and greet at 5/10.

• Introduce

Yourself with integrity by stating your name and role. #hellomynameis….

• Communicate

With teamwork what you are going to do, how long it is going to take and how it will impact the patient

• Anticipate needs/Ask with Discovery

By anticipating the patient needs, questions or concerns

• Respond with Respect

To patient questions and requests with immediacy or a sense of urgency

• Exit with Excellence

By ensuring all the patient needs are met

• We never pass by a parent/patient/family or visitor in need.
• It is everyone’s job to assist our parents, patients, their families, our

visitors and each other.

• It emphasises that parents, patients, families and visitors are not an

interruptions to our work.

• They are the reason we are here!
• If we are unable to help, we will find someone who can help.
• A No Pass Zone applies to EVERY member of staff, EVERY

Parent/Patient/Family/Visitor, EVERY time. Watch our training video here:

Many locations have implemented a

No Pass Zone

https://youtu.be/LNGSwEsFywk

WOWs: Giving

• Art and “Singing Medicine” bedside and in busy clinics
• Compassion Carts
• Pamper Hamper
• Pets as Therapy

National initiative made local: ‘Project Linus’

WOWs /Grateful Patients

WOWs/Giving—into Partnership

• Partnership begins with family access
• Baby Webcams: http://www.latimes.com/socal/burbank-leader/news/tn-blr-me-providence-

media-20170603-story.html

• Video of lead nurse detailing camera

https://youtu.be/sAF-uB6-kwY WOWs/Grateful Patients

WOWs: Voluntarism, Giving and Philanthropy

• ‘Grateful Patients’: channeling gratitude -

acknowledging the innate human need for reciprocity

• Grateful Patient Rounds: giving of time,

feedback / stories / money

• Planting seeds for philanthropy including

patient / family led PE Awards

• Highly structured, intentional, normalising

the ‘ask’ - making it simple for patients / families / businesses to give

WOWs/Grateful Patients WOWs/Grateful Patients WOWs/Grateful Patients

Family and Patient Centered Care

• Personalised care: food, discharge, information needs, family involvement
• Caregiver involvement: classes, inclusion, rounds, empowerment, facilities
• IFPCC toolkit: http://www.ipfcc.org/bestpractices/better-together.html
• Planetree Care Partner Programme:

http://planetree.org/wp-content/uploads/2017/04/11.-Care-Partners-Primer.pdf

• This tool from 2008 is used

to move services to being move patient centred: Patient Centered Care Improvement Guide http://patient-centeredcare.org

Patient and family centred care

The involvement continuum

Patients as partners

From “Real Involvement – Working with People to Improve Health Services”

Tech supporting partnership

Patients as partners

Your baby will need more milk soon. The doctor will be doing rounds in 20 minutes Join us for our annual NNU reunion. Come for a picnic with staff, doctors and babies and parents who have graduated from the unit. The Neonatal Forum is meeting Thursday night to discuss improvements to the

• unit. Join us!

Calling all grandparents: Meet in the lounge Tuesday at 10:30 for a short workshop on supporting the family with a premature baby. The unit is buying 3 new breastpumps this

• month. Can you

help with a contribution?

Patient Experience Hierarchy: Where to begin?

Patients as partners

Patient and family centred care WOWs - Harnessing Gratitude Outstanding customer service including service recovery Empathy

The Evolution of Patient Experience—moving to connection…

Commodities:

Science/ Medicine/Knowled ge

Goods:

Doctors/Nurses/B uildings

Services:

Directorates/Depa rtments/Specialtie s/Enter Customer Service

Experience Economy:

Disney/WOWs--Moving from staging an experience to actually connecting the patient to trusting their caregivers.

Connection Economy:

Credibility/Trust/T eamwork/Shared Empathy/Connecti ng Pts to what they need most: expertise/each

• ther, etc.

Contact/Reading

Thank you

Amy Maclean, Head of Patient Experience

amy.maclean@bwnft.nhs.uk @amymaclean

Great reads:

• Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way

by James Merlino

• An Epidemic of Empathy in Healthcare by Thomas H. Lee
• The Experience Economy by Joseph Pine
• Sorry Works

by Doug Wojcieszak

• If Disney Ran your Hospital by Fred Lee
• Black Box Thinking

by Matthew Syed