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I ntro duc tio n T he Pa st: I mpe ra tive fo r Culture Cha ng e T he Pre se nt: Using Pa tie nts to g e t to Why T he F uture : Sha ring De c isio n-Ma king HCMC: A Histor y of Car ing Minne so ta

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SLIDE 2

 I

ntro duc tio n

 T

he Pa st: I mpe ra tive fo r Culture Cha ng e

 T

he Pre se nt: Using Pa tie nts to g e t to “Why”

 T

he F uture : Sha ring De c isio n-Ma king

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SLIDE 3

HCMC: A Histor y of Car ing

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SLIDE 4

Minne so ta ’ s pre mie r L

e ve l 1 Adult T ra uma Ce nte r a nd L e ve l 1 Pe dia tric T ra uma Ce nte r

An e sse ntia l te a c hing hospita l fo r do c to rs a nd o the r he a lthc a re pro fe ssio na ls (1,000/ ye a r) who g o

  • n to pra c tic e thro ug ho ut the

sta te

Re c o g nize d fo r inno va tive a ppro a c h to e ng a g e a nd e mpo we r pa tie nts with c o - mo rb iditie s a nd histo ry o f c o mple x a nd c o stly he a lthc a re ne e ds.

3rd la rg e st e mplo ye r in do wnto wn Minne a po lis.

 462 Sta ffe d b e ds  2,373 Births  3,269 Hype rb a ric Me dic ine

tre a tme nts

 15,586 Surg e rie s  21,748 Disc ha rg e s  63,596 Amb ula nc e runs  74,490 Po iso n Ce nte r c a lls  100,066 E

me rg e nc y Se rvic e s visits

 496,416 Clinic visits

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SLIDE 5

 Hug e ly dive rse pa tie nt po pula tio n  72 la ng ua g e s  Bro a d sc o pe o f se rvic e s  I

nte g ra te d physic ia n g ro up

 Dive rse e mplo ye e s  Co unty le g a c y a nd b ra nd ide ntity  Go o d b ut no t g re a t pa tie nt sa tisfa c tio n

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SLIDE 6

 2008-09: I

nitia te d fo rma l a ppro a c h to pa tie nt e xpe rie nc e . T rie d a nd fa ile d to de plo y b e st pra c tic e s. No b uy-in.

 2010: E

mb ra c e d the po we r o f Pa tie nt- a nd F a mily- Ce nte re d Ca re . L a unc he d Ra llie s. Cre a te d the “why” b y liste ning to pa tie nt/ fa mily sto rie s

 2011: Pa tie nt E

xpe rie nc e b e c a me # 1 F

  • c us a re a o n

HCMC Annua l Pla n. E xe c utive Spo nso r ide ntifie d. Physic ia n e ng a g e me nt a c c e le ra te d.

 2012: E

xpa nde d use o f pa tie nt/ fa mily a dviso rs. Co ntinue d Ra llie s. L a unc he d Co mmunic a tio n to o ls fo r b e dside c a re .

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SLIDE 7

Patient- and family-centered care is working with patients and families rather than doing to or for them. Patients and families are partners in care.

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SLIDE 8

We kno w b e st. T his is the wa y we ’ ve a lwa ys do ne it. Do e sn’ t a lwa ys wo rk so we ll. We ’ re a ll pa tie nts to o . We c a n fig ure it o ut. Wha t wo uld

  • ur

pa tie nts wa nt?

L e t’ s a sk the m.

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SLIDE 9

› “Alre a dy do ing it, a nd I ’ m g o o d a t it to o .” › Pa tie nts a re so urc e o f c o ntro l = Cha o s › We a re the e xpe rts › Bla me PF CC fo r pro b le ms › L e a rning to a da pt pa tie nt/ fa mily input into “o ur” wo rk › L e a rning to a c c o mmo da te hug e ly dive rse pa tie nts into struc ture . › “Yo u do n’ t unde rsta nd ho w ha rd this is.”

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SLIDE 10

How are we asking and partnering?

 Faces of Inspiration  Patient advisory councils and

focus groups

 Patients on organizational

committees

 Patients on interview panels –

CEO, Chiefs, HR VP

 Lean events  Q study  Brave staff  Patient Experience Rallies

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› 8 ho urs › 500 sta ff a nd physic ia ns › 50-60 pa tie nts a t e a c h e ve nt—a t e ve ry ta b le , tra ine d to te ll the ir sto ry › Multi-me dia › Pa tie nt/ F a mily pa ne ls › “Pa tie nts a s a rtists” › E mplo ye e s-a s-pa tie nts pa ne ls › K e yno te spe a ke rs b ring c re dib ility › Wo rkg ro ups a ssig ne d to ta b le s › 4 time s/ ye a r

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 “Rally was g o o d re minde r to b e c are ful with

wo rds”

 “Po nde r b e fo re I

talk”

 “Be mo re aware o f my appro ac h with patie nts”  “Be mindful o f what wo rds to say”  “Be mindful o f 9 b e havio rs—the y will make my

jo b e asie r and my patie nts mo re satisfie d.”

 “I

ho pe I have g aine d a muc h b e tte r pe rspe c tive o f ho w my daily ac tio ns are re c e ive d, re g ardle ss o f the inte ntio n.”

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36 26 62 74

10 20 30 40 50 60 70 80 Ye a r 1 Ye a r 3

Pe r c e nt

Re sponse fr

  • m Rally Atte nde e s:

I unde r stand what my r

  • le and r

e spo nsibility is in tr ansfo r ming HCMC into a patie nt- and family-c e nte r e d o r ganizatio n.

Ag re e Stro ng ly Ag re e

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SLIDE 14

 Va lue s pro je c t

› 6 o f 8 g ro ups (1500+ re spo nde nts) na me d patie nt-c e nte re d a s the to p c ho ic e fro m 150 wo rds.

 Be ha vio rs a re c ha ng ing  Co nve rsa tio ns a re c ha ng ing  Pro c e sse s a re c ha ng ing  Wo rklo a d is c ha ng ing !

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SLIDE 15

70 72 74 76 78 80 82 84 86 88 90

Inpatie nt Satisfac tion L ike liho o d to Re c o mme nd Me an Sc or e 2005- 2012

  • Re spo nse

ra te impro ve me nt c o mmitte e

  • 1st pa tie nt

e xpe rie nc e ste e ring

  • Adde d F

T E fo r pa tie nt e xpe rie nc e

  • F

re d L e e 2- da y tra ining

  • Ple dg e

T ra ining Ma na g e rs/ Dir

  • E

PI C insta lle d

  • Go ve rna nc e

a nd

  • pe ra tio nsa l

c ha ng e s.

  • Pub lic

re po rting o f HCAHPS

  • initia te d

mo nthly pre se nt .to mg r huddle

  • Jt Cmsn.
  • 30 to PF

CC

  • Ho spita l

Pa tie nt Adviso ry Co unc il

  • initia te d -

Mo nthly pre se nt. to ME C

  • Sta te

"c la wb a c k"

  • Ho urly

Ro unding la unc he d Sc ripting initia tive a mb

  • Pa tie nt E

xp Ste e ring Co mmitte e

  • Pa t E

xp a dde d a s Annua l Pla n F

  • c us Are a
  • 18 to PF

CC

  • Ra lly # 1
  • Se rvic e

Re c o ve ry initia tive

  • CAY Be ha vio rs

a nd PF CC g uiding princ iple s

  • F

a c e s o f Inspira tio n

  • He re to He lp
  • Adde d F

T E fo r pa tie nt e xpe rie nc e

  • pe ra tio ns

T CAB units

  • Ra lly # 2,# 3, 4

(80% o f physic ia ns a tte nde d)

  • 29 to PF

CC

  • E

xc e lle nc e Co unc ils

  • F

a mily Pre se nc e Po lic y

  • Va le t

Se rvic e s

  • YMAD

upg ra de

  • Be ha vio rs

c a mpa ig n la unc he d

  • Jt Cmsn

surve y Ca re Bo a rds Wa it time b o a rds

5th

PE RCE NT I L E

7th

4th 6th 9th 16th 15th

  • Ra lly 5,6,7
  • 20 to PF

CC

  • T

OCC

  • Hig h

Impa c t

  • Va le t x2
  • Visua l

Mg mt Bo a rds

  • PF

CC F a c ility de sig n sta rts

  • Inte g ra tio n

Building Co nne c tio n s la unc he d Ne w phys c o mp pla n F

  • rma lize

Pa t Adv

All-time hig h po int July 2012 = 89.6 50th pe rc e ntile

25th

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SLIDE 16

 2013 a nd b e yo nd

› T e a c hing T he Why: Co ntinue with Pa tie nt E xpe rie nc e Ra llie s a nd c o ntinue to e xpa nd use o f pa tie nt/ fa mily/ c o mmunity pa rtne rs. › T he Ho w: Co mmunic a tio n skills tra ining – Building Co nne c tio ns; E xpe rie nc e Disc o ve ry a nd De sig n. Pa tie nts o n e ve ry stra te g ic c o mmitte e . › T he Wha t: L a unc he d spe c ific b e d-side / E xa m-ro o m stra te g ie s: Be dside Shift Re po rt, Ca re Bo a rds, I nte rdisc iplina ry Ro unds, L e a de r Ro unding o n Pa tie nts › All in: Org a niza tio na l Annua l Pla n insists tha t E VE RY de pa rtme nt fig ure o ut a wa y to e lic it a nd inc o rpo ra t pa tie nt/ fa mily fe e db a c k into the ir wo rk.

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SLIDE 17

 Dive rsity

› Cha lle ng e = ho w to g e t input fro m pa tie nts spe a king so ma ny la ng ua g e s › Oppo rtunity = he a r so ma ny inte re sting wa ys

  • f lo o king a t a pro b le m/ so lutio n

 No n-tra ditio na l fa mily struc ture s

› Cha lle ng e = ho w to kno w wha t fa mily- c e nte re d me a ns to e a c h individua l pa tie nt › Oppo rtunity = le a rn to a ppre c ia te tha t fa mily c a n b e muc h mo re tha n pa re nts a nd sib ling s.

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SLIDE 18

 L

imite d re so urc e s

› Cha lle ng e = fa irly c o mpe nsa ting pa tie nts/ fa milie s fo r the ir time › Oppo rtunity = Pa rtne rs wa nt to kno w first a nd fo re mo st tha t we a re ta king the m se rio usly.

 L

  • g istic s

› Cha lle ng e = pa tie nts with c o mple x live s c a n no t a lwa ys me e t with us o n o ur te rms › Oppo rtunitie s = fo rc e d to fa c e wha t b e ing truly PF CC me a ns

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Co nta c t: She ila De la ne y Mo ro ne y MPH Dire c to r, Pa tie nt E xpe rie nc e Se rvic e s a nd PF CC She ila .mo ro ne y@ hc me d.o rg 612-873-9829