Patient Experience Abroad Amy Maclean, Head of Patient Experience - - PowerPoint PPT Presentation

Patient Experience Abroad

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.

• Own and run a healthcare business

since 2003 and trained and worked with NCT from 2003.

• Service user since 2000, MSLC

member, Governor into the HoPE role in 2014 at BWH, now BWC.

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/

Most noticeable themes

• Thought Leadership—where do the ideas/learning

come from?

• Leadership and organisational structure
• Data drivers
• The things that jump out:
• Customer Service: Living/Breathing a ‘Service

Economy’—moving to a ‘Connection Economy’

• Utter compliance with standard behaviours
• Voluntarism/Giving/Philanthropy
• Partnership—Family and Patient

Centered Care

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 of 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

American Patient Experience Thought Leadership

• Beryl Institute
• Press Ganey/Picker
• Studor, partner of Press Ganey
• Planetree, partner of Picker
• Institute for Family and Patient Centered

Care

• Cleveland Clinic

Organisation Differences

• C-Suite positioning: Chief Experience

Officers more common

• Patient Experience Teams called

Departments of Service Excellence

• Pt Experience includes: Staff Experience,

Comms, Giving, Advocacy

• Still has a strong link of Complaints to

Risk/Legal elements

How they use data: What matters most:

Rising tides—Biggest ‘bang for your buck!’

Statistics tell us these ‘rising tide’ measures: By improving ‘nurse/midwife/doctor communication’ the following domains also improve: Safety, overall experience, reduced readmission, reduced pain. And two proven ways to improve nurse/midwife communication:

• 1. Purposeful rounds

(preferably hourly).

• 2. Bedside handover.

Tools to drive communication

A Service Economy: Far more than ‘customer service’

• Look to industry—our patients do!
• 15 Steps—5 Senses challenges

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

Outstanding customer service including service recovery

WOWs: Into Giving

National initiative made local: ‘Project Linus’

• Art and music bedside

and in busy clinics

• Compassion Carts
• Pamper Hamper
• Pets as Therapy

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

Voluntarism, Giving and Philanthropy

• ‘Grateful Patients’—channeling

gratitude—acknowledging the innate human need for reciprocity

• Grateful Pt 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.

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

Big current theme: ER Waiting Times

• Feinberg: Former UCLA CEO now in Pennsylvania at Geisinger

System working on reducing ER wait times to 20 minutes

• Dashboard for ER Waiting times:

https://projects.propublica.org/emergency/hospital/390006

• In his own words: https://www.youtube.com/watch?v=cZ5u7p-

ZNuE

• https://www.geisinger.org/en/about-geisinger/news-and-

media/news-releases/2017/06/19/19/46/david-feinberg-third-on- modern-healthcare-top-50-influencers-list

Patient Experience

Hierarchy: Where to begin?

Patients as partners

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

Six Aims of BWC Patient Experience

Systems Leadership

• Building and enhancing teams and processing for capturing, reflecting and reporting what patients/parents/carers/family members tell

us - and what we are doing about it – it matters to us!

Outreach, Engagement and Participation

• An Engagement Strategy developed with our children, young people, patients, parents and families which is inclusive of our seldom heard

parents/patients. Includes active participation forums and support for clinical group development.

Insight into action

• Robust triangulation of feedback from above functions, for interpreting and messaging to clinical areas. Demonstration of application of

learning from feedback.

Reciprocity

• Volunteering/feedback/giving (fundraising)/other opportunities for patients and families to connect.

Knowledge/Educatio n: Patient/Staff

• Patient: Information, learning, support, engagement our families and patients require and when—working in partnership with clinicians and

comms, developing mechanisms for the most effective knowledge support systems during health journeys.

• Staff: Staff health and well being, education, staff induction, ongoing staff training for patient / customer service, culture that encourages and

recognises initiatives.

Health Environment

• Art and facilities connections to ensure physical spaces enhance the patient experience – a healing environment!

Final Thoughts

• Stay curious to the world around us:

Industry and healthcare from patients’ and families’ points of view.

• Use your travel and share. This is a field in

its infancy and your thinking can make a difference.

• Muse out loud—you never know what ideas

may inspire others.

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