How will the Patient Experience evolve in Australia?

Australia is embarking on a major journey to put patients at the center of decision-making in the healthcare system. In order for us to understand how the patient experience landscape in Australia will change over the coming decade, we can observe the trends in the US as an example.

The pioneering hospitals in the US that invested in measuring and improving the Patient Experience did so because they believed was the ‘right thing to do’. This first phase was driven by the investment of ‘early adopters’. Their leadership had a belief that patients should be involved in various committees in the hospital’s administration to influence service delivery. 

The next big phase that brought greater change to the system was the public reporting of quality measures by the Centers of Medicare and Medicaid Services, the primary funder in the US. This reporting of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey on hospital websites drove senior leaders to take a greater focus on metrics that were important to patients. 

Note that there is a difference between active reporting and passive reporting. As more active reporting occurs on various websites, and those findings communicated broadly, the greater the pressure on hospitals to be accountable to their results. 

Transparency breeds trust, and greater public reporting should bring greater trust and engagement with the patient community.

The subsequent phase took approximately four years from the initiation of public reporting in the US for funding to be specifically tied to Patient-Reported Outcome Measures and Patient Reported Experience Measures (Satisfaction Scores). These value-based payments will increase from 1% in 2015 of the hospital’s funding to higher percentages over the coming years.  It demonstrates a great commitment from the US health system to align its payment incentives to what patients really need and want from their healthcare.

I would expect similar trends to play out in Australia. Though, I expect we may be quicker in our adoption of patient-centred measures to drive change.

On another note, while in Dallas for the Beryl Institute Patient Experience Conference 2016, I connected with Jeff Kauffman a CEO from the aged-care (assisted living) sector  in the US, who had a couple of secrets on aligning staff incentives with the resident experience in such facilities. 

Enjoy this episode and let me know your feedback!

 

You are the Patient Experience

I was fortunate enough to attend the Beryl Institute Conference on Patient Experience in Dallas TX a few days ago. The Beryl Institute is one of the leading institutions worldwide on patient experience and it seemed like over 1000 delegates were involved in the community gatherings as well as special interest communities on Patient Advocacy, Pediatrics, and Physicians.

Healthcare leaders discussed elements of supportive design, University of California in San Francisco and American Academy on Communication in Healthcare and Language of Caring conducted activities on relationship building with patients and strategy maps on effective improvement planning. Communications skills were regarded as advanced physician skills required for the current healthcare climate.

I witnessed an outstanding keynote from  Cynthia Mercer discussing the importance of culture in an organization and how staff want a purpose to work on, not a place to work in. Another keynote from TV show host and healthcare advocate Montel Williams captivated the audience with his inspiring message of overcoming the odds through his personal experiences within the US health system.

He emphasised some of the major healthcare challenges coming in the next few years with predicted acute staff shortages and rising demands from patients with chronic disease. Consumers and patients will still expect a good experience, despite these issues and they will be vocal about it.

I had the opportunity to produce a few more episodes of our Patient Experience Channel. I am experimenting with shorter videos that contain quick tips for insights and implementation. Let me know what you think of these as I interviewed Colleen Sweeney,  patient experience rockstar from the US who is the Founder of the Empathy Project and researched patients’ fears in the health system.

Watch this video to find out patient’s no. 1 fear as they enter the health system (hospital)

On the local front, if you are based in New South Wales, we are sponsoring the Patient Experience Symposium organised by NSW Health at the Australian Technology Park Everleigh on May 5 and 6, 2016. Please come and visit our booth as we are proud to support the patient experience movement in NSW hospitals.

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Finally, we acknowledge another happy customer! Sarah from NIB New Zealand had nice things to say about our work to help improve their customer experience.

“Dr Avi and team were very helpful in performing analysis which enabled us to isolate our top customer frustrations. The analysis was delivered in a timely manner, and their knowledge and enthusiasm for the topic was appreciated. The information provided by Dr Avi and team has been a great help to nib in focusing our efforts on improving customer experience.”

If you are having a challenge in your organisation you’d like to discuss , do feel free to reach out to me at avnesh@energesse.com. Happy to chat!

 

 

Do you know the common misconceptions in patient satisfaction?

The pulse of healthcare is now moving into a swing that smells like an Evolution, rather than a revolution. Everyone I speak to is starting to grasp the idea of ‘people power’ and frame it in the context of the healthcare system.

I hear words like patient satisfaction, patient experience, consumer engagement, patient-centred care and an evolutionary term – ‘Patient and Family Centred Care’. The latter is very appropriate as we often forget that children and critically ill patients have no voice for them, and it is the families that act as their voices. I can relate as this happened when my late father passed away in a hospital only 4 months ago.

Nevertheless, I am encouraged by these trends. Whilst many of these terms effectively mean the same thing, it is great to see these metrics embedded in the very fabric and Key Performance Indicators of many of our hospitals and primary care networks.

Watch the video of Australian 1st Real-Time Patient Feedback technology with Emotion analytics

However, not everyone feels this way. I hear objections from Chief Executives, Chief Financial Officers and other financially oriented personnel who do not believe in investing time or money in such initiatives as they perceive them to cost more money and don’t result in any savings or efficiencies.

I also hear objections from some clinicians and healthcare professionals who feel that this is the ‘soft, wishy-washy’ stuff that has no bearing on clinical outcomes for patients.

Both these sentiments are actually unfounded and incorrect.

It is in fact these sentiments and thought patterns that drive increased costs and poorer outcomes as these leaders cannot see the big picture of how change and improvement in healthcare really happens.  

 As a passionate advocate on innovation and patient-centred improvements, I searched globally for a proven solution that can help hospital and community health organisations in Australia (and now Asia) better engage with their patients, clients and consumers and solve many of the challenges they currently experience.

To learn more about this innovation, click here for the video of the MES Experience Debut at Australian Healthcare Week. Hope you enjoy it enough to share with your like-minded colleagues.

The day “patient-centred care” became a reality in Australia

Energesse, one of Australia’s leading healthcare IT consultancies, will be unveiling the first  patient feedback technology to measure patient emotions.  The MES Experience platform has transformed the NHS, and Energesse is bringing the technology to the exhibition after trialling it with one of Australia’s largest hospital districts for the past 18 months.

Dr Avnesh Ratnanesan from Energesse, together with the director of MES from London, Nick Goodman, will be showcasing the technology on stage in the Healthcare Innovation Zone at 3.40pm on 15th March.

The MES Experience technology is a multichannel platform for collecting patient experience and satisfaction data at point-of-care, and reports meaningful analytics for managers. This technology has the potential to truly enable patient-centred care in Australia by producing quantitative data on the emotional aspects of patient opinion in real-time. For the first time, health services will be able to monitor and adjust patient care according to the current situation.

If you are attending the conference, please do come and witness the debut of MES Experience software platform on stage in the Exhibition Centre. Free passes to the Expo can be obtained here, if you have not registered on any events yet.  Thanks and we look forward to seeing you on the 15th!

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A Conversation on Patient Experience – Lessons and Case Studies

Patient Centered Care and Patient Engagement are fast becoming buzzwords in healthcare, particularly as the belts continue to tighten and health institutions choose to invest in things that really matter.

As a leading firm that specialises in the field of patient experience and health innovation, we at Energesse decided to launch a Patient Experience Channel, to complement the Patient Experience Australia LinkedIn Group that launched in 2015.

Both initiatives were driven by the need for Australian healthcare professionals to connect, communicate and educate each other on how to diagnose, improve and monitor patient experience. They also provide very practical tips based on learnings and strategies implemented by practitioners around Australia and overseas.

For this first episode of the Patient Experience Channel, I had a conversation with Bernadette Brady, consultant and trainer with PartneringwithPatients. Bernadette and I are highly passionate about helping hospital and healthcare implement simple measures to transform healthcare to the way it should be – thinking about patients first.

In summary, some of the key learnings we highlighted are:

1. Enable patients to take control of their care and be in charge – ask them how they would like to be treated e.g. times they would want to be seen in hospital.

2. Clinicians should change from a ‘to’ mentality, to a ‘with’ mentality, when it comes to treatment program

3. Committees with patient representatives should have at least two of them on it, to ensure voices are heard

4. Learn to manage risk with patient choices – e.g. allowing early discharge from hospital even if there is a risk to patient staying at home – manage that.

5. The most effective solutions to transform care are simple – Every clinician should introduce themselves first. And always SMILE (when appropriate).

6. Celebrate success in Safety and Quality (rather than just focusing on negative events).

7. Consider the SECOND VICTIM ie. clinicians may need care and some protection too, especially when a bad experience occurs.

8. Know the difference between treating the disease and treating the person, the latter should come first.

9. Walk through the wards as if you were a patient one day – how does it feel and what observations about your environment have you made?

I’d love to hear your feedback on Episode 1 – content, length, quality, etc – what other topics around Patient Care would you like to hear about? Are there any experts in this field you’d like to hear from? Let me know and we’ll see what we can do to serve you…

Are we Ready for One Standard Measure of Patient Experience across Australian health?

Most recently, I had the pleasure of being invited to speak at the Improving Healthcare International Convention 2015 on the topic of Patient Experience case studies from the NHS, UK.

There is a growing body of evidence on patient experience measurement and linking financial incentives to them are starting to influence the thinking around patient experience measurement and improvement in Australia.

The last week I was having coffee with Michael Greco, the CEO of Patient Opinion in Australia. Patient Opinion is a website developed in the UK where patients can place elaborate comments, stories and experiences on a platform, such that it increases the transparency of how services are delivered in hospitals. The technology platform from the UK that Energesse introduced is called MES Experience, a multichannel platform for collecting patient feedback (patient experience/satisfaction) data at point-of-care and reporting meaningful analytics for managers.

As we are both heavily involved in mechanisms for improving patient experience through better data, it dawned on us that one of the major challenges in making a difference in Australia (compared to the UK) was that, we still do not have a single, clear national standardised metric for measuring improvement of patient experience.

Within the NHS there has been implementation of a standard measure of patient experience called the ‘Friends and Family Test’. Whilst there has been much debate about the measure over the last 5 years of its implementation, the one thing it has done is has raised the bar on the conversations and investments on how healthcare services should be measured and delivered in a truly patient-centred way, with input from patients.

Australian public hospitals are required to improve quality metrics around patient experience set around Standard 2, one of the 9 quality standards set by the Australian Commission for Safety and Quality in Healthcare. This standard calls for effective partnerships between consumers, healthcare providers and healthcare organisations which are deemed essential for safe and high quality care in national health policy in Australia.1-3

This standard aims to guide health services to become responsive to patient, carer and consumer needs and actually partners with consumers in the implementation of all other NSQHS Standards. However, according to the Commission reports, some health services have found the implementation of systems to meet the requirements of Standard 2 challenging4.

Private sector hospitals on the other hand are utilising their own divergent set of Patient Reported Experience Measures (PREMs), largely based upon surveys from the US healthcare system (HCAHPS) as well as the incorporating from other major payors such as health insurance funds. I’ve had conversations with several CEO’s and Directors of Clinical Governance who have really taken the lead in this space with patient experience measurement, and have evolved their own systems for managing it.

However, it remains clear that in general, Australian health services and hospitals are still at their infancy in terms of executing the latest strategies to collect, analyse, measure and improve patient experience. The lack of a standard national metric and the complexity of survey questions and aggregated data sources can further confuse management decision-making and budget allocation in this space.

Guidance from organisations such as the Picker Institute and Beryl Institute are helpful, yet implementation of these questions do require tailoring to local needs, such as in translation of survey questions to local ethnic languages. There also needs to be electronic mechanisms in place to complement paper-based collection in order to improve response rates, engagement and obtain meaningful insights in real-time.

Most importantly is the need to close the feedback loop and take action from patient experience data. Whilst some ward staff and executives may see this process as a ‘tick-box’ exercise, patient experience data collection is actually a driver for organisational strategy and a source for targeting innovation initiatives with real financial outcomes.

Why?

Because from my years as strategist in the corporate health sector (including for very successful pharmaceutical company with over $1bil in annual revenue), I learned one major fact – organisation that is close to its ‘customer’, is the most financially viable over the long term. Hospitals that are sensitive to understanding the needs and wants of its patients, will be the best performing over the long term.

Analysing patient complaints and frustrations may seem like a dreary task, however these ‘warning signs’ are particularly useful when coming directly from patients or front-line staff. Alleviation of patient concerns in an early stage acts as an ‘early warning system’ that can reduce systemic errors and multi-million dollar lawsuits. There are also often many positive stories that can be effectively shared in the organisation to lift morale and staff engagement.

One of the most neglected aspects of patient feedback is the long form narrative where the rich depth of patient insights often lie. In the business world, market research companies understand that these ‘long form narratives’ provide a rich source of insights on how an organisation should innovate its services. However, one of the reasons many surveys tend not to encourage these narratives is that they are difficult to analyse manually in high volumes.

Fortunately, many technologies now exist that can perform automated free text analysis to extract deeper actionable insights from this type of data and to keep service managers updated. Among them are tools like PanSensic, InVivo and SAS, some of which are customised for analysing patient experience data. Some of these tools are also able to analyse compassion, staff attitude and quality of communication.

From helping implementations of patient experience initiatives, here are 8 tips I’ve observed that can help Clinical Governance and Patient Experience managers:

  1. Have a systematic annual strategy and implementation plan that you’ve shared with a cross section of stakeholders in the hospital.
  2. Design your data collection, analysis and dissemination process so the right person gets the right data at the right time.
  3. How you design the questions for local use and ask the questions is critical – some patients/consumers will love doing a survey electronically at point of care, others may want to do it from home post-discharge – give them options.
  4. Analyse data effectively to translate them into actionable insights. Many ‘big data’ technologies that can save managers time, and perform these tasks more objectively and effectively than humans.
  5. Implement changes through a prioritisation process involving a multi-displinary team (that involves ideally 2 consumer representatives).
  6. Visibly demonstrate the results of feedback and management actions to drive culture change, motivation and results over the long term. Front line clinical staff want to know that their daily hard work is appreciated. It also helps them improve the quality of their care and communication if they understand that these aspects can actually be measured via patient feedback.
  7. Finally, monitor experience with a ward’s performance metrics to ensure that interventions are effective are continuously aligned with patient needs – many wards now have visibly transparent performance dashboards on the ward. The right way to do this is to have 3-4 main high priority metrics visible (not 20 metrics that cannot be easily seen by busy staff)
  8. Have the discipline to iterate the process to achieve continuous improvements to outcomes. Repetition is key to behaviour change. For any person, in any industry.

What are your thoughts on developing one standard metric for patient experience in Australia?

Do check out the Patient Experience Australia LinkedIn Community if you’d like to engage other leaders on this topic.

References

  1. Australian Charter of Healthcare Rights. Commonwealth of Australia, 2008. (Accessed 28 August 2014, at http://www.safetyandquality.gov.au/national-priorities/charter-of-healthcare-rights)
  2. Australian Safety and Quality Framework for Health Care. Australian Commission on Safety and Quality in Health Care, 2010. (Accessed 28 August 2014, at http://www.safetyandquality.gov.au/national-priorities/australian-safety-and-quality-framework-for-health-care/)
  3. Australian Safety and Quality Goals for Health Care Partnering with Consumers: Action Guide. ACSQHC, 2012. (Accessed 28 August 2014, at http://www.safetyandquality.gov.au/publications/goal-3-partnering-with-consumers-action-guide/)
  4. Safety and Quality Improvement Guide Standard 2. Partnering with Consumers. Embedding partnerships in Healthcare. Australian Commission on Safety and Quality in Healthcare. (Accessed 4 December 2015, http://www.safetyandquality.gov.au/publications/safety-and-quality-improvement-guide-standard-2-partnering-with-consumers-october-2012

How do we solve future health workforce needs with digital technology?

Over the past few months, a number of organisations across the healthcare ecosystem have engaged Energesse to help overcome challenges with the common theme of ‘needing to do more with less’.  It is unsurprising terminology for players in health system that is undergoing increased service demands but increasingly scarce funding supply. Hence we’ll be covering this in our Executive Breakfast in Melbourne in a few weeks.

The interesting fact is that this common problem emerges whether I’m speaking to a hospital CEO, a healthcare recruiter, a pharmaceutical industry executive or a healthcare technology vendor.

One of the stressors of this challenge in maintaining the existing business model and deliver services is that there is a need to maintain a significant workforce, whether it is doctors, nurses, HR, recruitment staff, accountants, sales reps and many more. At all levels of the ecosystem, the need for increased workforce is largely appears true, yet it forms one the most significant parts of the cost base of most organisations. And it is no longer sustainable.

As such, many organisations have spoken to me about how they can disrupt and innovate their own business or service model with technology, in order to manage the increasing cost and need of the workforce. However, most executives are challenged with exactly how to do this, and what thought process is required to start disrupting their own models digitally.

The answer is – it starts with your ‘customer’. One has to understand who the actual customer is in your part of the value chain and really understand their needs. The ‘customer’ may be the doctor, the patient, the pharmacist, the consumer/taxpayer, whoever it is your part of the organisation has to deliver value to.

One of the biggest mistakes is trying to adopt new digital technology solutions, is the tendency to jump to solutions (i.e developing a website or mobile app,or telehealth solution) , without really understanding who the customer is, and mapping out exactly where their needs, frustrations and pain points are in the customer journey. IT and digital solutions should target those pain points.

Customer Journey mapping is often done too narrowly in healthcare, and the questioning and analysis of real needs is actually done very poorly, if done at all. This results in enormous wasted financial resources on IT projects as well as not really solving the customer problem in healthcare. It certainly does not help manage the increased workforce requirements.  Similar insights on IT projects in healthcare were captured in research by Michael Porter and Bob Kaplan in Harvard Business School

If you’d like to learn more about this, do come along to our Executive Breakfast on  on Oct 30, 2015, 7.30 AM to 10.30 AM (AEST).  Download the brochure here.  Our breakfast event in Sydney was a great success, so if you happen to be in Melbourne, please join us if you are available, and feel free to pass on this invitation to your colleagues in healthcare. Click here to REGISTER