Six Stages of Measuring Your Patient Experience

In our mission to serve the lives of millions in healthcare, I am often asked to speak at conferences, share my ideas, interview hospital CEOs as well as connect and collaborate with healthcare experts and Patient Experience (PX) champions.

A key lesson I’ve learnt is the need for healthcare providers to understand how to measure their patients’ experiences, based on their stage of Patient Experience maturity.  Measurement is crucial – you can’t manage what you don’t measure.

We therefore developed our 6E framework, a step-by-step guide to understand and holistically improve patient experience. It touches first on Experience – measuring it and verifying it, through a range of research activities.

If you’re just starting out in PX, mapping the patient journey is your first step. Ensure you talk to clinicians, non-clinicians and patients to map the journey.  Consider using researchers posing as patients (like a mystery shopper) to understand key steps and challenges. Then develop a survey to measure current patient satisfaction for each stage of the patient journey you’ve mapped out.

If you have a patient satisfaction survey, but not getting information you need, review the patient journey (or ‘shadow’ a patient) and determine what factors influence satisfaction at each stage of that journey. You may need to tweak your questions, or consider the timing of the survey.

Dell Children’s Medical Centre found survey responses were neither timely nor representative. They shortened their survey and gathered information real-time (at the completion of patient consultation). Their response rate increased from 30% to 50%, they identified the need for a more child-friendly atmosphere and an information brochure for patients, and rectified a patient/staff safety issue. They formed a PX committee aimed at completing one new improvement project every month. (Beryl Institute)

If you’ve been surveying PX for a while and now require more context, consider holding small discussion groups of 6 to 8 consumers (focus groups) to get further insight into their sentiments, attitudes and perceptions.

If you feel you are getting the insights you need, consider asking the ‘quiet’ consumer (who may have low literacy, or are reluctant to share views in a survey) via small focus groups or one-on-one conversations, which are less intimidating.

If the challenge is linking PX outcomes to business outcomes, are you mapping and measuring the right element of the journey? For instance, a healthcare provider seeking to drive growth of their maternity services, will need to ensure they understand which elements of care during pregnancy, childbirth and follow up, have the strongest impact on new mother’s satisfaction level. (http://healthcare.mckinsey.com/measuring-patient-experience-lessons-other-industries)

If you’re looking to integrate continuous improvement into your PX management, consider use of PX technology providing real-time feedback, granular outcomes and data integration, to collate survey outcomes, for view and use by all staff in your setting. One of the technologies that does that well is called MES Experience.

Wherever you are in your PX development, we would love to hear your story, so drop us a line and you could be featured in our next blog.

A step-by-step guide to improving patient experience for PX champions

Are you interested to hear from patient experience champions on best practice strategies to improve the levels of patient satisfaction?

Improving Patient Experience and Choice held in Sydney on 10 – 11 October 2016, is a premier two-day forum bringing together key stakeholders from Government, Health Districts, Hospitals and Health Care Providers.

My company Energesse is happy to be the Knowledge Partner at this event. In line with this, will be chairing Day 1 of the conference and will also be leading the workshop:

The 6 E Framework

A step-by-step guide to improving patient experience for PX champions

This workshop presents the 6 E Framework, a step by step guide on how to holistically improve patient experience, adaptable for any healthcare setting. This workshop will provide you with tools and techniques that you can use immediately.

improve px

With the UK’s NHS Head of Experience of Care, David McNally, and other C-Suite Executives, Directors and Leaders in Patient Experience speaking at this event. This two-day forum is a timely event for you to develop strategies and share expertise on improving patient experience and choice in Australia.

Here’s a sneak peek at other program highlights

International keynote:

  • David McNally, Head of Experience of Care, NHS England

Patient-centered culture and care

  • Carrie Marr, Chief Executive, Clinical Excellence Commission
  • Robin Whyte, Chief Executive Officer, Eastern Melbourne PHN
  • Rene Pennock, Chief Executive Officer, South Western Sydney PHN

The final early-bird ends this month, 30th September 2016 (Friday).   You may also avail of group discounts, call 02 9368 3915.

Hope you will join me, David McNally, Jean-Frederic and other leading patient experience professionals from Australia in October – for an unrivalled networking opportunity and unprecedented access to Australia’s leading patient experience champions.

If you wish to have a chat before the workshop, I’d be happy to get on a call. Drop me a note at avnesh@energesse.com or call 02 8091 0918.

 

‘E-Framing the Patient Journey’

Based on a True journey.

A friend, on holiday in Christchurch, broke her toe. Luckily, it was her fourth toe. Unluckily, her companions were one high-maintenance 4 year old and two suitcases. It was, bluntly, crap timing. Hobbling about, she headed to a clinic.

After a long wait, the nurse was brisk. Her toe was examined and it was explained to her that she would only get an x-ray if the doctor deemed it necessary. It was also explained that the reason for this is that the treatment would be the same whether or not the toe was fractured.

Waiting room number 2.

The doctor greeted her but faltered at her name. No, she didn’t have one of those long unpronounceable Indian names; it was just misspelled on the system.

The doctor laughed and shook his head, apologizing for his frontline team.  ‘Sorry. Kiwis can’t spell. My wife is a Kiwi, she’s terrible at it.’

‘I know!’ my friend agreed, quipping, ‘Spelling is the only time I feel like I don’t fit in as a Kiwi!’ Laughter and chatter ensued.

He got down to business, examined her toe, and ordered an x-ray. He reiterated what the nurse said about the treatment being the same either way.

Waiting room number 3.

It took 3 tries before the radiographer could locate the injury, and identified as being on the distal end (top part) of the fourth toe.

Waiting room number 4.

Fracture confirmed, the doctor asked about her activities over the next few days, whether she wanted her toe braced or strapped up for more comfort, and offered her crutches. Instructed to raise her feet while sitting and take painkillers when necessary, she thanked the doctor and left the clinic.

Let’s look at this patient journey through the lens of our 6E Framework:

This was a simple journey, yet one that could be measured.

There were parts of the Experience that were long and potentially frustrating (waiting times) and parts that had alignment and clarity e.g. the initial nurse assessment, the first consultation and differential diagnosis by the doctor, the confirmatory radiological investigation and then the final diagnosis and management plan by the doctor.

There would have been Emotions associated with waiting times and administrative mistakes (data entry errors), but there was humour and there was reassurance. The doctor displayed Energy in his engagement – he conveyed empathy with the patient, and communicated the treatment plan well, he knew his purpose and seemed personally satisfied with his work.

There was sufficient time spent in Execution (radiographer’s persistence with protocol and multi-disciplinary assessment (alignment of nurse’s communication with the doctor’s treatment).

My friend walked away from the clinic, satisfied. She felt like an individual. She connected, in a human way, with the doctor. She could see the team (nurse, doctor, radiographer) all working toward her diagnosis. As a result of their excellence, she wasn’t very frustrated with the four (!) waiting times, her misspelled name nor the pain she came in with.

In this case, as in many others, Excellence was defined by the patient, not simply by the providers.

In fact, I don’t think she cared to remember any lack in the clinic’s systems.

To her, the patient experience trumped the patient process. Herein lies the potential for Evolution in the patient journey.

To find out more about the 6 E framework for improving the Patient Experience, feel free to drop me a line.

 

It’s Not What You Think About Them. It’s How They Feel About You.

Walk into a healthcare boardroom and you’ll find C-suite managers poring over hard data reports, analytics that tell them that, mostly, all patients are happy with them, all KPIs have been achieved. Shimmy up to the nurse manager on duty, and you’ll find out that she’s weary but yay, three patients have been discharged (including the one with the demanding hubby), so it’s all good. Take the lift down to reception, and they’ll tell you different tales of woe and wonder. Why don’t these stories always align? After all, there is a myriad of measurement taking place – statistical data, patient surveys, focus groups, patient emails, improved processes and tools….

Creating a true, holistic picture of the patient experience is challenging. The disparate pieces of research that take place in a healthcare setting don’t always fit together or come together. Staff are listening to differing views, reading contradictory reports and acting on different outcomes and priorities. Indeed, in a 2015 patient experience survey of 1561 respondents from healthcare settings in over 21 countries, less than half had actually formally defined patient experience for their organisation (Beryl Institute).

Our 6E Framework aims to improve patient experience by offering healthcare settings a step-by-step guide on how to produce this true holistic picture. It not only gets you thinking about mapping the patient journey and uniting the disparate pieces of data that is collected throughout your setting on this ‘journey’ (EXPERIENCE), but it ensures the encapsulation of ‘patient stories’ and patient feelings (EMOTIONS) to build one clear purpose for all staff to follow (ENERGY) in improving the patient journey. It helps you develop an accurate strategic plan and implement solutions (EXECUTION) and ensures you measure and repeat your successes (EXCELLENCE). Ultimately, the framework develops your organisational capability in patient experience (EVOLUTION).

The Hertfordshire Partnership University NHS Foundation Trust and Leeds Community Healthcare NHS Trust are examples of healthcare organisations that benefited from sound advice with improving their patient experience:

  • Response rates quadrupled, covering more age, gender and ethnicity groups.
  • Solid mapping and measurement of patient journey elements allowed for immediate implementable strategies – many as simple as the need to disseminate more information or provide further explanation to patients – to address concerns and issues.
  • When the patient experience measurement was repeated within the same year, the level of patient satisfaction had significantly increased – doubled and tripled in some cases!
  • In the Hertfordshire case, in some wards, 100% respondents felt listened to (up from 54%).

Patient Journeys. Emotions. A Team Living Its Purpose.

For some, these are soft, soppy, intangible metrics to measure. But for those in the industry of caring, there’s no denying its culture-changing results at the front-line.

The Process Manager, Efficiency Manager or the PX Champion – Which Type Are You?

A lady walks into a hospital. She winces, rubbing her arm then kneading it gently. She approaches reception. She sighs and scribbles what she needs to on a form and is then motioned into the waiting room. She scurries up when she hears her name and disappears into a consultation room. Two days later, she walks out to a waiting car outside the hospital. She’s not rubbing her arm anymore.

If you ask a hospital manager what they think about the above scenario, and their focus is process rather than patient experience, they would probably measure success as a patient’s condition resolved, her details recorded on the right forms and the availability of a hospital bed (length of stay) as a result of that problem resolution.

Turn now to the healthcare center whose focus is patient management and efficiency; they would ensure that the effectiveness of every step of the healthcare process – from the patient arriving at reception to patient discharge – is measured and efficient from a time and activity perspective.

Now question the healthcare center whose focus is the patient journey. They would do all of the above, and more. They’ll wager their time to understand and measure the ‘winces’, the ‘sighs’, the ‘scurry’, the manner in which the patient ‘walks out to the waiting car outside of the hospital.’ They ensure the right questions are asked of the right people at the right time. They would also very likely follow-up with her after discharge to ensure her safety and service satisfaction. For these healthcare centers – the Patient Experience (PX) champions – the patient is at the very center of the care they receive.

The focus would be:

  1. Did the patient require help filling out the form (was there a physical pain or language barrier) VS. did the patient fill in the form we need them to fill in?
  2. Did the patient understand what the doctor was saying VS. did the doctor explain everything to the patient?
  3. Did the patient experience compassion and empathy during treatment VS. were staff able to treat the patient in a professional and timely manner?
  4. Were the family members reassured about the patient’s situation VS. were the family members informed about the patient’s situation?
  5. Is the patient able to perform well at work and at home in the days and weeks after discharge VS. was the patient followed-up with the day after discharge?

Taking a holistic view, the PX champions would also ask staff, if they were making a difference, if they felt resourced, supported, celebrated and if they felt like they had meaning in their work i.e. ‘living their purpose’ ?

Understanding the various elements that comprise the patient’s journey and then measuring each element of that journey, is what separates the wheat from the chaff, the top performing healthcare centers from the average ones.

Many are now riding the wave of PX trends. A 2013 survey of management committees in more than 1000 hospitals conducted by Catalyst Healthcare Research and the Beryl Institute, found that 70% of respondents ranked ‘patient experience and satisfaction’ as one of their top three priorities over the next few years – it exceeded cost management, capital improvements, HR and healthcare processes. The survey also found that more and more healthcare centers were delegating this very important area to dedicated experience leaders.

What kind of healthcare leader would be more meaningful to you?

Election Policies Need to Put Patients First

The Australian Federal Elections are drawing near. The Conservatives and the Labour Party are once again pitching their wares – fighting it out on who has the best health policy. Amongst the spouted sales spiel and all its nation-centric statistical data, the patient’s (what the policies are/should be ultimately all about) voice is lost.

A recently released book on ‘Patient-Provider Communication’ (Blackstone, Beukelman and Yorkston, April 2015), noted ‘that patients, health care providers, policy makers, and researchers live in nearly parallel universes with differing incentives, access to data and information, accountability expectations, and time frames for action’. What this alludes to is the potential for differing visions in patient healthcare, experiences and communications – resulting in a potentially disparate state of affairs.

What if patient experiences were given a larger focus in the formation of national health policies? How much more refined would policies be? Undoubtedly, communication between patients and their clinicians/hospital management will have more prominence in local and national policies. And from high-level policy to on-the-ground realities, issues like how to better communicate with the patient over things like a treatment or healthcare plan would get the attention it so rightfully deserves.

In my recent trip to the Beryl Institute Conference in Dallas, I had the good fortune of meeting with Dr. Tom Scaletta and Julie Danker – who lead patient experience initiatives at the Edward-Elmhurst Hospital – and found out how they manage patient communications. Regarded as one of the leaders in this space with their G.R.E.A.T. coaching techniques, they imparted practical insight into communication and engagement techniques that can help patients and clinicians.

Here are some key takeaways from them:

  • Contact patients the day after ED discharge – it keeps them safe and satisfied
  • Engage patients digitally – it reduces cost and increases reach
  • Automate work processes – it allows charge nurses and case managers to efficiently intervene at the right points in the workflow process
  • Build in an automated response mechanism/module into your systems – it allows for the acknowledgement of compliments and resolution of complaints by ED leaders
  • Measure, measure, measure – use statistically-valid metrics and patient comments to drive provider performance. We can always keep improving.

If you want to know more, watch the video below from our Patient Experience Channel (or check out www.eehealth.org/great)

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!

 

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!

au-healthcare-week

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…