‘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.

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.