SH
Uploaded bySteve Harris
250 views

Improving Patient Experince

The document discusses seven drivers that enable hospitals to successfully improve and sustain higher levels of patient experience over time. These drivers are: 1) measurement of patient experience through timely and relevant data, 2) engagement of patients and families to understand their needs and partner on improvements, 3) engagement of organizational staff to create a culture of patient focus, 4) initial interventions targeted based on measurement data, 5) effective leadership to prioritize and drive the efforts, 6) process improvements throughout the organization, and 7) sustainability of efforts over time rather than temporary initiatives. The absence of any one of these seven drivers reduces the likelihood of success in improving and maintaining higher patient experience.

Download to read offline
Opportunities to Improve the Patient Experience Steven Harris David Brown Energize Learning & Development Oak House 15 Hodford Road London NW11 8NL +44 (0)208 731 9464 15 September 2009 +44(0)7946 398 831 Process Improvement Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Improved Patient Experience Measurement Initial Intervention Process Improvement Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Improved Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Improved Patient Experience Measurement Initial Intervention
Improving Patient Experience 2 of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Opportunities to improve the Patient Experience Introduction The opportunities to improve the patient experience in many hospitals are considerable. Nevertheless, despite the best intentions across the organisation, many do not see a return on their investment: patient experience scores remain low or, after a brief improvement, fall back. This paper, based on interviews with leaders in the NHS Hospitals, identifies seven drivers of hospitals successful in achieving sustained improvements in patient experience. Key Findings - The Seven Drivers 1. Measurement 2. Patient & Family Engagement 3. Organisational Engagement 4. Initial Intervention 5. Effective Leadership 6. Process Improvement 7. Sustainability Objectives of the Research There is considerable focus on improving Patient Experience as one the three components of quality (the others being safety and effectiveness). Nevertheless in our discussions with clients and in comments from across the health sector we see that delivering a sustained improvement to the patient experience remains elusive. Many organisations remain with stubbornly low patient satisfaction scores. Others make progress following periods of intense focus only to see many of the gains evaporate over the following 18 months. Our goals were to: • Understand why making progress was so difficult and how could institutions deliver lasting results. • Seek out best practices from highly performing or improving Trusts • Develop a road map around how to achieve and sustain improvements in patient experience. To answer these questions we conducted detailed interviews with over 35 hospitals, mainly with Directors of Nursing or in a few cases either the Chief Medical Officer or the Associate Director responsible for Patient Experience. We also compared our findings with the 2007 and 2008 National Inpatient Survey (NPS) Results.
Improving Patient Experience 3 of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Detailed Findings Improving the patient experience remains one of the top issues for all hospitals. Despite its importance, many hospitals are challenged to make and sustain improvements Respondents referred to four areas that made improving the patient experience difficult: 1. Although improving the Patient Experience is a national and local priority it quickly falls by the wayside as other mandatory targets take precedence. For many, the only necessary target is staying out of the “bottom 20%” and even then, the implications of being in this group are negligible compared to, for example, missing the 4 Hour Wait Target. 2. Most hospitals had a limited insight based on poor data. For all its strengths, the NPS has many weaknesses: timeliness, comprehensiveness, specificity. And many internal metrics, if they exist, are not robust enough to enable agreement and action. 3. Even where good data does exist, many organisations struggled to turn insight into action. Too often initiatives were tactical, local and short lived. 4. Most hospital leaders understood that improved patient experience is largely driven by attitude, leadership, culture and by winning the hearts and minds of staff. These are hard things to influence and take time, resources and management commitment. There are seven key drivers that enable hospitals to make and sustain significant improvements in the patient experience. The absence of any one characteristic reduces success. 1. Measurement Without a good measurement strategy there is little hope for success. There is a danger of driving towards the wrong goals in the wrong places with the wrong people. And then there is the problem of not knowing whether you are - or are not - making progress. We also heard organisations struggle in deciding the medium, frequency, coverage, stage in the pathway, length, localisation, language and level of localisations and personalisation. Even with good data many organisations are swamped by the complexity and the resulting “noise”. Based on our research, the 4 key characteristics that lead to success are that: 1. Organisations need to establish a good baseline before any intervention. This will enable the hospital to both celebrate and reinforce successes and highlight which areas need particular attention. 2. Data needs to be timely, believed and relevant and actionable. A strong fact base is a critical requirement in order to engage and sustain momentum. 3. Important decisions should not be based on a single data source. Reporting needs to integrate multiple inputs. The best Trusts integrate Safety and Effectiveness as well as Patient Experience reporting. 4. Collecting and even publishing data does not materially improve patient experience. It may tick a compliance box. But without a clear view how the data will turn into insight and then action, it is difficult to make progress.
Improving Patient Experience 4 of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience 2. Patient and Family engagement If we want to improve the patient experience at a local level we need to know what patients want. This is usually not clear from surveys. The best performing hospitals get insight from the experts - the patients - to really understand their needs and then continue to work with patients and families to improve pathways that will improve their experience, as well as drive efficiencies. The key mechanisms here are patient, staff and stakeholder workshops and focus groups to tease out the underlying issues and to generate buy in. The second benefit of patient and family engagement is that it is much easier to gain staff commitment to change when they hear from patients themselves. South Devon for example starts each Board meeting with a patient story. Another Trust only finally dealt with the parking issues when the Board heard from a widower how awful it was when he could not be with his wife when she was given very bad news about her prognosis: he was trying to park. Patients bring the issues to life. 3. Engage the entire organisation Patients and families have a huge number of points of contact in the hospital: admissions, reception, portering, catering, house keeping, maintenance as well as medical and nursing. Any one of those contacts has the potential to significantly impact a patient’s experience. Therefore improving the patients’ experience is everyone’s responsibility. There is a second and equally important reason to involve the entire organisation. In our research we asked: “Does how colleagues interact with each other impact the patient experience?” Every Trust was clear that how we treat each other is critical. As one Trust observed: “patients are great observers of how well we work together. When staff look glum or treat each other badly patients worry for their own care: “If staff can’t look after each other or themselves, how can they possibly look after me?” In improving the patient experience we need to pay as much attention to how we treat our colleagues as each other. Given the complexity of hospitals, treating colleagues well needs to include the interactions between specialities, work groups and levels. Too many hospitals are still too siloed and “when communications are poor it is the patient who suffers” observed one hospital. This is not just a frontline issue. Without high quality support functions delivering excellent service to each other and front line staff, failures will be visible either directly or indirectly through staff morale. “When front line staff are getting drawn into administrative fire fighting, it is very hard to find the energy to treat patients well,” commented one large Foundation Trust. As organisations explore what a great patient experience looks like there needs to be a shared view on “The way we do things around here.” Defining the “way we want to do things around here” needs to involve staff at every stage of the campaign. 4. Initial Intervention Staff know how they want to be treated as a patient and how they would like patients to be treated on their ward, clinic or hospital. This is confirmed by the Ipsos Mori research around the most important drivers of patient experience (communications / involvement in decisions; privacy and dignity, and cleanliness). Almost all of the key elements of a great patient experience are within the capabilities of the staff. Therefore the key question is around consistency: why don’t staff deliver a great service all the time?
Improving Patient Experience 5 of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience We have found that it is about choice supported by leadership. Our research indicated that those hospitals that focussed on a skills-based approach to patient experience tended to have a much shorter boost to patient experience. Conversely those that had an attitude or behavioural approach to change tended to get better, lasting results. These teams worked hard to stay upbeat, positive and motivated and understood that the importance of choice. Getting staff to believe that they can choose their attitude has a major impact. Therefore the ideal initial intervention creates awareness, explores the choices we make, changes attitudes and gains commitment to action. The intervention needs to be fun, short, relevant, practical and rolled out at speed. It needs to help staff reconnect with what they know to be good. It also needs to be “crunchy” with clear out comes for the individual and the organisation. Great Ormond Street Hospital has been running a compelling campaign with all these elements: the initial workshops for all their managers outlined the vision and enrolled their support to coach their teams in the required behaviours. All Staff were then taken through the programme and committed to three “Promises on the Premises” which became part of their personal and team objectives. 5. Leadership When we asked interviewees the top two determinants of a great ward or department, All of respondents cited the importance of leadership. Leadership means different things to different people, but in this context several themes emerged: • The ability to turn intent into action • The ability to encourage consistent adoption across the organisation • The ability to recognise that leadership lies at every point where there are line management responsibilities. Within this context they focussed their own activities on five areas: 1. They role model the ideal behaviours, sending out a clear signal of what is acceptable and indeed ideal behaviour. 2. They coach. These are not formal performance review type conversations: they are 5 minute interventions close to the front line, at the time situations occur and on a regular basis. Coaching conversations have a dramatic impact on helping staff feel confident, feel valued, keep the subject fresh and demonstrate its importance. Some people are natural coaches, others need help. 3. They treat their staff well; they engage, inspire and work as a team so that people feel valued and want to go the extra mile. They also seek to eliminate bullying behaviours and management by fear. 4. They allocate sufficient time and resources. And the biggest investment is around time. A simple example of this is making patient experience an ongoing and significant Board item. 5. They create a culture of accountability. 6. Process Improvement There will be actions around specific areas to improve the patient experience. Some will be simpler (more curtains,milk jugs at breakfast, better signage and protected meal times), others will be more complex and involve pathway redesign. In some ways these are the easier elements of improving the patient experience as they are far more tangible and measurable through traditional project management methods.
Improving Patient Experience 6 of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience 7. Sustainability And so to the last driver and perhaps the hardest: sustainability. Our research indicated this has a number of characteristics: The first is innovation across the enablers. For example, amongst the many things Walsall Hospitals did was to implement a discharge questionnaire. After launching the programme, they took actions and the scores rose then plateaued, they then realised they needed a much higher response rate. This then became a key measure. Again more insight, actions, rising scores and another plateau. Then rather than just look at average score they looked at % patients delighted, scoring 5/5. Again more insight, actions and rising scores. They have recently implemented a two week post discharge call to 80% of patients with some superb new insights and actions. They are now are looking to publish the results at ward level. This example is not to show that Walsall has the definitive strategy; but to show that over three years they continually innovated and kept the initiative fresh. The second key to sustainability is to include patient experience into as many supporting processes as possible. Examples include recruitment, induction, training and performance management. The third area is to be aware and take advantages of changes: new buildings, new services, new managers, mergers and expansion are all opportunities or threats to the patient experience. The return on investment from improving the patient experience is considerable and usually underestimated. An emerging area is development of the business case. Most hospitals said “we do this because it is the right thing to do.” In addition, some hospitals, particularly those who have cracked quality reporting, see reductions in incidents, improved patient outcomes, reduced complaints, increased referrals and lower staff turnover and absenteeism. Examples include a 50% reduction in falls, 40+% reductions in prescription errors, and a 60 place improvements in National Inpatient Survey Scores. These improvements have value to patients, staff and the Trust. As budgets come under pressure in the next few years, these investments of time and money should be easy to protect. They are relatively low cost and have an amazing return - both on the things you can count and the things you can’t. Conclusions 1. Improving the patient experience remains one of the top issues for all hospitals. 2. Despite its importance many hospitals are challenged to make and sustain improvements. 3. There are seven key characteristics that enable hospitals to make and sustain significant improvements in the patient experience. The absence of any one characteristic tends to reduce or undermine success. 4. The return on investment from improving the patient experience is considerable and usually underestimated. When organisations deliver a great patient experience it is because they deliver on each of the key enablers. Delivering a good or excellent patient experience is within reach for every organisation. ----------------------II----------------------
Improving Patient Experience 7 of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience About Energize Energize are an award winning change and coaching company, who work across both the public and private sectors, specialising in improving patient and customer satisfaction. In the healthcare sector they have successfully worked with Trusts and PCT’S to define the vision and outcomes needed to improve the patient experience then supported them in making those changes. About the authors Steven Harris Founder and Managing Partner of Energize Learning & Development Steven set up Energize in 2000 after developing a methodology for implementing a sustainable culture change at The Body Shop. Whilst the heritage of Energize lies in retail with clients such as Marks & Spencer, Selfridges & Liberty increasingly they have worked in the Healthcare sector with Chelsea & Westminster, Great Ormond Street and Enfield PCT. Whilst working in the healthcare sector Steven has designed and led “Improving patient experience” campaigns showing sustainable and quantifiable improvements. Prior to setting up Energize, he spent twenty years working in retail operations, buying and merchandising and franchising holding a variety of board positions with leading European and International retailers. Contact on +44 (0)7946 398 831 David Brown Partner, Energize Learning & Development David specialises in helping organisations change to be more successful. His particular focus areas are Strategy, Customer Experience, Business Development and Change Management. He has worked closely with Great Ormond Street Hospital to improve the experience for patients and families and co-leads Energize’s Healthcare practice. David has worked at senior levels with clients including Thomas Cook, MyTravel, Sodexo, GKN and The World Travel & Tourism Council. Prior to working with Energize, David was a Partner at Accenture and led the UK Strategy & Customer and Travel Services Practices. David is also founding Partner of Achieving Goals, a firm specialising in Strategy, Change Management and Business Development outside the Healthcare sector. For further information contact Energize Learning and Development on 0208 731 9464 or at info@energizelearning.com

More Related Content

PPTX
CNO Summit 2015 - Creating value though ‘Always Events’®: what matters to you...
byNHS England
 
PDF
Building Referring Physician Loyalty: OSUMC Gelb-PAN
byEndeavor Management
 
PDF
Step-by-step Physician Marketing
byEndeavor Management
 
PDF
how to market a doctors office 2015 guide
byBryan Cush
 
PPTX
Build referring physician loyalty with experience
byEndeavor Management
 
PPTX
Session 15--Assessing Readiness for Change
byDr. DawnElise Snipes ★AllCEUs★ Unlimited Counselor Training
 
PDF
Creating Enchantment with Referring Physicians - Cleveland Clinic - Gelb
byEndeavor Management
 
PPTX
Impact practice in the third sector for public health practitioners
byCatherine A. Greaves
 
CNO Summit 2015 - Creating value though ‘Always Events’®: what matters to you...
byNHS England
 
Building Referring Physician Loyalty: OSUMC Gelb-PAN
byEndeavor Management
 
Step-by-step Physician Marketing
byEndeavor Management
 
how to market a doctors office 2015 guide
byBryan Cush
 
Build referring physician loyalty with experience
byEndeavor Management
 
Session 15--Assessing Readiness for Change
byDr. DawnElise Snipes ★AllCEUs★ Unlimited Counselor Training
 
Creating Enchantment with Referring Physicians - Cleveland Clinic - Gelb
byEndeavor Management
 
Impact practice in the third sector for public health practitioners
byCatherine A. Greaves
 

What's hot

PPTX
Trust workshop presentations combined
byChris Jacob
 
PDF
Experience Management for Referring Physicians - WHPRMS Conference
byEndeavor Management
 
PDF
10 Must Know Techniques for Managing Physician Relations in Today's Digital W...
byEndeavor Management
 
DOCX
Rozelyn D Fields-Jackson R1LI-cleaned
byRozelyn Fields-Jackson
 
PPTX
CYP IAPT: Children & Young People's Improving Access to Psychological Therapies
byCharlotteCYPIAPT
 
PDF
2017 Physician Strategies: Physician Enagement - Gelb
byEndeavor Management
 
PPTX
Marketing to Referring Physicians - AAMC Presentation 2012
byJennings Healthcare Marketing (Dan Dunlop)
 
PDF
Physician Engagement 2014
byGail Games
 
PPT
Behavioral Health Outcomes
bystclairer
 
PPTX
Releasing Individual Potential through Employee Wellbeing
byOPRA Psychology Group
 
PDF
ROI of wellness programs - Optimity webinar series Dec 2016
byJane Wang
 
PDF
Nc live 8 3-10 presentation
byThe National Council
 
PPTX
Accelerating primary care transformation. Commissioning Live, Birmingham 2015
byRobert Varnam Coaching
 
PPT
Measuring Physician Relations ROI; Tools & Techniques
byRenown Health
 
PPT
Health Care Homes: Creating Effective Practice Teams
byMelissa DeBilzan
 
PDF
PCOMSintheLongHaul
byBarry Duncan
 
PDF
PCOMSandCancNoShows
byBarry Duncan
 
PDF
2017 Physician Strategies Webinar Series - Physician Relations Structure
byEndeavor Management
 
PDF
NCA - TBC - Session 1 Slides
byCHC Connecticut
 
PPT
The art of the possible will
byhowardcooper
 
Trust workshop presentations combined
byChris Jacob
 
Experience Management for Referring Physicians - WHPRMS Conference
byEndeavor Management
 
10 Must Know Techniques for Managing Physician Relations in Today's Digital W...
byEndeavor Management
 
Rozelyn D Fields-Jackson R1LI-cleaned
byRozelyn Fields-Jackson
 
CYP IAPT: Children & Young People's Improving Access to Psychological Therapies
byCharlotteCYPIAPT
 
2017 Physician Strategies: Physician Enagement - Gelb
byEndeavor Management
 
Marketing to Referring Physicians - AAMC Presentation 2012
byJennings Healthcare Marketing (Dan Dunlop)
 
Physician Engagement 2014
byGail Games
 
Behavioral Health Outcomes
bystclairer
 
Releasing Individual Potential through Employee Wellbeing
byOPRA Psychology Group
 
ROI of wellness programs - Optimity webinar series Dec 2016
byJane Wang
 
Nc live 8 3-10 presentation
byThe National Council
 
Accelerating primary care transformation. Commissioning Live, Birmingham 2015
byRobert Varnam Coaching
 
Measuring Physician Relations ROI; Tools & Techniques
byRenown Health
 
Health Care Homes: Creating Effective Practice Teams
byMelissa DeBilzan
 
PCOMSintheLongHaul
byBarry Duncan
 
PCOMSandCancNoShows
byBarry Duncan
 
2017 Physician Strategies Webinar Series - Physician Relations Structure
byEndeavor Management
 
NCA - TBC - Session 1 Slides
byCHC Connecticut
 
The art of the possible will
byhowardcooper
 

Viewers also liked

PPTX
Director General of WA Health - Launch Address
byPip Brennan | Author, Non Profits
 
PPTX
St John Ambulance Presentation - James Sherriff
byPip Brennan | Author, Non Profits
 
PDF
Health IT Summit Austin 2013 - Case Study "Implementing Interactive Patient C...
byHealth IT Conference – iHT2
 
PPTX
The Top Five Recommendations for Improving the Patient Experience
byHealth Catalyst
 
PPTX
Improving the Outcomes That Matter Most to Patients
byHealth Catalyst
 
PPTX
IT in Healthcare
byNetApp
 
Director General of WA Health - Launch Address
byPip Brennan | Author, Non Profits
 
St John Ambulance Presentation - James Sherriff
byPip Brennan | Author, Non Profits
 
Health IT Summit Austin 2013 - Case Study "Implementing Interactive Patient C...
byHealth IT Conference – iHT2
 
The Top Five Recommendations for Improving the Patient Experience
byHealth Catalyst
 
Improving the Outcomes That Matter Most to Patients
byHealth Catalyst
 
IT in Healthcare
byNetApp
 

Similar to Improving Patient Experince

PDF
Safe and Secure Hospitals
byDr Avnesh Ratnanesan (Avi)
 
PPTX
Patient Experience Roundtable Sydney 2018 Leading Change & Transformation in ...
byDr Avnesh Ratnanesan (Avi)
 
PPTX
Understanding the patient experience beyond the survey
byBaird Group
 
PDF
Avnesh Ratnanesan
byInforma Australia
 
PDF
PEN Awards Webinar series 5 of 6
byNHS Improving Quality
 
PDF
methodology 2
bySasha Cahill
 
PPTX
Patient’s experience, improve the quality health3
byzsaddique
 
PDF
Ways to improve patient satisfaction survey scores
byCare Analytics
 
PPTX
6E framework workshop Patient Experience & Choice Conference 2016
byDr Avnesh Ratnanesan (Avi)
 
PDF
Acting on Real-Time Patient Reports to Improve Safety: Alberta Health Services
byCanadian Patient Safety Institute
 
PDF
PEN Awards Webinar Series 3 of 6
byNHS Improvement
 
PDF
Overview of Patient Experience Definitions and Measurement Tools
byInnovations2Solutions
 
PDF
Empathy and Lean - Quality and Metrics
byEndeavor Management
 
PDF
Patient Experience - A Complete Guide.pdf
byJohn David
 
PDF
State of Patient Experience 2015 Infographic
byEngagingPatients
 
PPTX
Communicating Effectively: Strategies to Ensure the Quality of Communication...
byTraceByTWSG
 
PDF
From data to action
byEndeavor Management
 
PDF
PEN Awards Webinar series 4 of 6
byNHS Improving Quality
 
PPTX
Improving patients' experiences
byminu2
 
PPTX
PEN Awards Webinar – 29 Sept 2015
byNHS Improving Quality
 
Safe and Secure Hospitals
byDr Avnesh Ratnanesan (Avi)
 
Patient Experience Roundtable Sydney 2018 Leading Change & Transformation in ...
byDr Avnesh Ratnanesan (Avi)
 
Understanding the patient experience beyond the survey
byBaird Group
 
Avnesh Ratnanesan
byInforma Australia
 
PEN Awards Webinar series 5 of 6
byNHS Improving Quality
 
methodology 2
bySasha Cahill
 
Patient’s experience, improve the quality health3
byzsaddique
 
Ways to improve patient satisfaction survey scores
byCare Analytics
 
6E framework workshop Patient Experience & Choice Conference 2016
byDr Avnesh Ratnanesan (Avi)
 
Acting on Real-Time Patient Reports to Improve Safety: Alberta Health Services
byCanadian Patient Safety Institute
 
PEN Awards Webinar Series 3 of 6
byNHS Improvement
 
Overview of Patient Experience Definitions and Measurement Tools
byInnovations2Solutions
 
Empathy and Lean - Quality and Metrics
byEndeavor Management
 
Patient Experience - A Complete Guide.pdf
byJohn David
 
State of Patient Experience 2015 Infographic
byEngagingPatients
 
Communicating Effectively: Strategies to Ensure the Quality of Communication...
byTraceByTWSG
 
From data to action
byEndeavor Management
 
PEN Awards Webinar series 4 of 6
byNHS Improving Quality
 
Improving patients' experiences
byminu2
 
PEN Awards Webinar – 29 Sept 2015
byNHS Improving Quality
 

Improving Patient Experince

  • 1.
    Opportunities to Improvethe Patient Experience Steven Harris David Brown Energize Learning & Development Oak House 15 Hodford Road London NW11 8NL +44 (0)208 731 9464 15 September 2009 +44(0)7946 398 831 Process Improvement Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Improved Patient Experience Measurement Initial Intervention Process Improvement Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Improved Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Sustainability Organisational Engagement Leadership Patient & Family Engagement Patient Experience Measurement Initial Intervention Improved Patient Experience Measurement Initial Intervention
  • 2.
    Improving Patient Experience 2of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Opportunities to improve the Patient Experience Introduction The opportunities to improve the patient experience in many hospitals are considerable. Nevertheless, despite the best intentions across the organisation, many do not see a return on their investment: patient experience scores remain low or, after a brief improvement, fall back. This paper, based on interviews with leaders in the NHS Hospitals, identifies seven drivers of hospitals successful in achieving sustained improvements in patient experience. Key Findings - The Seven Drivers 1. Measurement 2. Patient & Family Engagement 3. Organisational Engagement 4. Initial Intervention 5. Effective Leadership 6. Process Improvement 7. Sustainability Objectives of the Research There is considerable focus on improving Patient Experience as one the three components of quality (the others being safety and effectiveness). Nevertheless in our discussions with clients and in comments from across the health sector we see that delivering a sustained improvement to the patient experience remains elusive. Many organisations remain with stubbornly low patient satisfaction scores. Others make progress following periods of intense focus only to see many of the gains evaporate over the following 18 months. Our goals were to: • Understand why making progress was so difficult and how could institutions deliver lasting results. • Seek out best practices from highly performing or improving Trusts • Develop a road map around how to achieve and sustain improvements in patient experience. To answer these questions we conducted detailed interviews with over 35 hospitals, mainly with Directors of Nursing or in a few cases either the Chief Medical Officer or the Associate Director responsible for Patient Experience. We also compared our findings with the 2007 and 2008 National Inpatient Survey (NPS) Results.
  • 3.
    Improving Patient Experience 3of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Detailed Findings Improving the patient experience remains one of the top issues for all hospitals. Despite its importance, many hospitals are challenged to make and sustain improvements Respondents referred to four areas that made improving the patient experience difficult: 1. Although improving the Patient Experience is a national and local priority it quickly falls by the wayside as other mandatory targets take precedence. For many, the only necessary target is staying out of the “bottom 20%” and even then, the implications of being in this group are negligible compared to, for example, missing the 4 Hour Wait Target. 2. Most hospitals had a limited insight based on poor data. For all its strengths, the NPS has many weaknesses: timeliness, comprehensiveness, specificity. And many internal metrics, if they exist, are not robust enough to enable agreement and action. 3. Even where good data does exist, many organisations struggled to turn insight into action. Too often initiatives were tactical, local and short lived. 4. Most hospital leaders understood that improved patient experience is largely driven by attitude, leadership, culture and by winning the hearts and minds of staff. These are hard things to influence and take time, resources and management commitment. There are seven key drivers that enable hospitals to make and sustain significant improvements in the patient experience. The absence of any one characteristic reduces success. 1. Measurement Without a good measurement strategy there is little hope for success. There is a danger of driving towards the wrong goals in the wrong places with the wrong people. And then there is the problem of not knowing whether you are - or are not - making progress. We also heard organisations struggle in deciding the medium, frequency, coverage, stage in the pathway, length, localisation, language and level of localisations and personalisation. Even with good data many organisations are swamped by the complexity and the resulting “noise”. Based on our research, the 4 key characteristics that lead to success are that: 1. Organisations need to establish a good baseline before any intervention. This will enable the hospital to both celebrate and reinforce successes and highlight which areas need particular attention. 2. Data needs to be timely, believed and relevant and actionable. A strong fact base is a critical requirement in order to engage and sustain momentum. 3. Important decisions should not be based on a single data source. Reporting needs to integrate multiple inputs. The best Trusts integrate Safety and Effectiveness as well as Patient Experience reporting. 4. Collecting and even publishing data does not materially improve patient experience. It may tick a compliance box. But without a clear view how the data will turn into insight and then action, it is difficult to make progress.
  • 4.
    Improving Patient Experience 4of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience 2. Patient and Family engagement If we want to improve the patient experience at a local level we need to know what patients want. This is usually not clear from surveys. The best performing hospitals get insight from the experts - the patients - to really understand their needs and then continue to work with patients and families to improve pathways that will improve their experience, as well as drive efficiencies. The key mechanisms here are patient, staff and stakeholder workshops and focus groups to tease out the underlying issues and to generate buy in. The second benefit of patient and family engagement is that it is much easier to gain staff commitment to change when they hear from patients themselves. South Devon for example starts each Board meeting with a patient story. Another Trust only finally dealt with the parking issues when the Board heard from a widower how awful it was when he could not be with his wife when she was given very bad news about her prognosis: he was trying to park. Patients bring the issues to life. 3. Engage the entire organisation Patients and families have a huge number of points of contact in the hospital: admissions, reception, portering, catering, house keeping, maintenance as well as medical and nursing. Any one of those contacts has the potential to significantly impact a patient’s experience. Therefore improving the patients’ experience is everyone’s responsibility. There is a second and equally important reason to involve the entire organisation. In our research we asked: “Does how colleagues interact with each other impact the patient experience?” Every Trust was clear that how we treat each other is critical. As one Trust observed: “patients are great observers of how well we work together. When staff look glum or treat each other badly patients worry for their own care: “If staff can’t look after each other or themselves, how can they possibly look after me?” In improving the patient experience we need to pay as much attention to how we treat our colleagues as each other. Given the complexity of hospitals, treating colleagues well needs to include the interactions between specialities, work groups and levels. Too many hospitals are still too siloed and “when communications are poor it is the patient who suffers” observed one hospital. This is not just a frontline issue. Without high quality support functions delivering excellent service to each other and front line staff, failures will be visible either directly or indirectly through staff morale. “When front line staff are getting drawn into administrative fire fighting, it is very hard to find the energy to treat patients well,” commented one large Foundation Trust. As organisations explore what a great patient experience looks like there needs to be a shared view on “The way we do things around here.” Defining the “way we want to do things around here” needs to involve staff at every stage of the campaign. 4. Initial Intervention Staff know how they want to be treated as a patient and how they would like patients to be treated on their ward, clinic or hospital. This is confirmed by the Ipsos Mori research around the most important drivers of patient experience (communications / involvement in decisions; privacy and dignity, and cleanliness). Almost all of the key elements of a great patient experience are within the capabilities of the staff. Therefore the key question is around consistency: why don’t staff deliver a great service all the time?
  • 5.
    Improving Patient Experience 5of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience We have found that it is about choice supported by leadership. Our research indicated that those hospitals that focussed on a skills-based approach to patient experience tended to have a much shorter boost to patient experience. Conversely those that had an attitude or behavioural approach to change tended to get better, lasting results. These teams worked hard to stay upbeat, positive and motivated and understood that the importance of choice. Getting staff to believe that they can choose their attitude has a major impact. Therefore the ideal initial intervention creates awareness, explores the choices we make, changes attitudes and gains commitment to action. The intervention needs to be fun, short, relevant, practical and rolled out at speed. It needs to help staff reconnect with what they know to be good. It also needs to be “crunchy” with clear out comes for the individual and the organisation. Great Ormond Street Hospital has been running a compelling campaign with all these elements: the initial workshops for all their managers outlined the vision and enrolled their support to coach their teams in the required behaviours. All Staff were then taken through the programme and committed to three “Promises on the Premises” which became part of their personal and team objectives. 5. Leadership When we asked interviewees the top two determinants of a great ward or department, All of respondents cited the importance of leadership. Leadership means different things to different people, but in this context several themes emerged: • The ability to turn intent into action • The ability to encourage consistent adoption across the organisation • The ability to recognise that leadership lies at every point where there are line management responsibilities. Within this context they focussed their own activities on five areas: 1. They role model the ideal behaviours, sending out a clear signal of what is acceptable and indeed ideal behaviour. 2. They coach. These are not formal performance review type conversations: they are 5 minute interventions close to the front line, at the time situations occur and on a regular basis. Coaching conversations have a dramatic impact on helping staff feel confident, feel valued, keep the subject fresh and demonstrate its importance. Some people are natural coaches, others need help. 3. They treat their staff well; they engage, inspire and work as a team so that people feel valued and want to go the extra mile. They also seek to eliminate bullying behaviours and management by fear. 4. They allocate sufficient time and resources. And the biggest investment is around time. A simple example of this is making patient experience an ongoing and significant Board item. 5. They create a culture of accountability. 6. Process Improvement There will be actions around specific areas to improve the patient experience. Some will be simpler (more curtains,milk jugs at breakfast, better signage and protected meal times), others will be more complex and involve pathway redesign. In some ways these are the easier elements of improving the patient experience as they are far more tangible and measurable through traditional project management methods.
  • 6.
    Improving Patient Experience 6of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience 7. Sustainability And so to the last driver and perhaps the hardest: sustainability. Our research indicated this has a number of characteristics: The first is innovation across the enablers. For example, amongst the many things Walsall Hospitals did was to implement a discharge questionnaire. After launching the programme, they took actions and the scores rose then plateaued, they then realised they needed a much higher response rate. This then became a key measure. Again more insight, actions, rising scores and another plateau. Then rather than just look at average score they looked at % patients delighted, scoring 5/5. Again more insight, actions and rising scores. They have recently implemented a two week post discharge call to 80% of patients with some superb new insights and actions. They are now are looking to publish the results at ward level. This example is not to show that Walsall has the definitive strategy; but to show that over three years they continually innovated and kept the initiative fresh. The second key to sustainability is to include patient experience into as many supporting processes as possible. Examples include recruitment, induction, training and performance management. The third area is to be aware and take advantages of changes: new buildings, new services, new managers, mergers and expansion are all opportunities or threats to the patient experience. The return on investment from improving the patient experience is considerable and usually underestimated. An emerging area is development of the business case. Most hospitals said “we do this because it is the right thing to do.” In addition, some hospitals, particularly those who have cracked quality reporting, see reductions in incidents, improved patient outcomes, reduced complaints, increased referrals and lower staff turnover and absenteeism. Examples include a 50% reduction in falls, 40+% reductions in prescription errors, and a 60 place improvements in National Inpatient Survey Scores. These improvements have value to patients, staff and the Trust. As budgets come under pressure in the next few years, these investments of time and money should be easy to protect. They are relatively low cost and have an amazing return - both on the things you can count and the things you can’t. Conclusions 1. Improving the patient experience remains one of the top issues for all hospitals. 2. Despite its importance many hospitals are challenged to make and sustain improvements. 3. There are seven key characteristics that enable hospitals to make and sustain significant improvements in the patient experience. The absence of any one characteristic tends to reduce or undermine success. 4. The return on investment from improving the patient experience is considerable and usually underestimated. When organisations deliver a great patient experience it is because they deliver on each of the key enablers. Delivering a good or excellent patient experience is within reach for every organisation. ----------------------II----------------------
  • 7.
    Improving Patient Experience 7of 7 Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Sustainability Patient & Family Engagement Effective Leadership Organisational Engagement Patient Experience Measurement Initial Intervention Patient Experience Measurement Initial Intervention Process Improvement Seven Drivers of Improving Patient Experience About Energize Energize are an award winning change and coaching company, who work across both the public and private sectors, specialising in improving patient and customer satisfaction. In the healthcare sector they have successfully worked with Trusts and PCT’S to define the vision and outcomes needed to improve the patient experience then supported them in making those changes. About the authors Steven Harris Founder and Managing Partner of Energize Learning & Development Steven set up Energize in 2000 after developing a methodology for implementing a sustainable culture change at The Body Shop. Whilst the heritage of Energize lies in retail with clients such as Marks & Spencer, Selfridges & Liberty increasingly they have worked in the Healthcare sector with Chelsea & Westminster, Great Ormond Street and Enfield PCT. Whilst working in the healthcare sector Steven has designed and led “Improving patient experience” campaigns showing sustainable and quantifiable improvements. Prior to setting up Energize, he spent twenty years working in retail operations, buying and merchandising and franchising holding a variety of board positions with leading European and International retailers. Contact on +44 (0)7946 398 831 David Brown Partner, Energize Learning & Development David specialises in helping organisations change to be more successful. His particular focus areas are Strategy, Customer Experience, Business Development and Change Management. He has worked closely with Great Ormond Street Hospital to improve the experience for patients and families and co-leads Energize’s Healthcare practice. David has worked at senior levels with clients including Thomas Cook, MyTravel, Sodexo, GKN and The World Travel & Tourism Council. Prior to working with Energize, David was a Partner at Accenture and led the UK Strategy & Customer and Travel Services Practices. David is also founding Partner of Achieving Goals, a firm specialising in Strategy, Change Management and Business Development outside the Healthcare sector. For further information contact Energize Learning and Development on 0208 731 9464 or at [email protected]