Where to Start?

wheretostart

It seems like this season is full of good intentions, new beginnings, and great ideas. This is never truer than for those of you working in the wonderful and rewarding world of patient experience! However, translating the concept and strategy for patient experience into an effective implementation of processes and protocols is clearly where the heaviest lifting is required. Quite often the mission can feel overwhelming. Recently I was asked “Where do you usually recommend healthcare organizations start in this process, so it seems doable?”

Our team is often engaged to help an organization when they just don’t know where to begin. We’ll come in and do an assessment to help them determine where best to start. However, in the absence of an outside resource to help you, I suggest the following:

Look at what your data (and your patients) are telling you

This requires looking beyond just your CAHPS data (HCAHPS, HH CAHPS, CG CAHPS, OAS CAHPS), and including other sources of patient voices. These may be through Patient & Family Advisory Groups, patient comments, patient complaints, responses to any rounding efforts in the organization, etc. These data can really help you know where to focus in terms of an area or two that collectively is coming from your patients.

Set yourself up for success: create your “village”

One of the first considerations (from a sponsorship, steering team, and patient experience leadership perspective) is the scope. Are we trying to tackle the whole continuum at once – hospitals, clinics, home health, long-term care, emergency departments, and ambulatory surgery – or on certain key aspects within that spectrum? Determining the appropriate beginning scope is essential to get started on the right foot.

From there it is essential to determine what level of leadership you need to adequately lead this work in your organization. Do you need a CXO (Chief Experience Officer), or a Patient Experience Director, or a Manager? Who will govern and sponsor this work from a steering and an executive leadership perspective?

Regardless of the structure you determine and can operationalize, I believe in the “village principle” of needing more people than just the CEO, the executive sponsor, and a patient experience director to care about patient experience in an organization. To truly transform a culture, and make meaningful improvements in service and patient experience, it truly takes a village.

One of the best ways to create this village is to form some component of a steering committee for the patient experience efforts in the organization. I always advocate for the presence of one to three patients (who also serve on one of the Patient and Family Advisory Councils), several frontline staff, and leaders from around the organization to participate in the Steering Team. This should be led by a dyad of the executive sponsor and the director/manager for patient experience or alternatively by the CXO. Finding those who truly have a genuine passion for the work is critical and can help to make your efforts blossom throughout the organization.

Build an engaged group of frontline staff and physicians

There are a multitude of reasons to care about this work. It is essential that making the case for patient- and family-centered care extend beyond one leader, one staff member, or one department. To do this, you have to find a way to articulate the WIIFM (pronounced whiff ‘em — What’s in It for Me) for some key groups.

Depending on the audience and the role of the person you’re encountering, there may be different strategies about how to make the case for patient experience. There are a variety of methods that I use to appeal to executives, physicians, and staff. I’ll try to refrain from making too many stereotypes as I find that what’s compelling to one person may not be to another.

There are several strategies that I use to try to approach people about why patient experience is important and why they should care about it. Broadly stated these fall into the categories of:

• What if it were me/my family?
• Employee engagement & physician satisfaction
• Financial
• Public image/transparency
• Patient activation/engagement

Rarely do I presume to start with the financial elements associated with the compulsories. To many caregivers, that’s almost insulting. Most entered the healthcare profession with an innate desire to help people and to make a difference in their lives. I generally try to appeal to people on a personal or even emotional level.

However, some caregivers have surprised me and insisted that the public transparency and financial components be shared with their colleagues. To that end, our team created this short video to help explain some of those elements. Check out “What the Heck is Value-Based Purchasing at: https://www.youtube.com/watch?v=dF8SGblP7-c

In closing, if you listen to your patients (and your data), recognize it takes a village to improve the patient experience, and engage physicians and frontline staff where they are at, you will have gotten off to a tremendous start!

Join us next time when we’ll talk more about setting expectations and how long to assume your improvement efforts will take!

Janiece Gray

I began my career as a social worker and later, with my Master of Health Administration (MHA), directed operations at Allina Health in Minnesota. I later directed patient experience at Allina. My background and experience give me strengths in approaching healthcare opportunities and challenges through a systems lens – with unique strengths, challenges and activation points. My experience is also informed by leadership roles leading performance improvement in patient-centered care and patient experience departments. Working in the client role with healthcare consulting firms inspired me to address some unmet needs in the industry, and to co-found DTA Healthcare Solutions. I have a Lean Six Sigma Black Belt, and find that the discipline of practice translates to healthcare work very well.

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