Patient Experience AbroadAmy Maclean, Head of Patient Experience

Bit about me

• Lived and worked in USA until 2000—From Chicago most recently.

• Married a Brummie in 1999—had been working in Chicago.

• Own and run a healthcare business since 2003 and trained and worked with NCT from 2003.

• Service user since 2000, MSLC member, Governor into the HoPE role in 2014 at BWH, now BWC.

21 USA Site Visits since ‘15

Most recently:

• Providence Hospital—Burbank, California

• Emory University Healthcare System—Atlanta, Georgia

• Keck Medical Center, University of Southern California

• Cedars Sinai Hospital—Los Angeles, California

• 2015—17 other US Hospitals: http://amymaclean.wordpress.com/

Most noticeable themes

• Thought Leadership—where do the ideas/learning come from?

• Leadership and organisational structure

• Data drivers

• The things that jump out:- Customer Service: Living/Breathing a ‘Service

Economy’—moving to a ‘Connection Economy’

- Utter compliance with standard behaviours

- Voluntarism/Giving/Philanthropy

- Partnership—Family and Patient

Centered Care

A few general principles

USA UK

326 million people 66 million people

50 governments 1 government

The marketplace dominates, so consumers win. However, once into an health

episode, it is difficult to exercise true choice. Reviews of facilities and

individual clinicians is readily available, and hospitals are protective of

reputational damage.

There is little to no ‘choice’ (market) in

healthcare—offering choice quickly becomes a

conversation about private healthcare.

Spirit of people:

• Fiercely self-reliant: personal freedoms, individual responsibility, resist

someone telling them what to do or how to live.

• Rapidly embrace change, seeing progress as a good thing. Easily mirror

industry and take that as a model to comfortably adapt to.

• Government holds solutions

• More skeptical of change, more likely to

resist changes which might infringe on

privacy.

• Ultimately do adapt to industry but it takes

longer.

Voluntarism/Giving/Philanthropy deeply engrained from early on. Present but less developed. Needs a nudge!

Obamacare centralised obligation to report on Pt Experience through monthly

reporting via HCAHPS (Hospital Consumer Assessment of Healthcare

Providers & Systems)

FFT came about in 2012-13 as first centralised

measure for Pt Experience

American Patient Experience Thought Leadership

• Beryl Institute

• Press Ganey/Picker

• Studor, partner of Press Ganey

• Planetree, partner of Picker

• Institute for Family and Patient CenteredCare

• Cleveland Clinic

Organisation Differences

• C-Suite positioning: Chief Experience Officers more common

• Patient Experience Teams called Departments of Service Excellence

• Pt Experience includes: Staff Experience, Comms, Giving, Advocacy

• Still has a strong link of Complaints to Risk/Legal elements

How they use data:What matters most:

Rising tides—Biggest ‘bang for your buck!’

Statistics tell us these ‘rising tide’ measures:

By improving ‘nurse/midwife/doctor communication’ the following domains also improve:

Safety, overall experience, reduced readmission, reduced pain.

And two proven ways to improve nurse/midwife communication:

1. Purposeful rounds (preferably hourly).

2. Bedside handover.

Tools to drive communication

A Service Economy: Far more than ‘customer service’

• Look to industry—our patients do!

• 15 Steps—5 Senses challenges

A focus on getting the ‘service right’ and

attempting ‘service recovery.’

Intentional interventions: Memorial Sloan

Kettering

What can we do? Coffee cards!

Outstanding customer service including service recovery

WOWs: Into Giving

National initiative made

local: ‘Project Linus’• Art and music bedside

and in busy clinics

• Compassion Carts

• Pamper Hamper

• Pets as Therapy

WOWs/Giving—into Partnership

• Partnership begins with family access

• Baby Webcams:

http://www.latimes.com/socal/burbank-

leader/news/tn-blr-me-providence-media-

20170603-story.html

• Video of lead nurse detailing camera

https://youtu.be/sAF-uB6-kwY

Voluntarism, Giving and Philanthropy

• ‘Grateful Patients’—channeling

gratitude—acknowledging the innate

human need for reciprocity

• Grateful Pt Rounds: Giving of time,

feedback/stories/money

• Planting seeds for philanthropy

including patient/family led PE

Awards

• Highly structured, intentional,

normalising the ‘ask’—making it

simple for

patients/families/businesses to give.

Family and Patient Centered Care• Personalised care: food, discharge, information needs, family

involvement

• Caregiver involvement: classes, inclusion, rounds, empowerment, facilities

• IFPCC toolkit: http://www.ipfcc.org/bestpractices/better-together.html

• Planetree Care Partner Programme:

http://planetree.org/wp-content/uploads/2017/04/11.-Care-Partners-Primer.pdf

• This tool from 2008 is used

to move services to being

move patient centred: Patient

Centered Care Improvement Guide

http://patient-centeredcare.org

Big current theme: ER Waiting Times

• Feinberg: Former UCLA CEO now in Pennsylvania at GeisingerSystem working on reducing ER wait times to 20 minutes

• Dashboard for ER Waiting times: https://projects.propublica.org/emergency/hospital/390006

• In his own words: https://www.youtube.com/watch?v=cZ5u7p-ZNuE

• https://www.geisinger.org/en/about-geisinger/news-and-media/news-releases/2017/06/19/19/46/david-feinberg-third-on-modern-healthcare-top-50-influencers-list

Patient Experience Hierarchy: Where to begin?

Patients

as partners

Patient and family centred

care

WOWs--Harnessing Gratitude

Outstanding customer service including service recovery

Empathy

Six Aims of BWC Patient Experience

Systems Leadership

•Building and enhancing teams and processing for capturing, reflecting and reporting what patients/parents/carers/family members tell us - and what we are doing about it – it matters to us!

Outreach, Engagement and

Participation

•An Engagement Strategy developed with our children, young people, patients, parents and families which is inclusive of our seldom heard parents/patients. Includes active participation forums and support for clinical group development.

Insight into action

•Robust triangulation of feedback from above functions, for interpreting and messaging to clinical areas. Demonstration of application of learning from feedback.

Reciprocity

•Volunteering/feedback/giving (fundraising)/other opportunities for patients and families to connect.

Knowledge/Education: Patient/Staff

•Patient: Information, learning, support, engagement our families and patients require and when—working in partnership with clinicians and comms, developing mechanisms for the most effective knowledge support systems during health journeys.

•Staff: Staff health and well being, education, staff induction, ongoing staff training for patient / customer service, culture that encourages and recognises initiatives.

Health Environment

•Art and facilities connections to ensure physical spaces enhance the patient experience – a healing environment!

Final Thoughts

• Stay curious to the world around us:

Industry and healthcare from patients’ and

families’ points of view.

• Use your travel and share. This is a field in

its infancy and your thinking can make a

difference.

• Muse out loud—you never know what ideas

may inspire others.

Contact/Reading

Thank youAmy Maclean, Head of Patient Experience

amy.maclean@bwnft.nhs.uk

@amymaclean

Great reads:Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way by

James Merlino

An Epidemic of Empathy in Healthcare by Thomas H. Lee

The Experience Economy by Joseph Pine

Sorry Works by Doug Wojcieszak

If Disney Ran your Hospital by Fred Lee

Black Box Thinking by Matthew Syed