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Exceptional Patient Experience. Leadership Development Session August 27 & 28, 2013 Beverly Begovich April Fairey Lara Burnside. Healthcare Today?. Positive Image or Negative Image? Trusted or Feared?. Objectives for Today. Review the impact of patient satisfaction
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Exceptional Patient Experience • Leadership Development Session • August 27 & 28, 2013 • Beverly Begovich • April Fairey • Lara Burnside
Healthcare Today? • Positive Image or Negative Image? • Trusted or Feared?
Objectives for Today • Review the impact of patient satisfaction • Introduction to Words that Work that demonstrates patient focused care • Understand differences between traditional patient rounding and “focused” patient rounding • Next steps for creating Words that Work that demonstrates patient centered care and getting to the “wow” experience
Patient Expectations • Don’t harm me • Make me better • Be nice to me Health Pulse of America Center for Survey Research – State University of New York, Stonybrook Do you worry something might go wrong during your hospital stay? 55% somewhat worried or very worried of a wrong treatment or serious infection while in the hospital.
Words that Don’t Work • You picked the wrong hospital to come to… • They never know what to do when I come here. • I never heard of that. I don’t know what to do. • It’s change of shift; you have to wait. • Nothing happens from 6:45 to at least 7:30. • No family is allowed in our ED bays the fist half hours;you know that rule!
Situations to Use Words that Work • High Volume Cycles of Service • Greetings • Goodbyes • Transitions/Handoffs at change of shift • Service Recovery • Delays • Waiting Room Protocols
The Voice of Our Customer • Why does this matter?
I gave you “usually” on your survey. I am six times morelikely to go to your competitorin the future.
I gave you “Always” on your survey. I am six times lesslikely to go to your competitorin the future.
What’s in the gap between the “usually” and the “always”? • The “very goods” to the “excellents”
The gap is the difference between the expectation and the actual experience
The Patient Experience: 3 Components • Loyalty • Emotional bonding • Psychological commitment • Likelihood to Recommend • Satisfaction • Meet/exceed expectations • Outcome delivered • How “Well” • Perceptions • Formed by experience • Perceptual quality • Behavior and consistency • How “Often” Traditional Satisfaction Survey HCAHPS
Impact of Transparency • Web traffic has increased 500% since Hospital Compare began publically reporting HCAHPS
Focused • Traditional vs. • Patient Rounding • Defined population daily • All new or All DC • Clinical Assessment • IP visit • Complaint Visit • Part of Interdepartmental Rounding • Problem disposition • Problem patient • Population is staff driven • Focus is derived from action plans your staff has committed to • Goal is listen and confirm that actions are consistent in all staff • Goal is setting expectation “our goal is excellent care…” • Goal is fix problem and seek recognition for staff
Outcomes for Patient/Family Rounding • Build relationships • Reward and recognize • Ensue patient safety • Ensure high quality of services provided • Identify opportunities for improvement • Remove barriers to a “WOW” experience
Getting Started • What is the goal? Overall satisfaction Percentile vs. Mean Percent? • What is the action plan decided on by the staff to address the priority items in the survey? • What questions might be asked that will validate consistency in following the action plan? • How frequently will rounding occur for patient/family?
Preparing to Round • Patient satisfaction surveys, comments, reports, censuses, and knowledge of services provided • Staff assignments • Business cards • Dry erase markers and/or pad and pencil • Ancillary department numbers and resource information • Items for “On the Spot” reward and recognition
Step 1: Build the Relationship • Provide an introduction • Maintain eye contact/smile • Put the person at ease
Step 2: Set Expectations • Explain reason for rounding • Encourage open and honest communication
Step 3: Focus the Inquiry • Listen, learn, and share • Use specific language that will get to the goal of improvement • Focus on fact-finding, not fault-finding • Ask probing questions – high-gain, open-ended • Be persistent and consistent
Step 4: Close the Encounter • Offer to provide additional assistance/help • Tell them what you will do with the information and by when • Say “thank you” and leave your contact information
Step 5: Act on the Information • Take notes and follow-up on actions • Act on opportunities for improvement • Under promise and over deliver • Reward, recognize, and celebrate! • Trend issues/opportunities for improvement • Share finding with the senior leaders, peers, and employees
Using Patient Data to Create Action Plan • Review Patient Measurement Report and identify the department’s top three priorities • Appoint one person in each group to act as the leader, the remainder of group are now staff members • Leadersfacilitate discussion with group to: • Identify the actions you will take to address top three priorities identified from sample Measurement Report • IE safety is top priority, action could be “This ID band is the first step in keeping you safe in our hospital”
Action Plan continued • Educate all staff to actions and advise effective date • Display agreed actions in common area on unit for visibility • Leaders document agreed actions on Pt. Rounding Log • Select patient population for rounding (consider staff assignment) • Begin rounding with focused questions • Document outcomes on rounding log • Share findings with staff and senior leaders
Entry Script To Interact with Patient’s Family • “I’m _______, the Director of _________. Our goal is that you receive Very Good care while you are a patient here. • Do you have time to answer a few questions for me?
Discovery and Apology Scripts • In the last 24 hours have you needed to use your call light? If so, what for? Were we timely in our response? • Describe your experience. • Tell me more. • Is there anyone I can recognize for providing you with “excellent” care? What exactly did they do? • I apologize for the delay in answering your call light. Tell me how I can make this better for you?
Focus on the Positives • Manage up • Send “Thank You” notes to the employee’s home • During rounds, identify employees within your department, as well as employees from other departments, who should be recognized for consistently following the action plan • Recognize those employees mentioned by name • Involve employees in the decision making process
Does Focused Patient Rounding • Really make a difference?
Outcomes of Leaders Rounding on Patients • Patients rounded on by Nurse Leaders reported satisfaction levels on average 59 percentile points higher than patients not rounded on by nurse leaders • Decrease patient complaints by 66% • Reduce Emergency Department LWOT from 4.5% to 2%
90 82 81 76 80 71 66 70 60 50 40 30 30 21 20 13 11 6 10 0 Aug Apr May Jun Jul Aug Apr May Jun Jul All Hospitals Inpatient - 2009 • Percentile Ranking Nurse Leader Rounded Yes No
Journey from the 24th to 99th percentile in 24 months Implemented Monthly Patient Satisfaction Tracking and Reporting System: turning data into actionable knowledge and transparency, accountability, Rounding, Words that Work
Likely Barriers to Effective Focused Rounding: • Not prioritized as part of daily schedule • Distractions and called to fight “fires” • Accountability Gaps • Overall lack of belief in patient focused rounding as a critical management tool • Failure to act on the information