Patient Experience is THE POWER OF & Jason A. Wolf, PhD, CPXP President, The Beryl Institute @jasonawolf @berylinstitute #PX2017 March 20, 2017
Patient Experience is THE POWER OF &
Reaching Beyond the Moon AND to bring, those we send, back safely! We choose to go to the Moon John F. Kennedy
ACCESSIBILITY AGILITY INNOVATION INCLUSIVITY COLLABORATION
Patient Experience Defined
Experience is Experience is something we have lived through. It is about something that happened and it is our lasting story It is defined in all that is perceived, understood and remembered
Satisfaction To satisfy is to cause (someone) to be happy or pleased. Satisfaction is in the moment. It is the idea of how positive someone feels about their expectations of an encounter.
Engagement & Centeredness Patient & Family Engagement Patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system direct care, organizational design and governance, and policymaking to improve health and healthcare. K.L. Carman, T.A. Workman, Engaging patients and consumers in research evidence: Applying the conceptual model of patient and family engagement, Patient Educ Couns (2016), http://dx.doi.org/10.1016/j.pec.2016.07.009 Patient- and Family-Centered Care An approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families. Institute for Patient- and Family-Centered Care
Patient Experience is PARTNERSHIPS & CONNECTIONS EMPATHY & COMPASSION INDIVIDUAL & INSPIRING
Patient Experience is A GROWING MOVEMENT
An Emerging Field Community of Practice Body of Knowledge Research Professional Certification
The State of PATIENT EXPERIENCE 2017
Every art and every inquiry, and similarly every action and choice, is thought to aim at some good; and for this reason the good has rightly been declared to be that at which all things aim. - Aristotle
Purpose & Methodology The overall purpose of this study was to determine what healthcare organizations are doing to improve the Patient Experience (PX) across the continuum of care. The Beryl Institute and Catalyst Healthcare Research collaborated on this important research initiative Online survey: Approximately 40 questions Survey period: Jan. 5 Feb. 5, 2017 Prepared in partnership with
Respondent Profile 1644 Total Respondents US Hospitals : 944 Non-US Hospitals : 246 LTC : 64 Practices : 106 49 US states + DC represented in this study 26 Countries represented covering 6 continents Top 5 outside US included Canada, United Kingdom, Australia, Brazil and Saudi Arabia 36% of respondents were directors or managers 17% were nurses, physicians, or other clinical team members 11% were C-suite members or other senior leadership
State of Patient Experience 2017 STAGES & PRIORITIES
The focus on PX is growing 56% 26% 18% 1% Not yet started Just beginning Established / making some progress Well established All segments Q: Which of the following stages best describes the current state of your organization s patient experience efforts? (n=1320)
PX remains top focus, engagement leaps forward Patient Experience (Quality/Safety/Service) 82% Employee engagement / Employee satisfaction 46% Cost management/reduction 37% Electronic health or medical records / Meaningful Use / IT Staff/Nurse recruitment and retention Population Health Construction / capital improvements Physician recruitment, employment, and retention Accountable Care Organization (ACO) development/implementation 22% 22% 21% 19% 14% 13% All segments Q: To understand where organizations are focusing their activities, efforts and actions, please review the items listed below and identify what you believe will be your organization s TOP 3 priorities for the next 3 years. Please select only the top three priorities. (n=1242)
Employee engagement fastest growing priority 58% 32% 46% 22% 44% 40% 27% 35% US Hospitals Non-US Hospitals LTC Practices 2015 2017 Q: To understand where organizations are focusing their activities, efforts and actions, please review the items listed below and identify what you believe will be your organization s TOP 3 priorities for the next 3 years. Please select only the top three priorities. (n=1242)
State of Patient Experience 2017 DEFINING PATIENT EXPERIENCE
Definition of PX on the rise across continuum 65% 64% 67% 47% 53% 38% 42% 45% US Hospitals Non-US Hospitals LTC Practices 2015 2017 Q: Does your organization have a formal definition of Patient Experience? (n=1250)
The Beryl Institute s definition remains most cited The Beryl Institute All segments Q: What is your organization s definition of Patient/Resident Experience? (n=483)
An Integrated Perspective
Integrated view of PX supported AND expanded Patient/Family Engagement 9% 89% Service 10% 89% Quality 11% 87% Safety 13% 85% Employee Engagement 17% 79% Cost Management 44% 44% Somewhat To a great extent All segments Q: To what extent should patient experience encompass each of the following: (n=1111-1124)
An Expanded Perspective
State of Patient Experience 2017 PX LEADERSHIP & STRUCTURE
Senior PX leader role is growing TITLE 2013 2015 2017 Experience Officer (CXO, Director, Manager, etc.) 22% 42% 58% Chief Nursing Officer (or equivalent) 14% 15% 11% Chief Executive Officer/Administrator/Executive Director 8% 4% 10% Committee, Team, Work Group, or Multidisciplinary team 26% 14% 6% Chief Operating Officer (or equivalent) 3% 4% 5% Individual Doctor, Nurse, or other Clinical Staff member 3% 3% 2% No one in particular 1% 3% 0% US Hospitals Only Q: Who in your organization is the individual with primary responsibility and direct accountability for addressing Patient Experience? (n=326)
Focus of PX leaders remains diluted 39% 100% 29% 30% 36% US Hospitals 36% Non-US Hospitals 50%-99% 30% 44% 50% LTC Under 50% 21% 26% 26% Practices 33% Q: As far as you know, what percent of this person's time is allocated to support Patient Experience efforts? (n=547)
Increased investment in PX staff 2017 12% 36% 18% 35% 2015 18% 30% 19% 33% 2013 28% 36% 11% 24% 0% 20% 40% 60% 80% 100% 0 (none) 1 to 2 3 to 4 5 or more US Hospitals Only Q: How many full-time staff members (or FTEs) are designated to support your patient experience efforts? (n=632)
PFA presence expanding Patient & Family Advisors Patient & Family Advisory Council(s) 79% 67% 62% 65% 54% 39% 27% 33% US Hospitals Non-US Hospitals LTC Practices US Hospitals Non-US Hospitals LTC Practices Q: Does your organization engage Patient & Family Advisors? (n=973) Q: Does your organization have a formal Patient & Family Advisory Council(s)? (n=971)
PX structures are expanding Functional Areas (Top 10 of 25) % of Orgs Selecting (Avg) Service Excellence 80% Patient Advocacy/Relations 68% Measurement/Analytics (Survey Management) 61% Staff Training & Development 46% Guest Services 29% Interpreter/Language Services 27% Volunteer Services 27% Organizational Development 23% Spiritual Care 23% Concierge Services 19% Wolf, J, 2017. Structuring Patient Experience: Revealing Opportunities for the Future, The Beryl Institute Q. Please select the functional areas that are part of your patient experience department. (n = 186)
State of Patient Experience 2017 DRIVERS & FOCUS
Motivation moving beyond mandates Government-mandated measurements such as HCAHPS, etc. Leadership s desire to provide a better experience 51% 50% 50% 58% Becoming provider of choice / community reputation Right thing to do Desire to provide better overall outcomes Movement toward value-based or risk-bearing payments 26% 41% 41% 39% 40% 37% 40% 38% Priority of your organization s Board 18% 2017 2015 US Hospitals Only Q: Please select the top three factors that are driving your organization toward taking action on Patient Experience. (n=771)
Motivation similar across segments Non-US Hospitals LTC Practices 2015 2017 2015 2017 2015 2017 Leadership s desire to provide a better experience 73% 72% Becoming provider of choice / community reputation 65% 56% Leadership s desire to provide a better experience 44% 56% Desire to provide better overall outcomes 57% 52% Leadership s desire to provide a better experience 59% 48% Becoming provider of choice / community reputation 33% 47% Right thing to do 52% 38% Desire to provide better overall outcomes 56% 44% Desire to provide better overall outcomes 44% 30% Priority of your organization s Board N/A 38% Government-mandated measurements such as HCAHPS, etc. 6% 40% Government-mandated measurements such as HCAHPS, etc. 39% 30% Q: Please select the top three factors that are driving your organization toward taking action on Patient Experience. (n=316)
Leadership & culture expands, while stress emerges DRIVERS 2013 2015 2017 US Hospitals ROADBLOCKS 2013 2015 2017 Strong, visible support from the top" 62% 52% 48% Other org priorities reduce emphasis on PX 46% 49% 42% Formal PX structure or role 30% 35% 46% Positive Organization Culture na na 36% Cultural resistance to doing things differently PX leaders are pulled in too many other directions 42% 46% 39% 48% 38% 34% Formal process review & improvement focused on PX 44% 36% 33% Caregiver (i.e., physician, nurse, etc.) burnout & stress na na 33% Having clinical mgrs visibly support PX efforts 55% 43% 31% Lack of sufficient budget or resources 26% 26% 28% Q: Which of the following, if any, have been most successful in supporting your organization s Patient Experience efforts? Please select the top three. (n=706) Q: Which of the following, if any, have been the biggest roadblocks to supporting your organization s Patient Experience efforts? Please select the top three. (n=697)
Leadership remains strong driver across segments Non-US Hospitals LTC Practices 2015 2017 2015 2017 2015 2017 DRIVERS Formal Patient Experience leader and/or structure Formal patient and family advisors or advisory council(s) Strong, visible support from the top 40% 50% N/A 47% Strong, visible support from the top Formalized process improvement efforts 49% 38% 56% 46% Positive organization culture N/A 38% Strong, visible support from the top 55% 57% 24% 38% Positive organization culture N/A 45% Formal Patient Experience leader and/or structure 25% 33% Clinical managers who visibly support experience efforts 26% 27% Clinical managers who visibly support experience efforts 41% 35% Formalized process improvement efforts 27% 32% ROADBLOCKS Other organizational priorities reduce emphasis on patient experience Cultural resistance to doing things differently Lack of sufficient budget or other necessary resources Leaders appointed to drive patient experience are pulled in too many other directions 49% 46% 42% 41% 36% 41% 16% 27% Caregiver (i.e. physician, nurse, etc.) burnout and stress Cultural resistance to doing things differently Other organizational priorities reduce emphasis on patient experience Lack of sufficient budget or other necessary resources N/A 44% 28% 40% 33% 35% 39% 26% Other organizational priorities reduce emphasis on patient experience Cultural resistance to doing things differently Leaders appointed to drive patient experience pulled in too many other directions Lack of sufficient budget or other necessary resources 37% 44% 43% 43% 20% 32% 25% 29% Q: Which of the following, if any, have been most successful in supporting your organization s Patient Experience efforts? Please select the top three. (n=287) Q: Which of the following, if any, have been the biggest roadblocks to supporting your organization s Patient Experience efforts? Please select the top three. (n=279)
Engagement leaps to top in achieving positive PX US Hospitals 2017 US Hospitals 2015 68% 52% 38% 34% 32% 44% 54% 62% 29% 22% Highly engaged staff/employees Healthy, positive and strong organization culture Purposeful and visionary leadership Clearly defined behavioral expectations Inclusion/Engagement of patient and family voice Q: Which of the following are most important for achieving a positive Patient Experience? Please select the top three. (n=703)
Engaged staff now leads across segments Non-US Hospitals LTC Practices 2015 2017 2015 2017 2015 2017 Highly engaged staff/employees 29% 59% Highly engaged staff/employees 52% 79% Highly engaged staff/employees 32% 62% Inclusion/Engagement of patient and family voice 39% 53% Healthy, positive and Healthy, positive and strong organization culture 41% 67% strong organization culture 42% 62% Healthy, positive and strong organization culture 40% 47% Clearly defined behavioral expectations 15% 38% Clearly defined behavioral expectations 23% 41% Purposeful and visionary leadership 61% 35% Purposeful and visionary leadership 56% 29% Purposeful and visionary leadership 70% 30% Q: Which of the following are most important for achieving a positive Patient Experience? Please select the top three. (n=283)
Investment led by training & patient and family engagement Staff training and development 59% 62% Expanded patient and family engagement via advisory councils, etc. 37% 40% Broader culture change efforts 38% 44% Facility upgrades / Environmental improvements 32% 32% Expanded measurement efforts 32% 33% 2017 2015 US Hospitals Only Q: Of the following efforts, identify the top three items in which you expect your organization to invest, either as a new effort or with additional resources, over the next three years to advance Patient Experience improvements. (n=677)
Investment led by training & patient and family engagement Non-US Hospitals LTC Practices 2015 2017 2015 2017 2015 2017 Staff training and development 54% 59% Staff training and development 67% 73% Staff training and development 39% 63% Expanded patient/family engagement via advisory councils, etc. 56% 51% Expanded measurement efforts 53% 41% Expanded patient/family engagement via advisory councils, etc. 28% 35% Expanded measurement efforts 49% 45% Expanded patient/family engagement via advisory councils, etc. 26% 32% Expanded measurement efforts 31% 33% Broader culture change efforts 44% 30% Broader culture change efforts 37% 27% Marketing, PR, and/or Communication Efforts 25% 29% Q: Of the following efforts, identify the top three items in which you expect your organization to invest, either as a new effort or with additional resources, over the next three years to advance Patient Experience improvements. (n=276)
PX focus: A return to purpose 2011
PX focus: A return to purpose 2015 State of Patient Experience 2015. Q: What are the top three (3) areas of focus or action for your organization s current Patient/Resident Experience effort? (n=330)
PX focus: A return to purpose 2017 Q: What are the top three (3) areas of focus or action for your organization s current Patient/Resident Experience effort? (n=820; includes all four primary segments)
State of Patient Experience 2017 MEASUREMENT & IMPACT
Clinical Outcomes EXPERIENCE Financial Outcomes Consumer Loyalty Community Reputation Wolf, Jason A. PhD (2016) "Patient experience: Driving outcomes at the heart of healthcare, Patient Experience Journal: Vol. 3: Iss. 1, Article 1. Available at: http://pxjournal.org/journal/vol3/iss1/1
Impact of PX expands to human experience Customer service Reducing patient and family anxiety Community reputation Consumer loyalty (likelihood to recommend) 17% 17% 19% 18% 81% 80% 78% 77% Clinical outcomes 31% 66% New customer attraction Employee engagement and retention 28% 31% 62% 60% Financial outcomes 39% 51% Physician engagement and retention 40% 44% 0% 20% 40% 60% 80% 100% Somewhat To a great extent All segments Q: To what extent do you believe Patient Experience efforts have a positive impact on each of the following? (n=927-936)
The consumer maintains experience matters PX Importance PX Significance in Decisions 12% 10% 28% 21% 87% 89% 67% 76% 2015 2017 2015 2017 Extremely Important/Significant Somewhat Important/Significant Q: Thinking of yourself as a consumer of healthcare, how important is the Patient Experience to you? Q: As a consumer of healthcare, how significant is the Patient Experience to your decisions or choices about your healthcare or your family s healthcare (i.e., selecting hospitals, doctors, nursing homes, etc.)? (n=1094)
State of Patient Experience 2017 REFLECTING ON PROGRESS
Perspective on progress on rise 66% 70% 65% 72% 62% 62% 75% 54% US Hospitals Non-US Hospitals LTC Practices 2015 Positive/Very Positive 2017 Positive/Very Positive Q: At this point, how do you feel about the progress (or lack of progress) your organization is making toward improving the Patient Experience? (n=938)
Feelings on progress rising for first time 25% 61% 17% 54% 20% 46% 21% 49% 2011 2013 2015 2017 Positive Very Positive US Hospitals Only Q: At this point, how do you feel about the progress (or lack of progress) your organization is making toward improving the Patient Experience? (n=672)
The State of Patient Experience is Strong Experience efforts expanding and now integral part of fabric of our healthcare efforts Patient experience remains a top priority, with a focus on employee engagement now a central driver in experience efforts. Leadership/culture now significant motivators vs. mandates/requirements, with recognition of impact of patient/family voice and caregiver engagement Role of PX leaders and use of a formal definition on the rise PX being recognized as integrated effort that drives clear and measurable outcomes And YOU are at the heart of it!
Patient Experience is MOVING FORWARD
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Meade
Moving Forward - 101-
Healthcare s Moment Policy (Uncertainty) Increasing Users Accessing System Shrinking Pool of Clinicians Consumer Expectations Financial Constraints Technology Evolution Expanded Access Points Will require our current healthcare models/systems to think, structure, and act in new ways.
Change in language from centeredness to collaboration and partnership Considerations for the Future of PX Shift in technology from internal processes to accessible, practical, and externally facing applications Expansion of transparency to include greater understanding of healthcare Freeing of data to enable more immediate and impactful decisions, actions, and results Explosion in choice driven by a proliferation of potential points of care Reframing of expectations driven by new and expanded points of comparison Wolf, Critical Considerations for the Future of Patient Experience, Journal of Healthcare Management 62:1 January/February 2017 Publication Pending
Patient Experience is PARTNERSHIPS & CONNECTIONS EMPATHY & COMPASSION INDIVIDUAL & INSPIRING
PARTNERSHIPS Patient Experience is & CONNECTIONS Doing TO Doing FOR Doing WITH Balik, 2011 (http://www.carp.ca/2011/06/24/hot-talks-the-history-of-the-patient-experience/)
PARTNERSHIPS Patient Experience is & CONNECTIONS I was blessed to be assigned a doctor who embodies the definition of patient centered care. Dr. Shulman was someone I could be personally connected with I believe the more information that you have the more powerful you are... I need to know you have my best interest at heart
Patient Experience is EMPATHY & COMPASSION
Patient Experience is EMPATHY & COMPASSION I had to rely on other people to provide that clinical expertise but also meeting our emotional needs in different ways. I think the first way you build a relationship with a patient is to build a strong foundation from the very first moment you meet them you have to be a good communicator, you have to be compassionate. For me it was really important that the doctors understood that this wasn t just about about naming my disease and identifying a treatment, it was also about the whole me and all the implications.
Patient Experience is INDIVIDUAL & INSPIRING N of ONE
Patient Experience is INDIVIDUAL & INSPIRING We are all individual human beings and that s an individual experience, physician to patient, and it s different every time He treated me like a human, like a normal person, I wasn t just another patient he was seeing, I was Victoria, and I loved that about him...for me it was life changing.
Patient Experience is the HUMAN EXPERIENCE
Never underestimate the power of dreams and the influence of the human spirit. We are all the same in this notion: The potential for greatness lives within each of us. - Wilma Rudolph and I would add among ALL of us!
CLUDED INFORMED SPIRED Keys to Stay Inspired on PX Journey, David Carl, Executive Director, Pastoral Services, Carolinas HealthCare System, The Beryl Institute Leaning Bite
Reaching Beyond the Moon AND to bring, those we send, back safely!
Patient Experience is THE POWER OF & Jason A. Wolf, PhD, CPXP President, The Beryl Institute @jasonawolf @berylinstitute #PX2017 March 20, 2017