Enhancing the Patient Experience in the Physician Practice

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Enhancing the Patient Experience in the Physician Practice Toya Gorley, Director of Client Services, CHAMPS Patient Experience / Santalucia Group Susan Kruger, Director of Physician Services, Lake Health

Toya Gorley, MBA 20 years of experience Director, Client Services at CHAMPS Patient Experience/ Santalucia Group Director, Service Excellence at Cleveland Clinic Passionate about improving the patient experience for patients and families 2

CHAMPS Patient Experience Vision Create strong patient-centered cultures by leveraging both people and process. Mission To ignite passion and purpose throughout healthcare to inspire and sustain a culture of empathy, service and respect. 3

Partnering to Create an Optimal Patient Experience CHAMPS Patient Experience/ Santalucia Group Lake Health Physician Practices Language of Caring 4

The Patient Experience Recent focus on the inpatient experience Employee connections shape the patient s perception of their experience Every touch point is significant 5

Communicating with Empathy Creates and strengthens human connections. 6

The Results When employees embrace empathetic communication: They have a greater sense of purpose. They are more confident in interactions. They can have a greater impact on everyone around them. 7

Creating The Culture of Caring Strategy: Teach empathetic communication skills to physician practice employees Vision Journey Sustainability Next Steps 8

Susan Kruger, FACMPE 30 years of experience Director, Physician Services at Lake Health Passionate about helping independent practices succeed Passionate about improving the patient experience 9

Lake Health Community hospital system in Northeast Ohio Approximately 2800 employees Over 500 physicians on staff More than 60 independent practices, 148 providers, 400 employees 28 employed practices, 90 providers, 300 employees Offer multiple programs to support our independent and employed practices 10

Lake Health 11

Lake Health Mission and Vision Mission To provide comprehensive health care services to the residents of Lake County and neighboring communities in partnership with those who share a commitment to local access, healing with compassion and superior quality. Vision LHS, in partnership with its medical staff, will be the first choice for superior care close to home. Together, we will coordinate a lifetime of health which patients and families experience as warm, responsive and state-of-the-art. Our organization and culture will produce the best opportunities to practice and work. 12

Lake Health Values RESPECT: We believe in treating everyone in a dignified and caring manner. INNOVATION: We believe that the pursuit of creative ideas leads to improvements that build a better future. TEAMWORK: We believe that working together and communicating effectively help us achieve shared goals. STEWARDSHIP: We believe that the wise use of our resources today assures our ability to continue our mission tomorrow. INTEGRITY: We believe that our words and actions need to be in harmony to build trusting relationships. 13

My Role Support Independent Practices Services Answer line Newsletter Networking Email blasts Programs Education Group purchasing 14

Why We Started the Journey CG-CAHPS Recognized inconsistencies in service delivery among practices To remain competitive in our market It s the right thing to do. 15

My Plan Get everyone on the same page Offer communication training that Is relevant to the physician practice Focuses on strengthening interactions with patients, family members and coworkers Promote ownership at the practice level by providing tools for managers to keep it alive Identify metrics to demonstrate success and impact The Ultimate Goal: To create and sustain a consistent service experience among all practices. 16

Our Journey Obtained leadership support Addressed immediate challenges Implemented the program Demonstrating ROI Found a program 17

Found a Program Content Consistent with organization s values Compliments the inpatient program Focus on communication and strengthening connections Skill-based training Easy to administer Proven to be successful Partnership Offer advice, expertise and creative ideas Provide guidance to adapt program to our environment Share best practices for implementation and sustainability 18

Heart-Head-Heart provides a framework for empathetic communication Seven heart skills enable all employees to make their caring felt Two-hour training to review all skills Follow-up sessions to reinforce and practice each skill individually 19

Obtained Leadership Support Approached the PHO for support and funding Received Support Had to be creative about how to fund 20

Advice: Leadership Support Find A physician champion immediately who will endorse the program and the approach Utilize Administrative staff from the inpatient side. They can be an advocate because of their experience with HCAHPS 21

Addressed Challenges Engaging physician practice network and independent practices Offered customer service training before Created interest by promoting program in newsletter and by email Leveraged office managers Competing priorities for physicians and practice managers Heightened awareness by educating on CG-CAHPS and impact on reimbursement Cost in time and money Offered on-site training at multiple times of the day Split total cost of program with the employed group Calculated per employee cost and charged back to the practice Limited resources to manage the program Found turnkey program and partner to assist with implementation 22

Implemented the Program Conducted 2-hour Jump Start training for office managers May 2013 Proposed 3 options for staff training: Managers conduct the training for their practice Staff attend group sessions offered for all practices I conduct training at the practices 23

Program Participation Program Component 2-hour Jump Start training for managers 2-hour Jump Start training for employees Skill-specific follow-up training 2013 Skill-specific follow-up training 2014 Independent Practice Lake Health Physician Group Participants 11 8 23 7 3 158 5 3 108 4 3 115 24

Advice: Implementation Do not get discouraged about fluctuations in participation Sites adopt at different rates Some sites may not complete the program Sites will come on board when you least expect 25

Demonstrating ROI Number of Participating Practices Goal: 50% increase in 2014 Communication Self-Assessment Self-reported improvement due to training Session Evaluation Understanding of skills and satisfaction with training Manager/Physician Observations Assessment of behaviors in action Patient Feedback Pleased with the experience and acknowledged the behaviors being used Other Heightened awareness of everyone s impact Consistency in service delivery among practices 26

Issues/Concerns The Beryl Institute - Patient Experience Conference 2014 Our (Quantitative) Data Data received from self-assessments didn t tell us anything Surveys given to patients at the end of the visit Hit or miss Low return rates Insignificant month-to-month fluctuation in courtesy of front desk staff metric 27

Our (Qualitative) Data Qualitative data proved to be most valuable 28

Employee Feedback I learned to explain how my work directly benefits the patient. They appreciate knowing why we are asking them to have a test performed or take a medication. It reminds me to stop and think about how the patient feels, not just that I should do my job but do it with more feeling and empathy. I like how it helped me to realize some things about myself without me feeling like I was being picked on. I learned a lot of other people struggle with the same communication skills. 29

Manager/Physician Feedback "I overheard one of the girls in billing lamenting about a tradesman who came to her house to install a front door and she ended up throwing him out. After hearing the story, her co-worker responded, Clearly he didn't attend the communication seminar we went to or he wouldn't have behaved that way. While most of it was common sense, he sure could have used some of the tips the instructor gave us. I see your handiwork popping up at workstations - a good sign - you speak and they listen! 30

Patient Feedback I love this office best doctor, best receptionist, best nurse (Mike) triage line easy to get through. Not only does everyone in the office do an excellent job, they actually care about you and your well-being. I have always had the best care from Dr. Baniewcz and his staff. They go above and beyond to ensure I get excellent care. The front desk receptionist was extremely pleasant and went above her duties on my expectations. She was very patient and kind. She informed me what to do. I was extremely satisfied. 31

Advice: Demonstrating ROI Identify and Obtain approval on metrics right away Ensure methodology for collecting data is sound Identify resource to manage the data collection and reporting process Share results on a regular basis Do Not discount the value and importance of qualitative data 32

Sustaining The Culture of Caring Strategy: Integrate skills with HR policies and provide tools to reinforce the skills within the practice Job description Standards of behavior New employee observations Performance improvement Evaluation Reminders Reward/recognition 33

Job Description Essential Functions Acknowledge patient/visitors Make eye contact Professionalism Competencies Service Orientation Respond promptly to patient s needs Professionalism Positive team spirit 34

Standards of Behavior Commitment to Coworkers I will treat coworkers respectfully and professionally by listening, avoiding defensiveness and refraining from public criticism. Communication I will listen to my patient s concerns in ways that show I care. Personal Attitude, Courtesy and Etiquette I will remain calm when dealing with an upset caller. I will listen to what they are saying, demonstrate that I care, and want to help. Commitment to Patient Service I will without placing blame, acknowledge and apologize for any delays and provide an explanation when appropriate. 35

New Employee Observations Behaviors that demonstrate great service "Always behaviors Positive attitude Verbal and non-verbal communication Listening skills 36

Performance Improvement Unsatisfactory service to patients Inappropriate conduct with a fellow employee 37

Performance Evaluations Attitude Relationships with patients Team support and co-workers 38

Visual Reminders 39

Reward and Recognition Intrinsic Extrinsic 40

The Journey Continues Develop Support Take Encourage Partner Consider recognition program managers to maintain enthusiasm and use of the skills physician engagement to the next level (Leaders & Role-Models) more practices to participate to offer patient surveying at a cost that practices can afford future of program (Where does it go from here?) 41

Advice: The Entire Journey Don t be afraid of the challenge. Know that there are others who are willing to join you and support you. It s the right thing to do. 42

Toya Gorley Susan Kruger The Beryl Institute - Patient Experience Conference 2014 Questions? Contact Us. Director, CHAMPS Patient Experience 216.255.3637 toya.gorley@chanet.org Follow me on Twitter @ToyaGorley Director of Physician Services, Lake Health 440.354.1996 susan.kruger@lakehealth.org www.lakehealth.org pxperspective.com and champspatientexperience.com 43