Competitive Strategies in a

Changing Healthcare Market

Why has patient

engagement become

so important?

Suzanne Wheeler, MBA

Director, Patient Experience,

Process Improvement

Adventist Bolingbrook Hospital

Darrell Atkin

Senior Director of Marketing

Skylight Healthcare Systems

The Beryl Institute, April 8, 2014

Why Patient Engagement?

• Reduced reimbursements

• Lower volume - High deductible

health plans- Large corporate

provider choices

92% of hospital executives say reduced reimbursement is top threat. - Health Leaders, 2013 Industry Survey

Reduced Reimbursements

• Reimbursements are only going down

• Max reimbursement under VBP is key

– 1,500 hospitals will take cuts based on VBP

– 1,300 hospitals will get bonuses

The Reality

Survive = prove you are better

– Accessible

– Convenient

– Good Service

– Share of Mind

Winners will “eat” the losers

Competitive Strategies in a

Changing Healthcare Market

Achieving Success – The Role

of Patient Engagement

Imperatives to Success in a Changing Market

• Satisfied patients and families

• Focus on the patient experience

• Shorter length of stay

• Reducing readmissions

• Gathering data and demonstrating outcomes

• Building strategic partnerships

• Improving efficiencies

WINNERS

Patient Satisfaction

Quality Outcomes

Operational Efficiency

Market Awareness

Winning Strategy in a Changing Market

Imperatives to Success in a Changing Market

WINNERS

Patient Satisfaction

Outcomes Data

Operational Efficiency

Market Awareness

Patient Experience

• Cultural change led from top

• Systems to drive change• Substantive & sustainable

• Real-time Feedback & Service Recovery• E.g. Nordstrom

• No time to wait for HCAHPS results

Imperatives to Success in a Changing Market

WINNERS

Patient Satisfaction

Outcomes Data

Operational Efficiency

Market Awareness

Streamline clinical workflow and save nurse time

Quality Outcomes

• Stay connected to patient long term

• Prove effectiveness of treatment

• Functional Outcomes post-discharge

Imperatives to Success in a Changing Market

WINNERS

Patient Satisfaction

Outcomes Data

Operational Efficiency

Market Awareness• Convenience

• Connection

• Communication

• Reputation

Market Awareness

Imperatives to Success in a Changing Market

WINNERS

Patient Satisfaction

Outcomes Data

Operational Efficiency

Market Awareness

Operational Efficiency

• Streamline clinical workflow and save nurse time

Competitive Strategies in a

Changing Healthcare Market

Characteristics of a Patient

Engagement Platform

What’s it really like for the patient?

Waiting for admission

Admitted to Room

Inpatient Stay

Discharge

• Fear & Anxiety

• Frustration over wait-time

• Pain & Discomfort

• Greeting may be less than optimal

• Admission Paperwork

• Sensory Overload

• Loss of Control

• Fear & Anxiety

• Pain & Discomfort

• Inability to Sleep

• Lack of understanding about diagnosis

• Questions about medications & other care needs

• Fear of the unknown

Creating an environment conducive to healing

PREPARING FOR ADMISSION

• What to expect when they arrive?

• What to prepare for their surgery/procedure

• What to expect after surgery

WHILE IN HOSPITAL

• Engage patient and family with information and education staggered throughout stay

• Provide patient with more control over their environment

• Create an environment of healing

• Support relaxation and reduce stress via music and videos

DISCHARGE

• Directly involve the patient in discharge planning efforts:

• Service requests

• Surveys

• Checklists

• Pop-up messages

• Reminders

• Display that discharge will occur

POST DISCHARGE

• Provide access to information/education to help manage care at home

• Support/Remind them of behaviors/actions for healing

• Ensure follow up with doctor’s appointments & medications

The TV becomes a key communication device

Changing the patient experience

Waiting for admission

Admitted to Room

Inpatient Stay

Discharge

• Patient / family can begin watching education videos specific to reason for admission

• Entertainment available to take patient’s mind off of wait time

• Relaxation video playing on TV screen

• Admission paperwork completed incorporating education videos specific to patient safety (falls/HAIs)

• Quiet at Night Initiative implemented

• Patient empowerment through direct messaging of service needs through TV screen

• Patient empowerment with education on disease process

• Creation of healing environment with effective pain management program and quiet, relaxing space

• Giving patient opportunity to request discharge - need assistance with real-time intervention

• Preparing patient to care for themselves after discharge through education on diagnosis, diet and medications

Skylight CareNavigator System Utilization

138 Private Bed facility – Level II Trauma

Medical Surgical Units

ICU

Woman Services

Emergency Department

January 14, 2008 - the first new hospital to be built in more than 25 years in Illinois

Regional Midwest system of 4 hospitals

New Admission Rounding

Accountability Measures

Patient Feedback Mechanism

(real-time)

Learning Experiences & Successful Journeys

– Staff Responsiveness

– Responding to Patient Concerns/Needs

▪ Empower through Education

▪ Reduce anxiety

▪ Real-time response….with real-time feedback

Executive / Nursing Buy-In

Skylight Education

Dedicated Committee /

Nursing Leadership /

Dedicated Account Manager

Creativity!

Patients Staff

Educating Patients to access…..Skylight CareNavigator!

Initial Rounding process

No follow-up system/close the loop mechanism

See EVERY PatientIdentify

Basic Needs

Informal (non-clinical)

advocate

TV Remote Basics

Free Movies, Internet Access, Games

Request A Service Feature

Patient Experience Callback Card

Hello,

Today, your Patient Guide stopped by your room to welcome you

to Adventist Bolingbrook Hospital.

Patient Guides are here to assist you with your non-clinical needs,

which include providing you with extra pillows or blankets, and

introducing you to our Skylight CareNavigator TV. In addition, if

you have a compliment or a concern to share, Patient Guides are

here to listen.

You may contact a Patient Guide by dialing ext. 6262 or 2616, or

by utilizing Skylight CareNavigator TV, which offers direct

contact with hospital services, free cable, movies, e-mail, and

internet access. Please follow the step-by-step instructions on

the back of this card to learn how to contact hospital

departments directly and access FREE movies and internet

through the Skylight CareNavigator TV.

If you have any questions regarding Skylight CareNavigator TV,

or need any other non-clinical assistance, please do not hesitate

to contact our Patient Guide department.

We look forward to being of service to you during your stay.

Sincerely,

Jennifer

Your Patient Guide

Ext. 6262 or 2616

Skylight CareNavigator TV Instructions

TV Remote Basics

1) Turn the TV on by selecting the yellow button on the remote entitled

“TV on/off”

2) Navigate through the menu choices by using the arrow keys

3) Select an icon by pressing the green “OK” button

Request Services

1) Select the Request A Service icon on the Main Menu

2) Once you have selected the Request A Service icon, you are able to

contact the following departments directly:

o Housekeepingo Maintenance o Charge Nurseo Food Serviceso Consultationso Pastoral Careo Patient Guide

3) Select the icon of the department you wish to contact. A list of applicable service requests will appear. Select the appropriate request. Please allow a 30-45 minute turn-around time for your request to be answered.

FREE Movies and Internet Access

1) Select the TV/Movies/Games icon on the Main Menu

2) Select the Watch Movies icon to access FREE movies

3) Select the Web Access icon to access FREE internet

4) Please utilize the wireless keyboard in your room if you choose to

access the internet. If there isn’t a keyboard in your room, please

contact our Patient Guide team (ext. 6262 or 2616). We will ensure

you receive a keyboard.

Front Back

348

275

449

541

473495

666

587

489

632 625

515

573

0

100

200

300

400

500

600

700

Q12011

Q2 Q3 Q4 Q12012

Q2 Q3 Q4 Q12013

Q2 Q3 Q4 Q12014

2011 – 2014 Quarterly Totals

Service Alert Requests

• Housekeeping• Maintenance• No Request• Nutrition/Food Services• Pain/Hygiene• Pastoral Care• Patient Experience

51%

65%62%

69% 67%72% 70% 71% 70% 71%

77%73% 73% 74%

78% 77%82%

79% 80% 79%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Q1

20

09

Q2

Q3

Q4

Q1

20

10 Q2

Q3

Q4

Q1

20

11 Q2

Q3

Q4

Q1

20

12 Q2

Q3

Q4

Q1

20

13 Q2

Q3

Q4

Quarterly Top Box% Trend

2011 - 2013

Accountable Ownership

• Goal:

• Educate Clinical team on system capabilities

• Establish ownership

• October 2010:

• 3 in-service sessions a day/week/Sundays

• Over 130 employees trained

• Nursing Orientation/Competency

• RN’s & PCT’s

Patient Feedback Mechanism

Decide on the Measurable Goal(s) Keep it Simple

Original layout: 7 questions

New layout with process:

▪ 3 questions

▪ Better correlation to patient satisfaction

▪ Easy to measure

Real-time Workflow Response

Leader receives

Skylight feedback alert

via e-mail and page

RN Director, CRN or PG listens; apologizes; gathers

info from pt / family member and explains the

hospital’s complaint resolution process

Patient Guide (PG) rounds on patient

(pt) / family member and acknowledges

receiving the pt’s/family member’s

feedback through the Skylight System

PG documents pt’s

feedback

on leader rounding log

RN Director, CRN or PG implements appropriate

service recovery

Reward and recognition hospital protocol is

implemented to acknowledge staff members

involved with providing pt with quality care

NO

YES

RN Director, CRN or PG documents

concern and follow-up details on

leader rounding log

Patient Feedback Alert Process

RN Director, CRN or Patient Guide (PG) rounds

on patient (pt) / family member and

acknowledges receiving pt’s / family member’s

feedback through the Skylight System

Yes

RN Director, CRN or PG follow hospital

complaint resolution protocolNo

Concerns

Resolved?

Patient is satisfied

with care?

Receive Alert

Round on Patient

Request Verbal Patient Feedback

Respond to Patient Feedback

Document Feedback and Staff Response

“I began playing the Tranquility video at the beginning of the day and end at Harmony; it is very helpful w/calming patients!”

~ABH RN

CEO Physician Advisory Council Patient Engagement / Educate!

Families are impressed

Tours –

Community outreach

High school Students H2E

Processes

Resources (people)

Skylight Fair

Ownership