why am i doing this? matching px efforts to organizational ... · 4/24/2018 · why am i doing...

Why am I doing this? Matching PX Efforts to Organizational Needs Tiffany Christensen | Vice President, Experience Innovation, The Beryl Institute

April 24, 2018

Improving the Patient Experience

- The Beryl Institute

Defining Patient Experience

www.theberylinstitute.org

PX Continuing Education Credits

• In order to obtain patient experience continuing education credit, participants must attend the program in its entirety and return the completed evaluation.

• The planning committee members and presenters have disclosed no relevant financial interest or other relationships with commercial entities relative to the content of the educational activity.

• No off label use of products will be addressed during this educational activity.

• No products are available during this educational activity, which would indicate endorsement.

This webinar is eligible for 1 patient experience continuing education (PXE) credit. Participants interested in receiving PXEs must complete the program survey within 30 days of attending the webinar. Participants can claim PXEs and print out PXE certificates through Patient Experience Institute. As an on demand webinar, it offers PXE for two (2) years from the live broadcast date.


Our Presenter

Tiffany ChristensenVice President, Experience InnovationThe Beryl Institute


Headliner WebinarApril 24, 2018

Tiffany Christensen, VP Experience Innovation

Why Am I doing This?Matching PX Efforts to Organizational Needs

Welcome!

• Brief overview of the The Beryl Institute and the Experience Journey• Explore how we choose partnership and bedside/exam

table/gurney PX Strategies• Consider our toolbox of potential strategies• Explore new ways for assessing opportunity/implementation of

strategies (including ROI)• Looking ahead• Q and A


What is The Beryl Institute?



Community of Practice Body of Knowledge

Research Professional Certification

Tiffany Christensen

• Cystic fibrosis patient, has received two double lung transplants

• Began career as PFA• TeamSTEPPS Master Trainer• Nationally recognized public speaker and the

author of three books • Served as a patient advocate in Oncology• Program designer for Patient/Family Advisor

Program for a large academic medical system• Patient and Family Engagement Specialist at the

State Hospital Association• Vice President for Experience Innovation at The

Beryl Institute

The Field of Patient Experience


Experience is…

Experience is somethingwe have lived through.It is about something thathappened and it is ourlasting story…

It is defined in all that isperceived, understoodand remembered…


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.

Satisfaction…


An ExpandedPerspective


Patient Experience Defined


Evidence to Support a Focus on Experience

Financial Return: https://theberylinstitute.site-ym.com/store/ViewProduct.aspx?id=902589

Improved clinical outcomes, financial outcomes, consumer loyalty, and community reputation: http://pxjournal.org/journal/vol3/iss1/1/

Additional journals across a variety of clinical specialties: http://pxjournal.org/do/search/?q=outcomes&start=0&context=5521800&facet=

www.theberylinstitute.org 20

https://theberylinstitute.site-ym.com/store/ViewProduct.aspx?id=902589

http://pxjournal.org/journal/vol3/iss1/1/

http://pxjournal.org/do/search/?q=outcomes&start=0&context=5521800&facet


PX Defined by The Beryl Institute: • The sum of all interactions, shaped by an

organization’s culture, that influence patient perceptions across the continuum of care

2010: Awareness that better care requires deep understanding of

actual experience, which is different than satisfaction

PFE Defined by IOM: • Providing care that is respectful of, and responsive to,

individual patient preferences, needs, and values; and ensuring that patient values guide all clinical decision

2001: Realizing that patients/family values can be included in clinical aspects of

care

PFCC Defined by IPFCC:• Patient- and family-centered care is an approach to

the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships...

1992: A new focus on thinking about how patients receive care

Our journey at a glance

Why this webinar topic?


We have been traveling this journey together for quite some time

We now have a large toolbox filled with strategies and evidence

At one time, when this work was brand new, we implemented strategies by modeling ourselves after

other organizations

Today, we are ready to be more strategic in what approach we choose and why


Standard Improvement MethodFor Quality and Safety

Choose a PX Strategy

How do we implement this PX strategy?

How will we know that our PX Strategy is

making improvements?

What are we trying to accomplish?

Commonly used approach for implementing PX strategies

It’s time to flip the model


TIME

Define Solve

Simplifying for today’s conversation


Partnership with patients, families and community members

Partnership at the

bedside, exam table or

gurney

Primarily: reflecting on past experiences Primarily: currently receiving care

Community and PFA Partnership Strategies


Common approaches to partnering with PFAs

PFAC

PFAs on boards and leadership

committees

PFAs in QI (RCAs, RIEs, Falls

committees)

PFAs as influencers (Peer Rounding, Staff Interviews, Secret Shoppers)


Challenges in the PFA model

PFACHigh Resource Requirement &

Agenda Burnout over time

PFAs on boards and leadership

committeesLimited space leads

to limited representation

PFAs in QI Resistance from

“risk” perspective leads to low

sustainability

PFAs as influencers Higher level of

training and staff coaching/supervision

needed

WHY AM I DOING THIS?

Lack of needsintervention

analysis leads to doing it because

that’s what others do


A Missing Puzzle Piece

A customized orientation for any PFA strategy sets everyone up for success.

Is design and implementation of

orientation for PFAs AND staff a part of your plan?


PFA Strategy

Readiness

Choosing a strategy: What’s the ROI?

Time required for the program

Volume of people and

other resources required

Dollars or cost required

Current value to the

organization Values a

successful project will

yield

www.theberylinstitute.org 31Adapted from Six Sigma

Saving dollars, improving

experience, increasing Joy in

work, etc

Improving community

relationships, hearing the VOPF,

etc

VOPF = Voice of patients/families

Additional Partnership Considerations

Leadership support

VOPF connected w/ power to change

VOPF represents population served

Process for orienting PFAs and staff

PFAs well matched to opportunity www.theberylinstitute.org 32

VOPF =Voice of

Patient & Family

Example: PFAC Challenges

• What was your goal for having a PFAC?

• Why did you choose to utilize a PFAC to meet that goal?

• Is there a strategy that could potentially be a better fit?


My organization started a PFAC 6 months ago. It was really hard to get off the ground. Now, I’m not

sure what to do with the PFAs we have.

Why a PFAC?

• Original Aim: PFAC was formed to hear the voice of the patient

• Is this aim specific?

• If you could rewrite the aim, how might you rewrite it?


Suggested aim (for purpose of today’s discussion)

Primary Aim/Goal: Improve community relationship by hearing the VOPF and, in so doing, naturally cultivating ambassadors


Strategy costs/benefits


Strategy Cost Time and people (in relationship to other potential strategies)

Potential value (in relationship to other potential strategies)

Additional Resources

PFAC Key considerations: Pay for staff?Pay for PFA transport?Materials cost?

High: Monthly meetings with agenda prep and logistics planning, ongoing recruitment

Low: Requires PFAs on PFAC be active and skilled in sharing efforts with community

Orientation program development, Meeting room, printing

Peer Rounding Key considerations:Pay for PFA transport?

Medium: Requires training for PFAs and staff + “buddy system” and process for measurement

Medium: Small sample size of community members touched but with high impact

Orientation program development

PFA Storytellers in community settings

Aside from ”time and people,” no associated costs

Low (but specialized): Coach required for impact and alignment of message

High: If well-organized, larger sample size, high impact if stories well-crafted

Coordinator/process for finding opps and scheduling

Additional Considerations

0

1

2

3

4

5

6

7

8

Representation Leader Support Value to Org

Evaluating 3 partnership strategies

PFAC P. Rounding Storytellingwww.theberylinstitute.org 37

Making a choice: Importance/Difficulty Matrix


PFACPeerRounding

PFAStories

Primary Aim/Goal: Improve community

relationship by hearing the VOPF and, in so

doing, naturally cultivating ambassadors

Making a choice: Importance/Difficulty Matrix


PFACPeerRounding

PFAStories

Luxury

Targeted (easy)

Strategic

High Value

How will we know we’ve made an impact?

Chosen Strategy: PFAC 2.0• Meet every 2 months (instead of

every month)• During meetings: Focus on

projects and programs in early stages to ensure VOPF is woven into to development

• Work on recruiting for and building capacity among current members to be community “ambassadors”


What might be your impactindicators or measures?

Partnership Strategies at the Bedside or Exam Table


To For With

PFCC and Co-Design: The Evolution


With

ForTo


Honoring Experience

Common practices for PFE

Passive Information Sharing

(White Boards, Access to EMR, )

Teach back

Rounding (Hourly, Leadership, Safety, Waiting Room etc)

Shared Decision Making

(Decision-Making Aids, PAM + MI, )


Challenges with PFE

Passive Information Sharing

Inability to assess comprehensionOften unclear if

information is utilized

Teach-BackLack of consistency with

practiceResistance due to perception of time

RoundingOften lack of clear aim in

roundingOften lack of system to make changes based on

data collected while rounding

Shared Decision MakingMany tools to choose

from, most require skill set

Sense that patients/families are not

able to make decisions

WHY AM I DOING THIS? Practices are often

perceived as “flavor of the month” or o0ffensive to those “already doing

this.” Resistance leads to lack of understanding

practice + a lack of hardwiring


A Missing Puzzle Piece

A one-size-fits-all approach will lead to

frustration and perception that the practice is

ineffective

Is assessing and facilitating readiness a part of your

plan?


PFE Strategy

Readiness

PFE Bedside Practices: ROI Case Study

• What was your goal for Leader Rounding?

• Why did you choose to utilize Leader Rounding to meet that goal?

• Is there a strategy that could potentially be a better fit?


Leaders in my organization started rounding about 6 months ago. At first,

everyone was really enthusiastic. Lately, they have been saying they

aren’t sure if it’s making an impact and some leaders have been decreasing

the amount of time they spend rounding.

Why Leader Rounding?

• Original Aim: Leader rounding was implemented to ensure leadership was visible to frontline staff

• Is this aim specific?

• If you could rewrite the aim, how might you rewrite it?


Suggested aim (for purpose of today’s discussion)

Primary Aim/Goal: Provide more timely recognition to staff to increase joy in work


What change will we make to meet the aim?How do we enhancing Leadership Rounding?

Contextual Inquiry (Shadowing with Narration)

Fly on the Wall Observation

Interviewing “How might we make working here better?”


Choosing the approach with Rose, Thorn, Bud

Rose = Positive (vote FOR)

Thorn = Negative (Vote AGAINST)

Bud = Opportunity (New idea, Variation)


For the purpose of today’s discussion:

Contextual Inquiry (Shadowing with Narration)


How will we know this change made an improvement?


Healthcare’s move into the “Design” space: EBCD and HCD


This woman is putting away files. What does she need?


Design, Human-Centered Design & Co-Design


Thinking Alongside

Thinking About

Thinking

The Experience-Based Co-Design process

patients at the heart of the quality improvement effort -

but not forgetting staff

a focus on designing experiences, not just systems

or processes

where staff and patients participate alongside one

another to co-design services

Donetto S, Pierri P, Tsianakas V and Robert G. (2015) ‘Experience-based Co-design and healthcare improvement: realising participatory design in the public sector’, The Design Journal, 18(2): 227-248

What distinguishes EBCD from the other approaches?

• Works as a first step or as a next step• Does not assume to know issues or

priorities• Nimble • Allows for more diversity• Measurement is built into process• Staff voice is equally weighted to

Patient/family voice• Process increases buy-in which increases

sustainability


WHERE WE GO FROM HERE


“The sweet spot of innovation”

Staff Experience

Expert Observations

from The Beryl Institute

Patient/Family Experience


Comments and Questions


Tiffany Christensen919.928.2958

Vice President of Experience Innovationwww.theberylinstitute.org

[email protected]

Thank you for participating!

Please look for a post- webinar evaluation coming soon.


Thank you for participating

why am i doing this? matching px efforts to organizational ... · 4/24/2018 · why am i doing...

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