Organizations have become frantic in their efforts to improve the patient experience, as well as their scores; the move from volume to value, after all, has been one of the toughest challenges that healthcare has faced in many years. We try lots of things. Some succeed; some don’t. But the truth is that campaigns, initiatives, and programs are not successful or sustainable on their own: it is organizations that make them work.
What patient-experience efforts often lack is the infrastructure to support them. I have the honor of working with many healthcare organizations, and one of the things I find fascinating is that identical efforts to improve the patient experience can succeed in one organization but fall flat in another. Even more interesting: that an improvement effort by one organization can succeed and become sustainable in one department but not in another.
The organizations that have enjoyed the most success share some common practices when it comes to their Patient-Experience Improvement efforts. Let me share just ten I’ve found.
1. Start With a Team
High-performing organizations have a concrete infrastructure to support their improvement efforts; it is not one person who drives the efforts, but an entire team that includes both clinical and non-clinical members. The organizations that operate most efficiently have approximately ten members on their team. When there are more than ten, things can get a little crazy; a larger committee can contribute to a lack of accountability on the part of the participants. Such a team may be titled the Patient Improvement Team, Patient Satisfaction Team, or Service Leader Team. It doesn’t matter what you call it—just let your improvements be team-driven.
2. Be Inclusive and Diverse
Think BIG when it comes to diversity on your Patient-Experience Improvement Team, making sure to include a wide range of people who will get you where you aim to be. Those who must be on the team are the CNO, the key nursing VPs, managers (a good sample of them), front-line nurses, and personnel from human resources, nutritional services, and environmental services. Be creative when picking the rest, though I would suggest you include the directors of volunteers, parking services, and any very visible and fluid departments in the organization. Also Include at least one out-of-the-box thinker who is perhaps new to healthcare. (New eyes are invaluable!)
3. Make It a Priority
Meet regularly and make every meeting a priority. Meet at the same times and on the same days every month so that everyone in the organization will know not to schedule any conflicting meetings. (As a member of a Patient-Experience Improvement Team, you must make your priorities clear.) Meeting just once a month is a suggestion for organizations whose efforts are well underway.
4. Cover It ALL!
Create sub-committees that are responsible for more specialized endeavors, such as a pain task force headed up by the pharmacy, or a discharge-phone-call team run by a nurse call center. Form committees around each domain, with representation from each modality. All of these sub-committees should report to the larger committee; a portion of every meeting should be dedicated to this.
5. Create a Common Language
Make sure that all team members speak the same language, one that’s specific to your culture of Patient Experience. Reinforce the language in every way imaginable, using newsletters, banners, messaging in elevators and staff restrooms, buttons, screensavers, and signage in employee parking garages. Cast the vision for your organization by using a common language over and over again.
6. Start With Your Mission
Begin every meeting, assembly, or get-together by sharing your organization’s mission. Have the marketing department create a slide that will be used first in EVERY presentation. The slide may even be given to outside presenters so that they can incorporate it into their PowerPoint presentations. If there is no visible presentation, whoever opens the meeting should begin by reciting the organization’s mission statement. How do you expect the members of an organization to move in the same direction and to live their promise to the community (your brand) if they aren’t all operating by the same mission statement? It can’t be done.
7. Train, Train, Train
If your goal is to change behaviors, team members need to be equipped with a new set of skills. However, this doesn’t happen overnight, so someone has to be dedicated to the training and monitoring of team members. As an observer, I often see, for instance, extreme differences between bedside reporting and leader rounding, which are done in as many ways as there are nurses. We wonder why things don’t stick but fail to think of the resources that often don’t accompany the roll-out of a new initiative. Skimping on resources when equipping team members with new skills will only cost you in the end.
8. Get Out!
I have worked in hospitals where there was a fair share of team members who had never worked in another organization. (In some cases, they had been born in that particular hospital, or their mother or father had worked there!) There is something to say about getting out and gaining some perspective, though it’s hard to tell people to aim for something they’ve never seen. Scores are transparent nowadays. Find an organization that’s doing well in an area that yours is weak in and request to visit, then ask as many questions as you can. I’m always blown away when I discover that one organization is a mere car ride away from another but won’t visit to find out what the latter is doing better; people love to show off what they do well. We really are good sharers—you just have to ask!
We want to be good at everything immediately, but it doesn’t work that way. I have gotten into a habit of asking organizations that I consult with to tell me one thing that they do well (with respect to a specific domain), even though it is a really hard question. Those who are honest say, “we do it all … but we’re not sure if we’ve perfected any of it.” So true! Choose one thing and be the very, very best at it!
10. Take Down the Kingpin!
No one has enough energy, time, or resources to go after every initiate that has proved to be a best practice. So, the question is: What do you pay attention to? I advise going after the initiatives that will have the biggest impact and the most influence on the patient’s perception of their care. Right now, improving communication—communication between nurses, in particular—is what you should concentrate on. If we get this right, it would influence other, related domains; almost everything touches on communicating effectively. Be relentless when it comes to perfecting techniques related to bedside-shift reports. If these are done well, they are pretty much the kingpin when it comes to knocking down all the domains! Go for it!