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Embed patient experience advisors hospital-wide

January 29th, 2014

by Doug Della Pietra

"There's a genuine sense that we're all in this together. We are being heard and acknowledged. We are valued around the table."

"Whether staff or patients or family members, we all want improved outcomes and that's only possible when caregivers and patients and their families are in partnership and work together."

Those are just two testimonials from patient experience advisors on Kingston General Hospital's Patient and Family Advisory Council (PFAC) that four of us--three patient/family advisors and I--heard when we traveled to Kingston, Ontario, a couple of weeks ago.

For starters, KGH's mission is compelling and clear: "Outstanding Care, Always." The hospital's strategy is explicit in its commitment to "transform the patient's experience through a relentless focus on quality, safety and service." Moreover, KGH has developed a simple and memorable definition for patient- and family-centered care: "Respect Me, Hear Me, Work With Me."

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At the center of the hospital's desire to transform the patient and family experience is KGH's partnership with the community and patient-centered commitment to shift from "doing to and for" to "doing with." Initial keys steps included engaging a few former patients and family members as voluntary advisors and establishing the PFAC. Since early in 2010, its patient- and family-centered approach has aggressively evolved through two other key initiatives.

1. Embedded advisors across the organization
In the conference room where we met with the KGH PFAC, a large display board listed more than 100 hospital councils, standing committees and short-term project teams, all of which have at least one patient experience advisor--KGH's term for patient and family advisors.

As one KGH leader said, "Fixing things that don't matter to patients and family members is a waste of time. Therefore, understanding what matters most to patients and family members--what they value--helps focus on improvements that will transform their experience." Embedding patients and family members at every level of and on all decision-making bodies in the organization improves KGH's chances of focusing on what really matters to patients and their families.

2. Patient-led forums
KGH's relentless commitment to continuous improvement is unmistakable. In December 2012, the hospital launched Patient-Led Feedback Forums to establish a mechanism for continuous improvement across the entire organization. Not only has KGH mandated continuous improvement training for all managers but it also now requires every one of its nine clinical programs to conduct two forums a year and implement four improvements linked to the patient and/or family feedback received at the forums. (See page 10 of KGH's 2012-2013 Q2 Master Performance Report for its definition of a patient-led forum.)

The process of setting up patient-led forums includes:

  • Identifying and supporting patients or family members on the best way to share their recent hospitalization experience with staff and physicians;
  • Aligning the patient experience to a clinical program, department or group;
  • Having the patient or family member engage in a 15-minute sharing of experience with the staff;
  • Facilitating staff discussion after the patient/family member has left, and identifying the positive and negative aspects of the patient/family experience heard by staff; and
  • Staff selecting one or two improvements, which may be immediately implemented or require a PDSA improvement cycle with a team that includes a patient experience advisor.

Staff and physicians are invited but not mandated to attend the forums. Additionally, KGH provides education for its managers so that they can help their teams process any negative feelings that may arise from the forums.

KGH's advice to other hospitals
For hospitals interested in embedding patient and family advisors at all levels and across the organization, KGH offers the following encouragement:

  1. Have a vision for what you want to achieve.
  2. Be clear and unwavering: "We want the patient perspective!"
  3. Don't get wrapped up in perfection before you start. Just do it! Make the commitment to transparency and when something doesn't go right, acknowledge it and move forward.
  4. Be an environment of continuous improvement.

"[W]e knew we had to meet our strategic direction of transforming the patient experience and there was no time to lose." - Daryl Bell, lead for KGH's Patient and Family Centered Care Initiative

Doug Della Pietra is the director of Customer Services and Volunteers for Rochester General Hospital in New York, where he directs an intentionally-designed patient- and family-centered volunteer program, oversees the front-line valet and guest services teams, and leads the service excellence element of the Patient Experience Initiative while co-chairing the hospital's Patient Experience Team. Follow Doug @DougDellaPietra on Twitter.

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