Striving to improve the patient experience has always been a key part of providing care -- after all, the desire to improve patients’ lives is what brings medical professionals together. However over the past few years, increased interest in strategies like patient engagement and patient shadowing have really placed patient experience in the spotlight.

As we begin thinking about how to improve in the new year, we’re drawing inspiration from 8 hospitals and health systems across the nation who have used a variety of strategies to truly improve the patient experience. We’ll also break it down and share how you can implement these best practices to improve patient experience in your own organization in 2019.

Here’s a sneak preview:

• Reducing stressn day of surgery for joint replacement patients at UPMC Magee Women’s Hospital in Pittsburgh, PA
• Rethinking rounds to ensure patient needs are being met at St. Luke’s Hospital in Boise, ID
• Using analytics to assess patient experience initiatives and improve communication at Cleveland Clinic in Cleveland, OH
• And many others!

Shadowing Patients

UPMC Magee Women’s Hospital Bone and Joint Center - Pittsburgh, PA

The Bone and Joint Center at UPMC Magee Women’s Hospital (BJC) had a recurring and very specific problem-- the first and second joint replacement surgeries of the day were often delayed. Patients assigned these early surgery times were asked to arrive by 5 AM, which seemed like a simple direction, the teams were in place to do the surgeries…. What was causing the delays?

In order to understand the situation, The BJC decided to employ patient shadowing, a strategy for patient care improvement that involves “shadowing” a patient through their care experience and recording observations, comments, questions and events in real time.

What was uncovered? It turned out that the main lobby doors were locked at 5am, requiring the patients - many of whom struggled with mobility-- to navigate around the exterior of the building to the emergency room entrance. This unexpected issue, caused significant stress and delayed their arrival at the pre-operative unit..

Following the patient shadowing experience, the hospital made a few simple changes-- like unlocking the lobby doors earlier to accommodate the earliest surgical patients and providing scooters to help patients navigate from the lobby to the day of surgery unit-- which improved patient satisfaction and significantly reduced surgical delays.

Best Practices: Explore emerging tools and strategies for improving patient care. Patient shadowing, in particular, is a great way to improve patient care because it allows for the closest view of the care experience from the patient’s perspective. Plus, with goShadow, it is easier than ever to collect and automatically aggregate patient experience and process data...

Addressing Patient Concerns

St. Luke’s Health System - Boise, ID

Unfortunately, it isn’t possible to protect patients from each and every health risk or pain point they may encounter during a hospital stay, but it is possible to deal with issues effectively as they arise. According to management at Idaho-based St. Luke’s Health System, communication is the key to providing a positive patient experience.

St. Luke’s employs a strategy called Leader Rounding. The goal of Leader Rounding is to ensure that at some point in every patient’s stay-- ideally, as early in their stay as possible-- they are visited by a Department Manager or another team leader to discuss any concerns the patient may have about their experience.

Interviewing patients on an individual basis helps caregivers identify and remove frustrations or points of friction as they arise. Clear and open communication with doctors, nurses, and other hospital staff also ensures that patients feel heard and as satisfied with their care as possible during their stay.

Best Practices: Identifying patient concerns in exit interviews and post-discharge surveys is helpful, but it is ideal to identify patient concerns in real time. That way, action can be taken immediately to correct the issue while the patient is still in the hospital, which allows for the best care experience possible.

Improving Communication

Cleveland Clinic - Cleveland, OH

In 2009, Cleveland Clinic began using analytics to better understand patient satisfaction and how well the care the provided compared to other large hospitals, like Mayo Clinic and Johns Hopkins. Initial surveys revealed a problem: patients were highly unsatisfied with physician-patient communication.

To address the issue, Cleveland Clinic brought in an outside firm to conduct a robust quantitative and qualitative study to understand what their patients defined as a “good” physician-patient interaction. It was  quickly discovered that 3 concerns outranked the rest:

• Respect
• Good communication between staff members
• Employee happiness
  

This information made it possible for the Cleveland Clinic to adjust the way caregivers interacted with one another as well as patients, providing a better overall care experience.

Best Practices: Improving the patient experience can be a daunting task and sometimes the best way to get started is by consulting an outside party. They are able to take an outside look inside your organization and  determine what data to gather and which metrics to use in order to assess your organiation efforts and performance. An embedded third party can also  give direction based on observations to better  patient experience efforts, as in the case of the Cleveland Clinic.

Exploring Alternative Medicine

CHI Health Mercy - Council Bluffs, IA

Nurses at CHI Health Mercy in Council Bluffs, IA discovered that it took a long time-- approximately 45 minutes on average-- for patients presenting in the  emergency room with symptoms of nausea and vomiting to receive anti-nausea medication. To provide patients with relief quickly, while maintaining patient safety, the hospital began experimenting with treating patients with essential oils and aromatherapy until they were able to receive full care and medication.

During the trial, 52 patients were provided with a blend of peppermint, lavender, ginger, and spearmint oils, which they could sniff to relieve nausea. On average, nurses were able to get the essential oil treatment into patient hands within 17 minutes of their arrival in the ER.

Best Practices: Addressing acute patient pain and discomfort quickly and efficiently is an essential component to achieving the ideal patient care experience. When it comes to designing those interventions, it can be worthwhile to explore creative solutions.

Creating a Positive Environment

Boston Children’s Hospital - Boston, MA

It’s no secret that hospital gardens have a positive impact on patients-- countless studies have suggested that exposure to nature helps relax and restore people. That’s why when Boston Children’s Hospital had to close its Prouty Garden in 2016 to make room for a new patient tower, plans for an expansive 8,000 sqft. rooftop garden were immediately set in place.

In addition to the rooftop garden, which opened in mid-2018, Boston Children’s Hospital has plans to create 2 indoor garden spaces, an additional rooftop green space and a ground-level garden.

Best Practices: Change is constant, but it’s important to consider how even the most necessary changes impact the patient experience. Whether that means ensuring that the care experience is seamless for patients during periods of transition or ensuring that unintended consequences (such as the loss of garden when building a new patient tower) are accounted for, the patient experience is a factor that should be considered at every stage of a project.

Reducing Noise

St. Barnabas Hospital - Bronx, NY

For those who live and work in the city, noise is something that often blends into the background. However, for recovering patients, noise can be a barrier that prevents rest and increases stress, leading to lower overall patient satisfaction and less satisfactory outcomes. To address this issue, St. Barnabas hospital in New York City launched a noise reduction program, beginning with targeting its three-north unit.

As part of the program, a device called a Sound Ear was installed on each unit to monitor hallway noise levels. If staff noise levels exceed a set limit, a red light flashes to alert them. Additionally, the hospital has implemented quiet hours from 10pm to 5am and developed a relaxation kit program, which involves providing patients with relaxation tools such as eye masks and ear plugs to promote better rest.

After only a few months, St. Barnabas has reported promising results and their patient satisfaction scores are on the rise.

Best Practices: When improving the patient experience, it’s important to rethink even the most basic elements of the patient care. Hallway noise and external noise are things that are often overlooked  because they are so ubiquitous, but even these ordinary things can cause distress to patients under certain conditions. When exploring options for improving the patient experience, no need is too basic to address.

Lighting the Way

Mount Sinai Health System - NYC, NY

We know that circadian rhythms play an important role in how we function in our day to day lives, but can they also be used to improve the patient experience? Researchers at Mount Sinai Health System believe so. They have been experimenting with exposing cancer patients to bright lights early in the morning in an attempt to boost patients’ moods and help them sleep through the night.

Initial findings suggest that patients exposed to the circadian rhythm stimulating light are less likely to develop depression or see their existing depression worsen during their stay.

Best Practices: This is another great example of how essential it is to examine every element of the patient experience. Whether you are approaching patient experience from a human standpoint (following individual patient experiences via patient interviews or patient shadowing) or an experimental standpoint, it is important to remember that any part of a patient’s experience can be improved, and therefore every part of a patient’s experience should be considered.

Extending Care Beyond the Hospital

Jackson Health System - Miami, FL

What happens to patients when the leave the hospital? For many patients, the answer is that they return home to continue their recovery. However for homeless patients, the answer is not that simple.

Oliver Castellanos, a nurse for more than 30 years, observed over the course of his career that homeless patients were often released into a situation in which there were no guarantees that even the bare necessities would be provided.

According to Mr. Castellanos: “At times, all they were discharged with was the paper gown they were provided while being treated.”

Understanding that these living conditions not only put patients under stress but also increased their chances of experiencing further health conditions, Castellanos began a collection to provide homeless patients with essentials like clothing and shoes. It did not take long for caregivers at the hospital and members of local churches to help Castellanos establish a fully-stocked closet that is now used to help homeless patients meet their basic needs upon discharge.

Best Practices: When it comes to the care experience, it is worth to considering external factors. While it’s impossible to control everything that goes on in a patient’s life, there are things that can be done within the hospital environment to address external factors that cause patients ongoing stress or that put patients at risk of returning to the hospital.

In Summary

We’ve covered several case studies in which major hospitals around the nation have used a variety of strategies to improve patient experiences. To keep things simple, we’ve summarized the best practices you should utilize in your patient experience improvement strategies in 2019 below:

• Get proximal to care delivery to understand how to improve it. Use goShadow  to collect real-time patient and staff experience data.
• Identify patient concerns as early as possible, ideally addressing them during the patient’s stay
• Use a tool like goShadow to  organize data as well as to give your patient improvement strategy direction
• Explore creative or alternative solutions to patient experience concerns
• Consider patient experience in all hospital decisions
• Pay attention to even the most basic elements of the patient experience
• Think about what you can do to improve patients’ lives beyond their stay in the hospital

Keeping these case studies in mind, we hope that your team is able to take advantage of these best practices and truly improve patient experiences within your organization in the coming year!