For the past five years, the Service Excellence program at Yale-New Haven Hospital has provided a framework that has allowed employees to improve how they care for patients and families, welcome visitors, and support one another as they create a positive experience for the thousands of inpatients and outpatients the hospital sees each year.
The fruits of the labors of Service Excellence were evident in last year's patient satisfaction scores that translated into a successful PIP payout for employees. But well before the final results were published, YNHH was at work on taking Service Excellence to the next level and that next level is called the Patient Experience.
Patient Experience focuses attention on the patient and family and builds on the important foundation laid by Service Excellence and the Service Excellence pledge, which recognizes and honors employees, physicians and volunteers who live the pledge in their daily work lives. Patient Experience also relies on the work of committees like the Quiet Committee, which is charged with developing ways to help employees provide a quiet, healing environment for patients.
Physician engagement This year, Michael Bennick, MD, was named the first medical director for Patient Experience. "At Yale-New Haven, the patient must be the center of our attention," said Dr. Bennick, who works closely with chiefs and chairs to deliver the Patient Experience message to physicians at all stages of their careers.
"We must create and maintain a healing environment where the patient and the family can flourish, and that takes doctors, nurses and others who must re-commit to the patient and the experience they have here."
Dr. Bennick engages medical leadership in the work surrounding the Patient Experience and has been joined in that effort by Peter Schulam, MD, chief, Department of Urology, other medical leaders and the Graduate Medical Education Committee. They are creating training programs to improve the skills of residents in developing positive relationships with their patients.
The building blocks to Patient Experience Patient Experience expands on Service Excellence and reinforces new skills. In 2011, every YNHH employee heard first-hand about Patient Experience and took a required class on HealthStream.
Employees learned about the AIDET model (acknowledge, introduce, duration, explanation, thank), the 10/5 rule (eye contact within 10 feet of a person and a greeting when within five feet), and no venting where a patient or visitor might hear it. Patient satisfaction scores as recorded by Press Ganey and HCAHPS improved in the past year.
"Patient Experience is our approach to patient- and family-centered care — across the continuum of care," says Jeannette Hodge, director, Patient Relations, Volunteer and Guest Services. "In ways large and small, each of us contributes to the patient experience and each of us is responsible for ensuring that it is an exceptional experience."
Hodge and Dr. Bennick point out that a close relationship exists between an emphasis on the patient and safe, high-quality results.
"The Patient Experience is more than making patients happy," said Dr. Bennick. "It involves including the patient in all aspects of his or her care and communicating in ways that will help them heal.
"When you focus on the patient, you will make sure that you discharge him with the correct prescriptions and proper safety instructions so he will recover successfully upon discharge," said Dr. Bennick. "If patients don't understand their medications, for example, they won't comply and that impacts negatively on their experience at this hospital."
Introducing Patient Experience on Saint Raphael Campus As the Patient Experience executive sponsor, Cynthia Sparer, senior vice president, Operations, and executive director, Yale-New Haven Children's Hospital, is responsible for expanding Patient Experience on both campuses. In January, Saint Raphael Campus employees will begin to get the same training that their York Street colleagues received. "We will bring the tools of AIDET, 10/5 and no venting to SRC and will refresh it as needed on York Street," said Sparer. "We will introduce leader rounding with purpose — which is a highly effective way to surface issues and find solutions that advance the patient experience — on Chapel Street as we have done on York Street.
"In addition, attendings and residents on both campuses will participate in training programs designed to provide positive outcomes for their patients," pointed out Sparer. "We are extremely fortunate because we have highly engaged physician leaders who are committed to improving the Patient Experience."
Shhhhh …. big push for quiet in 2013 On Press Ganey and HCAHPS, patients are asked to rate the environment of their care while hospitalized at YNHH. Remaining focused on providing a quiet, clean environment will help improve how patients rate the cleanliness and quietness of their environment. Patients comment about the noise created by staff conversations in patient care areas, as well as the noise created by TVs and visitors. Medicare now compensates hospitals on how their patients rate their environment and publishes those scores.
"We are re-doubling our efforts on both campuses to remind employees to use ‘library voices' throughout the hospital and to refrain from personal conversations near patients," said Hodge. "The hospital is a place of healing for our patients and we are responsible for creating that healing environment." From the first moment of contact, Patient Experience
"Ensuring an exceptional patient experience for each of our patients is a tall order. We have many patients and some must have multiple encounters with our hospital," said Sparer. "We have the structure in place to fully engage our doctors, nurses, clinical and non-clinical staff. I am confident that we will see gains throughout the hospital this year as we focus on our patients and the issues important to them."