Patient Experience Alpa Vyas Vice President, Patient Experience
Vizient Global Executive Services Consortium
SHC Mission & Vision
SHC Mission: To care, to educate, to discover
SHC Vision: Healing humanity through science and compassion, one patient at a time
SHC Patient Experience: Aspirational Vision [Do whatever it takes to]
Enable and empower patients and families to focus on health, healing and recovery
Patient Experience Pillars
Show Me The Way
Know Me Coordinate For Me
Anticipate my needs and status
to deliver effective care
Own the complexity of my
care through coordination
Guide and prompt my actions to arrive at
better outcomes and better health
Navigation Services Fouzel Dhebar Admin Director
Special Patient Services
International Medicine
Medical Center Development/Relationshi
p Management
Clinical Advice Service
Ground Navigation
Enterprise Contact Center Steven Alexander Executive Director
Radiology Scheduling
Access Operations Contact Centers
(PATH, SPARC, MD Relations)
Guest Services Call Center
UHA Contact Centers (Emeryville)
Service Excellence Mysti Smith-Bentley
Admin Director
Patient Satisfaction Feedback ,Reporting &
Deployment
Physician Coaching
C-I-CARE & Service Programs
Health Education, Engagement & Promotion
Marissa Duswalt Admin Director
Health Library
Supportive Care
Health Education
Product & Service Design
Finance & Operations Khatra Latifi
Director
Retail Programs
Music, Massage, & Art Therapy
Interpreter & Translation Services
Finance & Business Analytics
Shared Services
Patient Experience Alpa Vyas
Vice President
Volunteer Services
Includes support for the Administrative Fellows program
Patient & Family Partner Programs
Patient Relations
Prog
ram
s & S
ervi
ces
Marketing, Communications
Expansion Strategy, New Facility Planning
Busin
ess
Uni
ts
Second Opinion
ACO Integration
CareCounsel Tom Tang
Operations Director
Contact Center Operations – SHC Alliance,
CareCounsel
CareCounsel Service Excellence
Contact Center Operations – Affinity, SHC
Advantage
HR/Benefits
Client Services
6
Provide International Patient & Visitor Logistics
• 24/7/365 in-person access to services
• Information – general and health/medical
• Intake & Visas • Financial arrangements • Compliance & regulation oversight • Cultural competence • VIP Patient Services • Language capabilities in house
(10) • Referring Physician coordination • Physician record review / specialty
second opinion • High Touch Navigation Services
Develop/Maintain Long-Term Relationship for
Stanford Medicine
• Maintaining international network with patients, families, and healthcare professionals
• Liaison to hospitals, government, and business entities in selected countries to strengthen local and regional presence for Stanford
• Promoting marketing and branding effort customized for region and culture
Enhance Professional Training/Education for International Providers
• Clinical observerships including administration and faculty- driven clinical research
• Hosting on-campus visit for int’l guests (only if relevant to patient services, educational program, marketing, development, consulting /advisory services)
• Regional conferences, domestic or overseas, for training and education
Support Global Strategic Programs
• Evaluation of business opportunities (e.g. speech request, collaboration request from patient referral services and education agencies) based upon Stanford Medicine strategic criteria
• Partnering with SoM/SHC/LPCH leadership to develop infrastructure and resourcing to operationalize programs, including faculty communication, compensation model, monitoring mechanism, etc.
International Medicine Services
The Patient Experience Team at Stanford Health Care
C-I-CARE
Patient Need Access to SHC Visit/Stay Post-Discharge Home/Community • Contact Center • Navigation • Access Support • Clinical Advice
Service • Health Education,
Engagement and Promotion
• Products & Services
• Amenities • Navigation • Interpretation • Real Time Feedback • Wellness Programs • Volunteer Resources • Health Education,
Engagement and Promotion
• Products & Services
• ED Call Back • Clinical Advice Service • Patient Satisfaction
Surveys • Complaints/
Compliments • Health Education,
Engagement and Promotion
• Products & Services
• Health Education, Engagement and Promotion
• Products & Services
C-I-CARE Behavior & Communications Framework
8
C-I-CARE: Background
Program Components
• C-I-CARE practices (standard, department specific)
• Department rounding
• Recognitions
• Training & Onboarding
• Service Recovery*
• Management rounding C-I-CARE is a framework for structuring best practice communications and developing relationship-based care approaches with patients, families, and our colleagues
Local accountability
*For complex issues and formal complaints and grievances the Patient Relations team offers support and follow up for the organization
C-I-CARE: Background C-I-CARE is a framework for structuring best practice communications and developing relationship-based care approaches with patients, families, and our colleagues.
Onboarding & Training
• C-I-CARE Recruitment • New Employee Orientation • New Leader Onboarding • Training Videos • HealthStream Module • Badge Cards • C-I-CARE Practices &
Templates • Press Ganey Training
Active Daily Management
• C-I-CARE Department Rounding
• C-I-CARE Management Rounds
• Rewards & Recognition • Service Recovery • Web Application • Message of the Month • C-I-CARE Intranet Site • Press Ganey Data Analysis
Supporting Programs
• Physician Coaching & Communications Workshops
• Public MD Star Ratings • Likelihood to Recommend
Celebrations • Stanford Storybank • Real Time Feedback • Patient Experience Week • Centralized Press Ganey
Reporting & Support • Improvement Work
MD C-I-CARE Program support includes: • Advancing Communications Excellence at Stanford (ACES) Workshops • MD C-I-CARE Video • Physician Communication Coaching & Consultation • MD Star Ratings Program
Stanford Storybank
Patient Experience Week
MD Profile – Star Ratings
C-I-CARE: Leader Standard Work
• C-I-CARE in Huddles and on Vis Walls • Rewards and Recognitions (2 per month)
• Service Recovery Daily
• C-I-CARE Department Rounds (every employee rounded on once per month) Weekly
• C-I-CARE Management Rounds (1 daytime session per month, 1 evening session per quarter) Monthly
• C-I-CARE Template Refresh (2 times per year)
• C-I-CARE HealthStream Training (100% of staff) Annually
Routine & Ongoing: Sharing Message of the Month during daily huddles and posting on vis walls, onboarding new employees to department and role specific C-I-CARE expectations
Quarterly LTR Recognitions
C-I-CARE Spirit at Management Rounds
Navigation As A Service
12
SHC Navigation Model
The Complexity & Burden
Their experience often includes interactions and activities that happen before, between and after these events of care
Outpatient Emergency Department
Diagnostics & Treatments
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Events of Care
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Inpatient
Tiered Navigation Model
CLINCIAL NAVIGATION
Clinical and administrative resources that provide after-hours medical advice, inpatient discharge follow-up, emergency department discharge follow-up to patients and families 3
SPECIALTY/HIGH TOUCH NAVIGATION/CONCEIRGE
An administrative single point of contact to act as a liaison who assists in activities such as finding a physician, scheduling an appointment, facilitation of communications between and among physicians, amenities as appropriate *High-profile patients, international patients, corporate partners, etc.
2
GENERALIST/GROUND NAVIGATION
Generalist navigator based at various inpatient, outpatient and call center locations. Provides general information, courtesy visits, service recovery and amenities as appropriate 1
Reflections
• Human Glue
• Feedback Improvement
• Behavior/Communications
• Metrics – Acuity Standards/Unit of Service
• Partnerships • Operations: Access, Coordination of Care, Financial Services • School of Medicine/Faculty: Clinical Trials, Research, Global Strategy • Strategic Partnerships • Development: Grateful Patient Opportunities, Culture of Philanthropy
C-I-CARE 2.0 How do you scale?
Service: C-I-CARE 2.0
ILLUSTRATIVE ONLY
Recruitment
Onboarding
Contribution Management
Coaching & Training
Career Planning
Succession & Transition
• Clear value proposition and culture • Screening and interviewing for
service orientation and fit
• C-I-CARE overview • C-I-CARE practices for
role/department • Empathy: Through the eyes of our
patients/families • How do I personally contribute to
the patient and people experience vision?
• Rewards and recognitions • Department rounds for individual feedback • Competencies aligned to service
orientation/expectations • Moments of Truth • Proactive Responsibility • Sense People’s Needs Before They Ask
• Annual training and reinforcement
• Improvement methods & tools • C-I-CARE communications
• Alignment to patient experience vision through
leadership progression
• Transitions with respect
C-I-CARE 2.0 Awareness/Recruiting Onboarding Contribution Management Coaching & Training
Enterprise (T5/4) • Clear value proposition around mission, vision, strategy
• Employees are custodians of the brand and work to deliver the brand promise
• Service orientation assessment • Culture/C-I-CARE acknowledgement • Staff stories/Storybank • C-I-CARE expectations in all job
descriptions
New employee orientation • “Delivering the Stanford Difference” or “Being
Uniquely Stanford "program • C-I-CARE overview – service culture at SHC • Empathy: Through the eyes of our
patients/families • Name badge refresh
New leader orientation • How to deliver feedback, importance or
rewards and recognition • Translating organizational goals to your area • Incorporating service rituals
• Reporting of organizational performance in management meetings
• Rewards and recognition • C-I-CARE Spotlight Award • Physician Award for Excellence in
Service • Annual employee awards celebration
• Annual HealthStream training • C-I-CARE Management Rounds • C-I-CARE Message of the Month • Annual SHC Patient Experience
Conference/Collaborative
Department (T3) • Clear articulation of how department contributes to patient experience goals
• Welcome and reinforcement of department goals and contribution to patient experience from department leader
• Reporting of departmental performance • Service rituals
• Sharing patient comments, feedback, stories
• Performance improvement activities
• Tier 3/Tier 2 leader linked check-ins/rounds
Business Unit (T2)
• Hiring managers trained in behavioral interviewing
• Clear reinforcement of roles/expectations
• Clear articulation of how department contributes to patient experience goals
• C-I-CARE practices for role • Practices • Behaviors • Words that Work
• Role specific training completed • Demonstration and modeling of excellent
service (see one, do one, teach one)
• Reporting of business performance • Design role based competencies for service
orientation/expectations • Service rituals
• Sharing patient comments, feedback, stories
• Performance improvement activities
• Rewards and recognitions • Department rounds for individual
feedback • Competencies aligned for service
orientation/expectations
Individual (T1) • Assess personal culture fit to that of Stanford Health Care
• Commit to service culture
Commitment to Organization: I personally contribute to the patient experience every day through _____.
• Monthly department rounds and feedback • Monthly department rounds and feedback
Relationship-Centered Communication Programs
at Stanford
The Physican Partnership Program
Establish a shared model of communication amongst all physicians and APPs at Stanford Health Care.
Improved Likelihood to Recommend Care Provider
Heightened Physician Wellness (i.e. burnout, professional fulfillment, self-compassion)
Measurable Self-Reported Behavior Changes (measured longitudinally)
Create a relationship-centered culture at SHC to improve the well-being of our patients and providers.
Available to all Stanford Physicians, Trainees, and APPs
Facilitated by 12 Stanford Faculty & Staff 1:6 ratio of facilitators to
participants One day – 8 hours long Free for all providers to attend Interdisciplinary Establishing a shared provider
communication framework at SHC
ACES Workshops Are… Work to Date
ACES is a foundational, evidence-based workshop designed to help clinicians advance their fundamental communication skills with patients, families, and colleagues.
Advancing Communication Excellence at Stanford ACES
Inclusion in Funds Flow reimbursement
61 workshops completed (since Sept. 2017) 636 providers attended 124 providers registered to
attend 20 additional workshops
scheduled (through Feb. 2019) 91% Likelihood to Recommend
ACES to a colleague (n=319)
Testimonials From ACES Participants
"ACES helped me learn more communication skills than I have in my 30 years of practice.”
“I took the ACES course yesterday and I wanted to congratulate you on a really great experience. The openness and shared learning, not just about patient communication but about each other, was really a gift. How often do we get a chance to reflect, introspect, learn and practice something that we normally rush through the same way every day? The course structure was very helpful, and the focus on specific skills and “words that work” was very effective. I learned a lot, and made some new friends in the process. Right after the class, I made an old fashioned house call, and I practiced the skills I learned, and I’m pretty sure it made a difference. Thank you.” Sang-ick Chang MD, MPH Associate Dean for Clinical Affairs
"I thought this degree of communication would slow me down, but now I realize it makes me more efficient.”
*Testimonials were collected anonymously unless otherwise noted.
ACES Outcomes
Decrease in Interpersonal
Disengagement and Burnout
Improved Self-Reported
Communication Behaviors
Increase in Compassionate Self-
Improvement
Increase in Professional Fulfillment
*Calculated using data from Pilot Workshops (Sept. – Nov. 2017). Data collected 1 week before and 3 months after attending ACES. N = 37.
After attending ACES, the following statistically significant improvements were observed in Physicians and APPs*…
p=0.02, n=37
p=0.01, n=37
p=0.01, n=37
p=0.003, n=37
Summary & Next Steps
SHC Patient Experience: Aspirational Vision [Do whatever it takes to]
Enable and empower patients and families to focus on health, healing and recovery
Patient Experience Pillars
Show Me The Way
Know Me Coordinate For Me
Anticipate my needs and status
to deliver effective care
Own the complexity of my
care through coordination
Guide and prompt my actions to arrive at
better outcomes and better health
Summary & Future Work
Show Me The Way
Know Me Coordinate For Me
Anticipate my needs and status
to deliver effective care
Own the complexity of my care through
coordination
Guide and prompt my actions to arrive at
better outcomes and better health
• Implementing core behaviors and principles of C-I-CARE 2.0
• Designing the digital experience for specific archetypes
• Reimaging patient/family experience measurement
• Leveraging technology beyond traditional CRM
• Implementing core behaviors and principles of C-I-CARE 2.0
• Developing caregiver support programs and services
• Leveraging technology to enable and engage patients/families in their care
• Implementing core behaviors and principles of C-I-CARE 2.0
• Focused operational improvements on response times, access
• Continued trials of care navigation models in oncology
• Leveraging administrative and clinical contact center capabilities
THANK YOU
Questions?
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