The Importance of Connection

On the Road at Newport Beach Regional Roundtable – November 2013

The Beryl Institute’s Regional Roundtable series remains a central component of our efforts to support and reinforce the power of connection, collaboration and sharing of ideas. These concepts are central to an effective community of practice and have been our commitment at the Institute from our beginning.

The November 2013 Regional Roundtable in Newport Beach and hosted by Hoag Memorial Hospital Presbyterian was our largest regional gathering to date and exemplified the power of sharing even among competitors. Healthcare systems and organizations from up and down the West coast gathered to engage in a critical dialogue, hear from expert thinkers and learn from one another. The warm southern California day was overshadowed by the connection among the participants themselves.

This November’s event featured two powerful keynote presentations and an exciting redesign of the working session to engage participants in addressing priority issues impacting patient experience improvement. Our first speaker, a rising leader in the provision of patient experience solutions, Anne Mendoza of Baptist Leadership Group, was also the very first Institute Patient Experience Grant Program recipient in 2010. Our closing keynote was Joseph Michelli, the New York Times bestselling author, speaker and consultant whose work focuses on customer-centric organizations both in and outside of healthcare.

The intention of Regional Roundtables continues to be that through collaboration, the sharing of ideas and a focus on action we can accomplish great things for our healthcare organizations and for the patients, families and communities we serve. The lessons learned, ideas shared, plans developed and connections made in Newport Beach exemplify all that is key to patient experience excellence. This is fundamental to the community of practice we have created through The Beryl Institute and more importantly a key to lasting improvement and sustained success.

Implications for Individual Leadership
Anne Mendoza opened the roundtable with an insightful and practical look at the importance of lighting our own fires as leaders in healthcare. With a powerful metaphor of climbing a mountain, Anne helped us recognize the critical steps in fulfilling our purpose in organizational life and focusing on clear outcomes. In reinforcing the importance of engagement and analyzing the key areas of focus to driving engagement in organizations, Anne drove home the point that it takes not only personal engagement, but also the ability to engage others in our organizations that supports success.

Anne also stressed the importance of accountability, a concept that rests at the core of effective patient experience execution. It is something many struggle with and continues to be raised as a roadblock to accomplishing objectives. Anne framed accountability as an intention and personal choice and something we need to find in ourselves, rather than enforce in others. This leads us back to her point that in identifying engaged people they are most often already wired with a focus on accountability.

Anne also provided attendees with practical tools to focus on developing a personal leadership plan. By understanding what is important to you as an individual and a leader you can make strong choices and move towards clear objectives. The conversation of leadership is important as we consistently find leadership at all levels to be a fundamental component of overall patient experience success.

Getting into Action: Overview of the Working Group Session
Staying true to the primary purpose of the working session, a redesigned process was used to connect participants and engage in active dialogue on critical patient experience issues. The session began with participants brainstorming a list of the current issues they are facing in their organizations and prioritizing the topics of greatest interest to explore more fully. The brainstorming and prioritization activity resulted in the identification of 6 areas, which included: accountability, sustaining efforts, physician engagement, employee engagement, culture and voice of the patient.

The framework used to dig deeper, share ideas and come away with new insights was in the spirit of a world café format. The power of the world café is fostering authentic conversations and knowledge sharing among people of varied backgrounds and experiences on conversations that matter. Through three rounds of dialogue, each participant was able to explore three different topics of their choosing and spend time networking with a variety of people in attendance. Having a table host taking the responsibility of recording the conversations from each round and building upon what was shared in the previous round gave the advantage that all were able to hear a summary of all topics discussed. Below are headlines from those conversations.

Accountability is a topic that often rises to the top of the priority list for discussion. With several organizations weighing in on ways they are addressing accountability, it is apparent that there are some key strategies being used, but they are being modified based on an organization’s culture. Two key concepts discussed in greater detail included the importance of connecting to purpose and recognizing employees both as a means of sustaining a culture of accountability. The strategies used at many facilities to drive these concepts include rounding (leader and patient) and surveying of both patients and employees. Part of this discussion was also on how the use of different technology has increased the consistency and accountability with these efforts. In closing, an interesting and key idea that emerged from the discussion was accountability for service should have the same level of importance as accountability for patient satisfaction scores.

Sustaining/Hardwiring efforts can be more challenging than the initial implementation. Finding a way to sustain and hard wire processes begins with setting clear expectations, goals and deliverables as well as making sure that staff are aligned on what these are and why they are important. Before the processes can be “hard wired” in place, the process and behaviors must be set up and defined. Once they are in place, consistency is the next step. A common theme that arose from the conversation was the role of leadership as being key to sustainability. As with accountability, the discussion focused on the importance of leader rounding. Through rounding, leaders are able to identify staff recognition and coaching opportunities. Another important role of leaders is ensuring staff has what they need to be successful. If there are barriers or obstacles to completing the process, it will be very difficult to consistently deliver on the expected behaviors. Rounding can be used to identify these roadblocks and explore solutions.

Physician Engagement and partnering with them on patient experience efforts is top of mind for the organizations represented at the Regional Roundtable. It was exciting to have physicians present and participating in the conversation and sharing their perspective. Evident by the discussion is that many physicians want to be engaged as partners in the patient experience. One suggestion in getting their involvement is to simply seek out their opinions and listen to their ideas. They want the same consideration that would be given to other front line staff. Another successful strategy commonly used is to identify physician champions and engage with them. Ask them to be physician coaches and mentors to other physicians. Have them sit on physician panels, lead in-service training and do physician rounding. Organizations are also supporting their physicians by providing training. Understanding that learning doesn’t stop in medical school, organizations are bringing in facilitators and trainers to teach communication skills and exploring the many ways to successfully interact with patients, families and staff. Creating positive working environments and physician partnerships can lead to higher levels of physician engagement that many organizations are seeking.

Employee Engagement continues to be a topic of interest in the focus on improving patient experience. One key theme that came out in the discussions was the need to find a common thread or platform for employees to unite behind. Whether it’s the organization’s vision, mission, values or something else, having that commonality is a key driver to success. Some ways that organizations are working to reinforce that commonality is through employee orientation programs. One organization talked about their “90 Day Welcome Back” program where they bring employees back after 90 days from their hire date and facilitate a 2 hour meeting revisiting the organization’s mission and purpose. This day serves as a reengagement and helps employees reconnect to the purpose of the organization. Daily huddles are another tool organizations are using. In the huddles, employees take advantage of the time to explore any roadblocks they are facing and discuss solutions to effectively handle these situations. In these five to seven minute huddles, employees may also share a “wow” story as a way to motivate others around them. Organizations are discovering that finding opportunities for employees to connect to purpose and share their stories is a powerful way to keep all engaged in the positive impact they are having on the patients they serve.

Culture as a key factor in shaping interactions that impact patient perceptions is identified in The Beryl Institute’s definition of patient experience. Roundtable participants clearly agreed that addressing organization culture is a crucial step in improving overall patient experience. Having strong leadership support was identified as the most important factor in building a desired culture, followed by engagement and accountability. Leaders need to model compassion, build trust, get to know staff and be seen working in the trenches with their teams. Staff members want to feel supported and work in a transparent environment, so having clear expectations is extremely important. Staff must feel empowered to do what they need to do to create sacred moments for patients and families. One way to model this is in encouraging staff to take care of themselves and their peers. That mindset will overflow onto patients. Reminding people why they got into healthcare in the first place and using that passion to inspire them to be their best and to personally connect to the why. Leaders need to be willing to assess culture on an ongoing basis to determine what should stay and what should change. Some organizations have found success in adding culture-related questions tied to company values to annual performance appraisals. Others simply stated that you will know you’ve achieved the desired culture when staff is self motivated to do what’s right and/or when they’re doing what’s right when they are not being observed.

Voice of the Patient everyone agreed is a critical component of the work that is being done. The challenge is that while we are hearing the voice of the patient in a variety of ways are we really listening and responding to what they are saying. The data gathered through surveying and other tools is important but making an emotional connection to a patient through his or her own stories can be more impactful than looking at a scorecard. In addition, the patient voice is not just spoken. There are also the unspoken cues and body language that can convey important information. Learning to recognize and read those cues can be a challenge and so we learned, that organizations are realizing the value of educating staff on recognizing nonverbal cues. Another practice used in many facilities is always asking patients, “What is your concern today?” It was recommended that in the inpatient setting, this question should be asked every day as it can change based on the patient’s current experience. And finally, it was encouraged to “listen to their own” and seek input from employees and their family members who have been patients. They are a great resource for feedback.

An Outside in Perspective on Patient Experience
Joseph Michelli engaged participants with an informative and emotionally compelling story of the importance of our work. He opened by declaring “I am proud of you”…for the work you do is noble and the commitment taken on in healthcare is significant. He shared a new perspective that for as much as healthcare has relied on outside industry for its ideas, it is other industries that are now turning to healthcare for the cutting edge thinking in service improvement. Joseph outlined four key points in which we suggested it was critical for participants to focus on in their efforts to create an unparalleled experience. They included talent selection, culturally relevant service templates, storytelling excellence, and connecting metrics to the purposeful.

In highlighting his suggestions consider the following:

• Talent selection: Organizations looking to create the best in experience must start not with process or tools, but with the people who deliver at every point of interaction. Selecting talent is perhaps one of the most strategically critical aspects of performance success. Start with the right people and the path forward gets much easier to execute.
• Culturally relevant service templates<: When designing service plans, the generic will not do. You cannot pull a model off the shelf and apply to any setting. Rather it is the creation of processes that meet the nature of your organization, the people that comprise it and the population you serve that will provide you the best road to success.
• Storytelling excellence: There is great power in the sharing of stories. Stories provide a compelling means for shaping how people experience your organization. It is also in understanding the stories of your customers and the community you serve that allows you to plan and execute more effectively.
• Connecting metrics to the purposeful: It is often said what gets measured, gets done. The reality of this idea is that if you want to have a meaningful impact, metrics need to be more than targets, they must be tied to what you are trying to accomplish to the greatest end. How does your mission and purpose shape your work, and how do your measures ensure an unwavering focus on these objectives? That may be the most critical question in focusing and reinforcing action in your organization.

Joseph’s message was clear and focused, passionate and personal. He concluded with a challenge to the participants that they have a great opportunity to make a significant impact in their work. Be clear about clarifying, declaring and living your purpose, he urged. It was clear Joseph was doing just that.

For those wanting a chance to hear more from Joseph Michelli, we encourage you to join The Beryl Institute for Patient Experience Conference 2014 next April where Joseph will be speaking on Patient Experience Excellence – The Balancing Act of Why and How.

Concluding Thoughts
As Regional Roundtable Newport Beach wrapped up the participants walked away energized. They carried with them renewed energy around defining and living their roles as leaders. They made new connections that lead to the sharing of powerful ideas across some of the most critical issues impacting the improvement and sustained performance of patient experience. They were inspired to know that with a clear purpose and path, the possibilities for experience excellence were wide open. Most importantly they realized that there remains great power in the gathering of hearts and minds to work on this critical issue – of improving the healthcare experience for those in all of our facilities, organizations and systems.

With this shared purpose and commitment, new friendships were established, old connections solidified and the potential for new and stronger outcomes expanded. Regional Roundtables remain an in-person model for all we hope community members and guests gain from engaging in the Institute every day. In knowing that as a community of practice, we all gain from the contributions of others and what we offer are true gifts.

Our thanks to all who engaged in the event and we hope to see all of you at an Institute gathering in the near future.