Culture & Leadership

A System Commitment to Improving Patient Experience

On the Road at the Dignity Health Patient Experience Summit – March 2013

by Jason A. Wolf

Actions Do Speak Louder Than Words

In my travels and conversations with healthcare leaders, I often “hear” how important patient experience is to their efforts. “Of course it is a focus of all we do,” one leader might say; while another shares, “Patient Experience is key to our organizational strategy.” These statements are in fact incredibly encouraging in the face of competing demands and the continuous decisions around priorities healthcare leaders must make. But we must also recognize while these are exciting words, what remains to be seen all too often is the commitment to true focus and action.

This operational leap of faith, from saying what might be important, to literally turning words into action was what brought me to my latest On the Road visit. It is a unique story in that this is not about a review of practices implemented or challenges overcome which have shaped the generous sharing and incredible learning of previous visits. This On the Road exemplified a big, bold action taken at the system level to reinforce a commitment, educate a workforce and inspire (and encourage) them to action. Yes, to be cliché, this On the Road is about actions speaking much louder than words and the opportunity and challenge that effort still poses for healthcare organizations.

A True Commitment

I had the opportunity to participate in (and in full disclosure, speak at) the Dignity Health Patient Experience Summit this month in Las Vegas. As I share the story with some, the first question I often get is what do you mean by Summit. What Dignity Health committed to and (having been part of a few conference planning scenarios myself) executed near flawlessly was a true system-wide patient experience conference. If no other lesson is learned from this story, one to remember is the true investment in its people Dignity Health made to bring over 400 people together from across their entire system to not just be talked to by leadership, but to truly learn from one another. And perhaps most impressively the attendees were not executives or directors being told to make patient experience a priority in their work. The participants at the event were the front line nurses, the direct caregivers, and yes the executives and leaders who together drive strategy and execution to impact patient experience.

Tracy Sklar, SVP Quality, Sandra Rush, Director, Patient Experience, and Laurie Schwartz, Ministry Transformation CoordinatorThe team at Dignity led by Tracy Sklar, SVP Quality, Sandra Rush, Director, Patient Experience, and Laurie Schwartz, Ministry Transformation Coordinator, (pictured left) and supported by many other volunteer leaders from across the system, created an event that was on par with any other professional conference I have attended, but this one was all for them. I had the chance to choose my table for the first general session and sat with an incredible group of nurses from labor and delivery units and the NICU who were being given the chance to connect with their peers across the system to share, but just as importantly were being exposed to leading thinking and provocative keynotes to stimulate and evoke new ideas and greater commitment. One of the nurses shared with me that she had never in her long career felt such a sincere commitment to learning or a statement of the importance of a strategic priority made by a healthcare organization. I could see why she felt this.

Beyond Learning to Mission

What the team at Dignity Health did in bringing together the more than 400 people in attendance was to go beyond learning to clarifying and reinforcing their commitment as a system. Tracy Sklar opened the event by explaining the distinction of this first of its kind event at Dignity Health and outlining the unique nature of the program. It was the largest gathering ever of nurses at Dignity Health and the first to include an extensive number of patient and family advisors not only as attendees but as presenters and panelists as well.

In her opening, Tracy also reinforced the critical importance of experience overall not just from the perspective of the right thing to do, but also for its influence on quality and the associated financial implications of providing the best in experience. Another key word that emerged for me in observing this event was the strength of candidness and transparency. Tracy shared the great successes and also exposed those areas where Dignity Health needed to continue to focus. This raw honesty was received with a powerful sense of respect and among the nurses with whom I sat I could see they took it as a challenge and an opportunity to continue to try to find ways to constantly improve.

Dignity Health President and CEO, Lloyd DeanThis commitment to openness to ideas, to shared learning and to a commitment to act, was punctuated by Dignity Health President and CEO, Lloyd Dean (pictured right). He opened the event by stressing the importance of patient experience to all that Dignity Health does, saying, “Patient Experience is one of the greatest and best investments we as a system can make.” But perhaps reinforcing the power of moving beyond words to action, Mr. Dean shared his own patient experience story contrasting a positive and negative encounter he recently had, making the point and raising the challenge that a poor patient experience was not just something to address, it was something that should not, and as he stressed would not happen at Dignity Health. The message was received with rousing response.

A Program for Action

But more than just hearing from leaders who many on the front line would expect to stress the importance of these issues, the team at Dignity Health put together a powerful and comprehensive learning program, bringing together 4 keynotes and almost 20 breakout sessions over the two day event. Keynotes including e-patient Dave (Dave deBronkart) reminded the group “patient is not a third person word” and reminded the caregivers in attendance to “let patients help.” Britt Berrett, President and CEO of Texas Health Presbyterian Hospital, talked about the power of culture and creating the right environment as the true foundation on which effective patient experience efforts can be built. Dr. Jim Merlino, Chief Experience Officer at Cleveland Clinic reminded the attendees, “Patient Experience is not just everything, it is everyone!” But beyond these keynotes were numerous sessions that provided for the sharing of industry expertise, the opportunity to hear the voices of patients and family advisors, and the space to disseminate proven practices from within Dignity itself. What was evident in all the learning I observed was that it stirred a sense of excitement, of energy and of action. The sessions, each facilitated by a member of the Dignity Health team, were not simply knowledge dumps, but were structured to provide for discussion about “what’s next,” about how the learning itself would be used.

Putting a Plan in Place

A critical element of this event and what made it stand out to me among others that I have seen attempted was a portion of the program just prior to close where all members in the respective service areas of Dignity Health were brought together to share what they learned, discuss key takeaways and ultimately determine the top items they would address upon returning to work to impact and improve the patient experience.

These regional sessions were led by the operations leaders and executives. They were framed by sharing the real data of how each region was performing down to the facility level. Again transparency was at play, not to chastise or punish, but to set the stage for collective commitment and action. The regional groups then set out in smaller subsets to determine key learning, determine top priorities for action and report back to the larger group. The energy in these sessions was palpable and the sense of possibility was tangible as from front line nurse to executive these teams translated the learning and shared ideas from their time together at the event into clear and tangible plans. The outcomes reflected what the individuals had learned over the course of the Summit, and it was clear they were working to translate learning into action.

Dignity Health Patient Experience Summit

In summing up the efforts and the event overall, Dr. Robert Weibe, EVP and Chief Medical Officer of Dignity Health reinforced the message that the event was not just for learning, but about “how we take actions back and act on them immediately.” He stressed the plans and the overall intent of the summit was to move to focus, action and accountability. He reinforced this as he closed. With a clear and focused statement he looked squarely at the participants and stressed, “We all have to own the patient experience!”

The Impact of Opportunity

While this story is not on specific practices, I think it bears great consideration as an exemplar of a power commitment and yes, investment in what it means to improve the patient experience. Dignity Health did not just push down the required practices for improvement or the checklists of specific actions. They instead saw the opportunity for engagement, conversation, planning and movement. The Dignity Health Patient Experience Summit exemplified all I have ever stressed about patient experience being not an initiative, but an essential component of any healthcare organization’s very existence. That might seem a big task, but I believe those in attendance those two days in Las Vegas would say it is an effort worth taking, especially when they see the investment and commitment their organization is willing to make for them.

Page West, Chief Nurse Executive of the Greater Sacramento/San Joaquin Service Area of Dignity Health, added that the hidden benefit of the event was not just the clarity and reinforcement of priorities, it was that the event “reconnected us to what we are here for, the patient. It reengaged our teams around the passion we bring to this work.” Page added that “the commitment in both the clear investment to produce the event and the various levels of people in attendance reinforced this is and will be a priority for us. The commitment also reinforced that the patient is at the center of all we do.”

Natasha Meineckie, Patient Experience Coordinator also shared how the event “showed where the real commitment to patient experience is and how important it is to the organization.” She expressed great hope that the event was just the first step in a reinvigorated effort to grow performance, improve outcomes and ultimately stay the course.

This message was also shared by the team of nurses with whom I sat during the general sessions (pictured left). After I joined them on day one we found ourselves sitting together over the course of the Summit. As we learned more about one another this incredible team of front line nurses, managers and directors seemed energized, but perhaps what I also saw was a great sense of encouragement. The commitment made from leadership at Dignity Health, the investment to ensure these individuals learned and knew what was important, truly touched them. They shared their honor in being invited and their excitement to learn. While I could not interact with all 400 people, I can say that they hung on to the very close where they were challenged again to take their learning back and make something happen regardless of role they played, the organization in which they worked or the circumstances they faced. As Sandy Rush, Director, Patient Experience summarized, “The patient experience is the core of what we do at Dignity Health, and the Summit was designed to reinforce the importance of the patient and family experience.”

What the team at Dignity Health exemplified was a bold new action in improving patient experience. That it takes a systemic commitment, whether in a practice, an individual facility or a multi-organizational system. If there is a commitment to learning, to providing support for action, to transparency of reality and of accountability for results, then great things are possible. I know that is what the team at Dignity Health is striving for. They took very powerful and bold first steps. One from which we can all learn. I wish them all the best on the journey.