Back on the Road, Virtually

On the Road with University of Chicago Medicine, Virtual – December 2020

by Stacy Palmer, CPXP and Terri Ipsen, CPXP

We began our On the Road program over 10 years ago, just after establishing The Beryl Institute as a membership organization, as a means to highlight challenges and successes in driving experience excellence. The series offers a virtual guest pass to leading healthcare organizations through feature stories shared with our patient experience community. The program also serves as a valuable connection for our team at the Institute to our members and to the incredible work happening in the field every day.

Since 2010, we have been invited into over 80 organizations around the world. The feature stories from each often begin much like a travel journal, as we have been fortunate to physically visit each of these organizations, walking their halls, meeting their staffs, eating in their cafeterias, and soaking in both their environments and cultures. These visits were highlights of our work and much anticipated experiences for our team members.

With the challenges brought by the global pandemic this year, we reevaluated the program as travel was restricted and healthcare organizations began limiting visitors to control the spread of the COVID-19 virus. However, as 2020 reinforced in many ways, much can be accomplished through virtual connections. We are, after all, a virtual organization and community at The Beryl Institute, and we are thrilled to share with you our virtual On the Road, marking the first fully virtual “visit” and feature story.

A Virtual Visit to The University of Chicago Medicine

We are excited to highlight The University of Chicago Medicine (UChicago Medicine), a long-time organizational member of The Beryl Institute that has demonstrated a very thoughtful approach to addressing COVID while continuing to live out their values. UChicago Medicine is a not-for-profit academic medical health system based on the campus of the University of Chicago in Hyde Park, with hospitals, outpatient clinics and physician practices throughout Chicago and its suburbs. We connected virtually with members of their Patient Experience & Engagement team to learn about their overall experience philosophy and evolving approach during the pandemic.

Kicking off our series of virtual visits was a meeting with Sue Murphy, Chief Experience Officer at UChicago Medicine and member of the Institute’s Experience Leaders Circle. Under Murphy’s leadership and by leveraging key partnerships from departments throughout the organization, UChicago Medicine’s Experience team oversees Patient and Family Insights, Experience Improvement and Innovation, the Friends and Family Destination Medicine Program, Discharge Care Call Center, Screening Checkpoints and Patient Education.

Murphy shared that UChicago Medicine’s approach to the pandemic was not just about COVID, but about amplifying the continued need to “magnify the importance of our core belief, that patient care is at the center of what we do and continue to shine a light on the impact and importance of bringing empathy and caring to everyone every day.” Her team quickly reinforced the importance of taking the time to have conversations around empathy, caring and compassion, not just with patients, but with staff. “The actual way staff showed up every day was more important than ever for the care of the patients, whether it be remotely through telemedicine or inpatient experiences,” said Murphy.

Another foundational element shared by Murphy is that all leaders within the organization understand, own and influence. “It’s about bringing awareness of everyone’s way of being to how they create exceptional experiences,” referring to their focus on cohesive collaboration to make sure everyone has their mind and heart on the experiences of both our patients and the staff.

Even prior to the pandemic, inclusion and engagement with staff was a primary focus for UChicago Medicine’s Experience team. But with the onset of the pandemic, the team gained influence by inserting themselves throughout the organization and keeping the focus on experience present and relevant. For example, Murphy attributes much of the overall experience success to the integration and partnerships that were formed, including having a seat on the COO’s Operation Council and integrating experience into management daily huddles and on everyone’s huddle boards. This partnership model fueled much of the team’s opportunity to influence and contribute during the pandemic response.

Murphy acknowledged a partnership between the Patient Experience team and the Operational Excellence department as a breakthrough that further integrated UChicago Medicine’s leadership approach to cultivating an improved organizational culture. “We look at process improvement together with the Patient Experience,” she shared, explaining how their focus on improving operational efforts includes helping team members show up the best way they can every day. This foundational value was reinforced in each of our virtual interviews with the team and is embedded in the practices highlighted throughout this story.

Strengths-based Leadership: A Return to Purpose

A cornerstone of UChicago Medicine’s experience efforts, both during the pandemic and before, is the hArt of Medicine®, a program designed to create a positive and personal human interaction that sets the stage for an organizational culture fostering exceptional healthcare experiences for patients, families and caregivers. UChicago Medicine introduced the program over five years ago with a series of workshops to improve communication and create empathetic relationships. The strengths-based approach has resulted in a culture transformation that has changed the way staff show up each and every day to work and how they do their work.

“I believe everybody has the capacity to change a world,” said Diane Rogers, CPXP, Founder and President of Contagious Change LLC and developer of the hArt of Medicine® program. Through the workshops, Rogers encourages people to “turn their observers on,” to see the difference they are making, which generally is the reason why they went into healthcare. Turning observers on helps reinforce how impactful their work is and why it matters. “By bringing their hearts into it, they find joy and a return to purpose, which leads to better patient experiences.”

Not long after the pandemic began, the workshops transitioned to virtual town halls bringing together leaders across the organization. The gatherings are focused not just on how to take care of their patients, but how to take care of themselves and their teams. “We decided that it is even more important now that we cultivate our culture to create those exceptional experiences every day,” said Murphy. The town halls focus on three phases of how leaders show up for work: how they show up for themselves; how they show up for others; and how they collectively show up for each other. “It’s been really successful; we’re getting more participation, and people are understanding the why.”

Rogers partners with Steve Perkins, Manager of Patient & Family Insights to deliver a virtual orientation program to welcome and care for new nurses coming into the organization. The goal is to create a powerful self-awareness around how these caregivers bring their magnificence or best self forward in their patient interactions to create exceptional experiences for their patients. “I think it really creates ‘aha’ moments for these nurses for them to see how they elevate the human experience,” said Perkins. He highlighted an exercise where participants are asked to close their eyes and reflect back to a moment where they were able to create an exceptional experience for a patient and go into detail about what that looked like. “It is really eye-opening, not only in how they positively impact the patient experience, but also the positive effect the patient can have on them.”

Perkins shared that the experience energizes the new team members and sends them forth to the floors enthusiastic, appreciative, and ready to practice the techniques discovered and reinforced in the workshop. “You can see that the learning sustains itself, even weeks after the workshop has ended. Our hope is that this newfound awareness becomes so contagious that they bring it back to their units time after time.”

Similarly, UChicago Medicine offers a Leading hArtfully® program to orient new leaders into the idea of “how you show up is how they show up” to influence the organization’s culture and performance. Participants are invited to adopt a coaching mindset that values and respects each individual as unique and capable, believing that everyone has the capacity to be and do their best.

“In healthcare, we have done an incredible job in squashing visibility to the impact individuals make just by being who they are,” said Rogers. “In this workshop, we work really hard to help people see the magnificence within themselves.” She pointed out that ‘magnificence’ combines the words magnify and essence, and she defines it as ‘the quality of magnifying the essence or intrinsic nature (that which is within) of an individual or experience’.

From Rounding to Creating Conversations: Virtual Care Rounds

UChicago Medicine refers to rounding as Creating Conversations to reinforce the intention when connecting with patients. Pre-COVID, UChicago Medicine, like many other healthcare institutions, implemented in-person leader rounding that focused on understanding and improving patient experience. Creating Conversations asks questions, such as How has your stay been? What else can we do to ensure you understand your plan of care? What staff would you like to acknowledge?, to invite a dialogue between the patient and the leader.

When the institution experienced an increase in COVID-19 cases, UChicago Medicine shifted practices to heighten the awareness of safety for its patients and employees. This shift prompted UChicago Medicine to limit in-room leader rounding and the number of visitors entering the patient rooms. The Experience team immediately recognized the negative impact this had on the patients’ experience and their well-being. We met with Sunitha Sastry, Director of Experience Improvement and Innovation, who explained the pandemic’s impact. “Our patients were here all alone, anxious, with limited human-to-human connection,” stated Sastry. Guided by their strengths-based approach to patient care, Experience team members were redeployed to support a virtual patient rounding program through daily phone calls to patients in their rooms. The goal of these virtual care rounds was to “extend care into the room through a heartful connection and touch as many patients as possible,” reported Sastry. The calls had less to do with clinical care and more to do with emotional care and support of their patients, demonstrating to patients that UChicago Medicine cared about their experience and their emotional well-being.

The Experience team members were aligned to dedicated units so they had an opportunity to connect with the same patients every day to create personal and meaningful conversations and develop trusting relationships. Having the same team member call each day brought them closer to their patients and their stories, for instance, relishing in one patient’s excitement over his son’s upcoming graduation. Patients appreciated the human connection, and when asked if they wanted a call back the next day, “the majority of the people said, yes, please call me back,” reported Murphy.

Being able to bring comfort and restore confidence to patients and families during COVID was gratifying and reconnected the staff to their purpose of making a difference in people’s lives. “This experience gave us a connection to the institution, to the patients and the positive impact we make each day. It was a gift to all of us,” concluded Sastry.

Making a Difference Every Day

At UChicago Medicine, Making a Difference Every Day (also known as MADED) is not just a slogan; it’s an organizational way of being. The MADED program is the foundation for ensuring that all good deeds get noticed and acknowledged.

Perkins serves as the co-chair of Making a Difference Every Day, the organization’s recognition program. Through this program, he seeks out and acknowledges employees for creating exceptional experiences, not only for patients, but also for each other. Since its inception in 2015, the program has had over 2,000 colleagues nominated. Through a variety of communication channels, employees are celebrated for their impact to patient experience. By magnifying big and small gestures, UChicago Medicine believes that staff acknowledgement is meaningful. “Many employees have worked here for 5, 10, 15 or 20 years. This gives us an opportunity to say, ‘I appreciate the great job that you do’,” stated Perkins.

Pre-COVID, celebrations were a big component of Making a Difference Every Day, prompting quarterly events that acknowledged nominees within that quarter. Award winners and their families were invited and treated to refreshments and giveaways, while sharing their story on stage to highlight what they did to be nominated. Post-COVID, Making a Difference Every Day events have been suspended due to social distancing requirements. UChicago Medicine is currently brainstorming creative ways to duplicate these events while adhering to CDC guidelines.

Best Practice Forums

As a Lean process improvement organization, UChicago Medicine intentionally focuses on improvement opportunities. From this sentiment, events called Best Practice Forums that recognize best practices from the care team and the exceptional experiences from a patient perspective were born.

The idea started eight years ago with a question the team posed when reflecting on operational excellence efforts and gleaning insights on best practices worth cultivating. “Why aren’t we reporting out on things that are working well, bringing the voice of the patient forward and acknowledging our care partners in an open forum where we can learn and leverage the best practices of others?” The Experience team quickly moved the idea into reality as part of UChicago Medicine’s strengths-based approach to patient care by providing a platform where patients and families could tell their story and care team members could share their participation in the story.

Best Practice forums invite patients, families and care teams to engage in a conversation where they each share their lived experience. “We don’t talk about what didn’t work well; we celebrate where routine actions and interactions were remarkable.” said Sastry. Clinical and non-clinical team members participate in the event. Multi-disciplinary clinical care teams are acknowledged for their expert care and empathic interactions. Many times, housekeepers, food service technicians and valet services are also acknowledged for the powerful, personal, and meaningful encounters they shared with the patients.

Please take a moment to experience the Dove Family Best Practice Forum. [https://bcove.video/31FUCHv]

Through the organization’s commitment to patient care excellence during COVID-19, UChicago Medicine is in the process of transitioning Best Practice Forums to a virtual platform to continue sharing beautiful stories of human connection.

Stories from the hArt

In support of UChicago Medicine’s lean approach to improvement, every Friday the organization hosts report-outs for Lean Kaizen Event achievements. Geared towards operational improvements, the Kaizen teams report out their week-long event activities and progress. During these sessions, the institution recognizes the opportunity to integrate experience excellence with process improvement. Employees are invited to share a story that connects their heart to the work they do each day. These narratives are called Stories from the hArt where leaders and staff share personal stories that reflect on what is meaningful to them, why they come to work each day and what motivates them to work in healthcare. It is the shared story around the journey of caring for another human being that “connects people on a different level,” commented Sastry. “These gatherings serve as a remarkable way to return to purpose and acknowledge individuals for who they are, rather than just what they do.”

Due to COVID-19, UChicago Medicine has transitioned Stories of the hArt to a virtual platform to continue reinforcing team members’ return to purpose.

Ambulatory Recognition Program

The Ambulatory Recognition Program celebrates how individuals in the medical practice setting are creating exceptional experiences for patients and families. The program serves as an intentional and deliberate means to shine a light on the actions, attitudes and behaviors that employees and providers exhibit in their patient interactions. The celebration is championed by Executive Leadership who are present in the clinical space to acknowledge the teams for their intentional actions to positively influence patient experience and to recognize their individual strengths and ways of being.

The Ambulatory Recognition Program has been so successful at UChicago Medicine they are translating it throughout the institution. “The holistic type of approach has been a beautiful way to build in the culture of exceptional experience,” said Sastry. “Because, when we come around and recognize how individuals are ‘being’ and how they are creating connections and creating conversations with patients and families, it just reinvigorates them.”

Sastry said many humble staff downplays the recognition with ‘Oh, it’s just what I do.’ “But it’s not,” responded Sastry, “because they have a choice.” It is clear that bringing forward this level of engagement, relationship and loyalty is what makes The Ambulatory Recognition Program extra special.

Gaining Actionable Insights from Feedback

With a keen focus on experience excellence, UChicago Medicine brings in the patient voice to better understand the drivers and opportunities for improved care. Analyzing complaints and compliments across their institution ensures the patient voice is heard and issues are resolved. “We take feedback very seriously,” said Perkins. For complaints, his team of specialists takes the feedback and works with leaders to provide a resolution. For compliments, he ensures that each employee and their leader is notified so they receive personal acknowledgements.

The Patient and Family Insights department is supported by a feedback database by RLDatix. Dedicated intake specialists input feedback from patients received in person, on the phone or via email. The process of these committed intake specialists is full circle, meaning the specialists follow up with the patient, determine the type of service recovery that is needed, and then connect them with the proper leader for action.

Recognizing the importance of the patient voice, UChicago Medicine expanded their feedback analysis approach to include NarrativeDX. This platform utilizes artificial intelligence which interprets patients’ comments, separates them into themes and presents them in dashboards for certain service lines for analysis. NarrativeDX allows leaders to interpret comments and uncovers trends that recognize best practices and identifies improvement opportunities. We met with Stacy Coulter, Program Manager of Experience Improvement Innovation with oversight of NarrativeDX, who stated this approach is providing expanded visibility to improvement opportunities in innovative ways.

Coulter provided an example of how they are effectively utilizing NarrativeDX. She referred to the common theme of cleanliness and suggested that typical survey-collected comments on this topic default to an interpretation of cleanliness to mean the hospital, i.e., the patient rooms, the bathrooms, or the floors. NarrativeDX has brought forward additional clarity on this topic from a patient perspective. For example, when analyzing cleanliness comments in NarrativeDX, the sentiment on cleanliness is now expanded to include personal cleanliness and proper healthcare team hand hygiene, offering a targeted and accurate focus area for improvement.

Coulter is excited about continued and future insights that NarrativeDX provides to UChicago Medicine leadership. The NarrativeDX technology is proving to be a thoughtful and meaningful way to support experience excellence throughout the institution. “There is excitement every time we peel back a layer and bring further awareness of patients’ perceptions across the continuum of care,” concluded Coulter.

At Your Service

UChicago Medicine Guest Services Ambassador program is another example of elevating the human experience. Before COVID-19, Guest Services Ambassadors were located at all entry points and were the first people visitors see when they entered the hospital. While their first responsibility was to meet and greet patients and families, they also served as the hospital’s exclusive personal escorts, ensuring patients and families arrived at their destination within the system safely and that their needs were accommodated to the greatest extent possible.

A New Role as Screener

Due to COVID-19, the Guest Services Ambassadors were reassigned to operate as screeners. The screeners are posted at the main entry points to ensure that patients, visitors and employees have taken appropriate precautions before entering the facility. They remind people about wearing masks and good hand hygiene, and they screen visitors for COVID-related symptoms. Guided by the CDC, screeners monitor state travel bans, denying access for visitors who have traveled to banned states.

Smiling through the Mask

Managing people in healthcare during a pandemic is vital. UChicago Medicine uses these moments to acknowledge their team members whenever the opportunity presents itself, according to Perkins. One of the most challenging adjustments for their Guest Services Ambassadors was being removed from their previous responsibilities and redirected to a new assignment. As a supervisor, Perkins believes his role is to rejuvenate the team, ensuring them they have the support needed to be successful. During these trying times, he calls out employees when he observes them using different tactics to engage the visitors, like using humor to get a laugh. “They’ll even smile though the mask, and you can see their energy in those interactions,” said Perkins, who thinks by communicating the ‘why’ behind what they do has a lasting impact on the service they provide.

A Virtual Visit to Remember

What we experienced from our virtual visit to UChicago Medicine was as poignant as being physically on site. Under the guidance of the Patient Experience and Engagement team, UChicago Medicine has managed to create an organizational culture that is phenomenal; it is clear that they operate with intention to have everyone in the same boat and rowing the same direction. They have embedded strengths-based principles into how they recruit, interview, evaluate and coach their employees, which has contributed to a cultural consistency weaved throughout the fabric of the organization. “Our human resources team integrates a strengths-based approach in their hiring practices, because they want to select individuals whose return-to-purpose shines through,” said Sastry. As a result, there is little resistance from employees to bring their magnificent selves to work each day, because that’s the culture that has been laid for them. According to Perkins, UChicago Medicine brings awareness around what is already inside their employees.

Perkins reflected on his role as a patient experience professional. “I see a lot of people who are at the worst point of their lives. I feel joyful in seeing them arrive in one way but seeing them leave in an entirely different light. If they come in sad and angry but leave smiling and joyful with a bit more hope, that’s when I get the most out of my position here.”

Murphy closed our interview acknowledging every individual within UChicago Medicine and the choice they make each day to connect, comfort and care for their patients. “Our staff and faculty bring humanity, kindness and empathy to each patient encounter, making a difference every day. Patient experience is not a UChicago Medicine initiative or a department name; patient experience is at the center of everything we do – Creating Exceptional Experiences Every Day, Every Encounter, Every Individual.”

We were inspired by the efforts of UChicago Medicine and appreciate the willingness of their team to share their accomplishments and learning through our first virtual On the Road. It is one we will always remember.