Culture & Leadership

The Power of People in Patient Experience Performance

On the Road with Henry Ford West Bloomfield Hospital – May 2014

by Jason A. Wolf, Ph.D.

I have heard and read a lot about the Henry Ford West Bloomfield Hospital, as I am sure many of you have as well. It carries a lore about the facility and what it represents, the consideration in the design, the ability to build from a literal green field, an established leader who came in from outside healthcare to bring new perspectives on what the experience could be and the story goes on. This perfect combination of elements of facility and personality is without question central to the identify of West Bloomfield, but in my experience I soon came to see that was only the border on an incredibly powerful picture of patient experience performance.

Warm Welcomes
It was an unusually cool and wet spring day when I arrived at the facility. As I was making my way to the door I spotted a gentleman wearing a hat and suit greeting patients, families and guests as they arrived at the well-marked “main entrance”. As I approached he turned and without missing a step asked, “Mr. Wolf? We are so glad to welcome you to West Bloomfield today.” That gentleman, Patrick Dwyer, was one of the facilities formal doormen. He was also the first stop of my visit for this On the Road.

Seeing Patrick and his team work was astonishing. The engagement they showed for all who arrived either via car at valet or foot from the parking lot was consistent and clear. Their welcomes were as well. I do not believe I saw anyone sneak by without at least a hello and a smile. I can tell you that at even some of the greatest experience performers I have had the chance to visit, I quietly found my way in to the lobby or to my initial destination. Here the chilly, damp morning felt instantaneously warm.

In fact the perspective I was about to gain was already being framed. I was so engaged by the welcome and the efforts to help others, I glanced at the incredible architecture and services adorning ‘main street” at the facility, but was ready instead to hear more about these relationships and connections I saw being built in every moment.

What Patrick conveyed to me was simple, but profound. “We are the first and last impression many people have of our facility.” And he noted this came with a significant responsibility to provide not only warm welcomes, but also as he shared, comfort, ease, directions or a list of other potential requests. “You never know why someone is here,” he added, noting that they could be a patient, family member or other guests, for happy occasions or sad events.

The key for this welcome Patrick framed was clear, “we must anticipate needs, we must communicate effectively and we must always treat our guests with dignity and respect.” He noted this was not just for his team at the front door, but was core to the expectations for all interactions in the facility. And through this treatment great things can happen. The team has raving fans, many which bring them food, not because they are coming to the facility, but rather because of the relationships they have built and care they felt.

Patrick also insightfully addresses the value his team and effective warm welcomes can bring to the facility. “If we do our job well, we help flow, we get people to appointments on time, ensure they can find and get where they need to go quickly and as a result not only impact experience, but the bottom line.” In addition, Patrick acknowledged the special environment he was in, coming to the hospital from over 30 years in hospitality, he noted the special opportunity there was in healthcare to provide the best in experience. He offered a great insight on the opportunity we have in addressing patient experience in saying, “People can come to any hospital to be ‘treated’, but what people will ultimately remember is how they were treated.” That is what Patrick said he was able to do in his role every day, adding, “it feels like we are doing a million good deeds every day.”

The clarity of purpose, passion and pride was evident in every moment of our conversation to start the day and reinforced an important issue for me, we deliver on experience through the interactions we have with others. I was excited and ready to see what the coming interactions would bring as I continued to explore West Bloomfield.

Thoughtful Planning
From my opening discussion with Patrick, I then spent time with my host Rebecca Kuchar. She helped build on the foundation of people to further clarify the process and framework on which the West Bloomfield experience was built. A unique and powerful distinction was apparent from the start, and it came in context of the consolidated role Rebecca represented, as the Director of Marketing, Public Relations and Service Excellence, Rebecca purposefully had a pulse on all levels of interactions with members of the facility community, from patients and families, to visitors and staff.

By having oversight to the entire communication stream Rebecca and her team can frame ideas, communicate externally and internally and ultimately integrate message, with actions, to shape and drive experience and outcomes. This is not done based on random ideas, but on clear analysis of data in as real time as possible to identify and address needs. She noted that at West Bloomfield, while the aesthetics were an important part of the equation, they in some ways made efforts more important as they elevated expectations for what people would experience. For that reason building a culture of service, grounded on the very people who comprise the organization was and remains critical.

With a consumer mindset in providing the best in experience, Rebecca acknowledge that in healthcare our primary objective is to ensure our core product – clinical care – and the experience that encompasses it, exceed expectations. For that reason very clear processes and programs have been established, much as we saw from Patrick and his team, to ensure expectations were understood and addressed. As equally important, issues and complaints were gathered, addressed and improvements made. Rebecca noted these data points both from when things did and did not go well were gold. They did not see these ideas as problems to be fixed in so much as opportunities to address in providing the best for all in the facility on both sides of the care equation.

The structure in place to support this effort was comprehensive and included some powerful examples of bringing the human touch (and the ability to address needs) back to healthcare. In particular, the use of a concierge staff in major areas of the facility has been seen to reduce anxiety, improve communication, address needs and ultimately impact the experience. In visiting with a member of the Surgical Services Concierge Staff, I learned of all they did, not only to help the surgical process flow, but also the role they played in keeping family and friends informed and cared for as well. This incredible role serves as both guide and support and continues to have significant impact on the experience of those at West Bloomfield.

From the use of concierge staff, there is also an extensive network of over 150 volunteers (from the hospitals pool of over 700 volunteers) specifically committed to service efforts. They play a role in supporting warm welcomes. They round on units to determine needs from both staff and guests. Not only do these volunteers have the ability to address issues when they see them, but they too become a network of eyes and ears for Rebecca and her team in identifying, addressing and even anticipating needs. “The ability to have a presence and awareness of what is happening across the facility is a great support in our ability to provide a superior experience,” Rebecca offered. And this example of outreach and listening brings us back to the powerful consumer mindset that drives the effort at West Bloomfield.

Through these various processes and frameworks for communication, both in person, in the community, via social media, etc., Rebecca underlined the focus on and commitment to responsiveness overall. She stressed that often in healthcare settings we feel lost, alone and/or afraid. The power of consistent and effective communication is critical. In the feedback process it is even more powerful in that it builds loyalty, and I dare say brand loyalty. The ability to respond to both acknowledgements and complaints is a key component of the experience effort and is fundamental to the effort in engaging the patient, family member, guest or community member. It is not just about the response, but more so and as feasible, the ability to engage people in solving the problem. Rebecca noted they pride themselves not only in people’s acknowledgement that “you got back to me”, but also that individuals feel listened to, included and informed. “In empowering our consumers in both good and bad situations, we are building lasting customers,” she shared. In giving them their power back in a potentially and/or typically vulnerable situation people realize the care they are receiving goes well beyond healing. That is perhaps where one of the greatest levers in building lasting experience efforts rest.

Purposeful Leadership
Rebecca’s framing of the effort at West Bloomfield provided important context to Patrick’s stories and set the stage for the perspective of senior leadership. I was able to get a great perspective from strategic leadership to clinical and medical leadership in spending time with Lynn Torossian, CEO, Karen Harris, CNO and Dr. Betty Chu, CMO. In my time with these individuals exploring the West Bloomfield experience, I was able to engage in three unique, but clearly aligned perspectives.

In speaking with Lynn, the facilities’ new CEO, she started off acknowledging the incredible physical environment built at West Bloomfield, but quickly guided me to what she saw as central to the experience. “People are the heart of this place,” she offered. She shared without question the patient-focused nature of the efforts at West Bloomfield from design, to services, to person-to-person interactions. “Every meeting we have starts with a patient story,” she added. “This keeps what we do connected to why we do what we do and reminds us that what we do is very special.”

As important she stressed is that for all the audiences a healthcare executive must engage with in their roles, without question the people who come to work everyday at the hospital are one of her primary customers. She reinforced a critical expectation that everyone is and should be a leader and that the work to provide the best in care, the best in experience, never ceases. In ensuring the organization has the right talent, clarity of roles and shared expectations great things can happen. This does not diminish the intricacies of leading in healthcare today, but reflect the fundamentals that can and do drive distinction.

Lastly she offered that to be successful in healthcare today and to provide a sustainable and viable experience is to offer value. In framing value she explained, “we must continue to offer an affordable and accessible product, but that is not enough. We must also strive every day to exceed expectations. In doing that you provide the best in experience overall.”

I continued my conversation with leadership with Karen Harris, CNO. A common theme continued. “I support the people that deliver care to people,” she said reinforcing a strong sense of servant leadership that I experienced from the team. She reinforced the strong foundation of people they have built and the commitment they have to care for them as well. She also added that what has helped them in their success, is they are “not afraid to do things differently here.” This willingness to act, try new things and push the edges of care was established with the opening of the facility in thinking “beyond the boundaries.”

With that said, Karen was clear in stressing that for all these efforts there must be a foundation of clinical excellence. Consistent with what I see elsewhere and what I believe most would not question, a healthcare experience built on shaky clinical practice has no chance of taking hold. I would also add that from the patient perspective, they do not delineate aspects of experience the way those of us in healthcare might, thus reinforcing the integral nature of quality, safety and service as the full picture of experience.

From this foundation of clinical excellence, Karen reinforced the idea of people as the building blocks for success at West Bloomfield. From talent-based selection processes, to setting and reinforcing expectations, to keeping the right people and being willing to move on with those that cannot perform to expectations, again the foundation of people in driving the experience was reinforced. Karen shared the four filters on which the efforts at West Bloomfield are based – safety, memorable experience, compassionate care and efficiency (pictured here) and offered that in maintaining a clear and unwavering focus on these filters, they have been able to accomplish great things.

My leadership conversation continued with the newest member of the team, Dr. Betty Chu, CMO, who too reinforced the common theme and provided some insights into what attracted her to the facility. She stressed that West Bloomfield and the system in general is focused on its people. This is fundamental to what they do from professional development, to professional satisfaction to diversity of thought. Dr. Chu offered, “From the patient experience standpoint, this is the perfect foundation on which to build.”

Dr. Chu also raised the important perspective on the role the physician plays in the patient experience. As healthcare becomes more complex, dynamic and interconnected, the continuum of care becomes more critical to overall experience and the transitions of care fundamental synapses in the experience journey. This means that the physician team needs to keep a broader perspective in mind as they engage with patients at various points on their personal journey. They too then must realize the impact they have on the experience of those in their care.

Dr. Chu offered that most physicians are aware of this, but are also impacted by the anxiety of the new healthcare marketplace with shifts in provider delivery requirements and patients’ perceptions and engagement in care. More importantly she sees an opportunity for physicians overall in care settings to continue to expand awareness of patient needs, while being provided with an outlet and mechanism to address issues and make change. This perspective reinforces the continuing efforts we see across healthcare to engage physicians in the experience conversation. Dr. Chu reinforced this was central to success at West Bloomfield and supported the notion that we must all work to continue engaging physicians as owners in the experience conversation.

Committed People
From the continued theme of people – at all levels and across roles – and their impact on the experience efforts at West Bloomfield, I was excited to get a greater sense of what was happening on the front line. I had the chance to talk with a number of people as I toured the facility and visited units hard at the work of providing quality care and unparalleled experience.

My conversations included time with Trica Klasa, Obstetrics Nurse; Reverend Jim Kraft, Manager, Pastoral Care; Dr. Eyad Akhras, Hospitalist; Julie Johns, Manger, Service Excellence; Lois Eagal, Director, Clinical Operations and Michelle Lutz, Resident Farmer, as well as provided the opportunity to visit the Innovation Unit and experience a team huddle.

While each of these individuals had compelling individual stories, it was the alignment they shared that stood out and provided a comprehensive overview of the approach fundamental to West Bloomfield as they tackled their experience efforts. Julie stressed the importance that experience efforts were focused on treating the whole patient, not just a diagnosis or ailment. “In understanding and anticipating their entire spectrum on needs, we can meet and exceed expectations,” she said. “That must be the foundation of our work.”

Jim raised the issue that experience at West Bloomfield was about more than meeting explicit needs and dug deeper to identify and address the unspoken needs of patients. He offered, “When we focus on the broader range of needs, it puts us in the role of servant.” This is not to be subservient to patients, but to be clear that in healthcare we are in service to those in our care. He expanded his idea from just the wholeness of needs, to reinforce Julie’s point about the wholeness of the individual overall. With a strong focus on wellness for all those in the facility – from staff to patients and families – there is also a physical infrastructure from spas and salons, to greenhouses and demonstration kitchens, all designed with the purpose of taking care of the whole person.

Tricia added, “we have worked hard to meet people where their needs are.” It was clear that people across the organization had an astute awareness that all those in the facility, patient, family and peer alike had broader and deeper human stories. Perhaps it was here that the unspoken reality of the focus on people was realized. What West Bloomfield has worked to achieve, is to bring a bit of humanity back into the healthcare experience for all involved. This was reinforced when Tricia shared the efforts to help her staff on her unit see things “through the patients eyes.” This program in which patients come in and revisit their experience as a story for the staff, helps them put the humanity back into what can sometimes evolve into rote process. She acknowledged that caregivers do not intend to become numb to the work they do, but circumstances and other factors sometimes cause this to happen. They have worked hard to avoid this by bringing in the reminder of the person behind the care, the perspective beyond the charts and the reality of the impact each individual can and does have.

This integrated and thoughtful perspective and picture of the organization at work was powerfully supported by Dr. Akhras who added, “In healthcare today it is hard to find a place with a truly engaged staff and nurses, with a commitment to improvement, where physicians have a sense of ownership (figuratively) and there is a shared commitment to putting the patient at the center of all they do.” He shared this, not to criticize, he said, but to reinforce how difficult it is to get all these elements aligned and working together. It is a formidable and extremely critical challenge, but one in which drives the team at West Bloomfield forward.

The Power of Innovation
I saw these ideas play out as I rounded on a few of the units with Lois Eagal, Director, Clinical Operations, and had the opportunity to visit the Innovation Unit and sit in on a team huddle. In its commitment to a foundation of clinical excellence, the four filters and an unparalleled experience, the facility established the Innovation Unit. The unit is a working part of the hospital where a select team of individuals not only conceptualizes, but also tests new practices and ideas. These ideas are monitored for effectiveness and impact and once validated can be shared across the facility.

The concept that ideas matter, that that status quo has a shelf life and that innovation can bolster the experience is a fundamental idea for West Bloomfield. It brings us back to the concept of moving beyond boundaries. In having the right people, thinking of new opportunities with patients and peers in mind reinforces the value of continuous improvement central to the dynamic nature of healthcare experience. It also reinforces the value of evidence-based design and the empowerment of people in the facility to make chance. Ultimately it has been leading to some measurable outcomes in very positive ways. While not every concept works, the lessons learned provide invaluable. As I observed an afternoon huddle to see new processes tested, it was evident that the patient was solidly at the center of the discussion and the overall experience – quality, safety and service – was a strong guide in moving these new ideas forward.

Creating a Healthy Community
An innovative idea developed parallel to the Innovation Unit itself was an effort that brought a strong connection of the facility to the ideas of wellness, the environment in which it resides and the community it serves. I spent some time with Michelle Lutz, Resident Farmer, who shared the power that wellness and community engagement can play. While much has been written on West Bloomfield’s work to provide healthy foods and education that not only supports wellness, but also a healthy lifestyle overall for those both well and those facing chronic issues or other health needs, what was underneath this effort was a powerful statement about how West Bloomfield wanted to take care of each other, the people they cared for and the community they served.

The green house on campus serves the role of providing fresh food, an escape for healing or relaxation and an education center for literally thousands in the Detroit area. While this effort would require a whole article in itself, what it represents is the fundamental and unique approach to experience West Bloomfield has taken.

Implications for Others
The approach I saw at West Bloomfield was one in which at its core takes the whole person into account. Patient experience in the organization is not just about checklists or survey results, though those are tools and indicators, it is also not just about an incredibly beautiful facility adorned with amenities to provide a 5 star encounter at moments when people may need it the most. Rather what I saw was an effort that realized providing the best in experience for all in a healthcare organization is about providing what is best for the whole person.

Built on a foundation of clinical excellence, bolstered by a sense of unwavering compassion, reinforced by efforts to anticipate and address needs and a process to rapidly act on (and engage others in) improvement opportunities, West Bloomfield has created in their effort a vibrant and powerful center for experience to thrive. It comes back to the point that Lynn shared in suggesting these efforts never stop. “There will always be someone who needs our care,” she offered. It is clear the people at West Bloomfield’s greatest pride is that they are ready for the challenge, with a commitment to each other and to those they serve. They truly exemplify the power of people in patient experience excellence and I was honored and privileged to learn from them.

My greatest thanks to my host Rebecca and the whole team at West Bloomfield for warm welcomes and fond farewells and for the generosity of insight, the willingness to share and the commitment you exemplify each and every day.