Using Patient and Family Centered Care Fundamentals in Establishing an Office of Patient Experience

Presenters:Keith Gran, CPA, MBA, Chief Patient Experience Officer

Molly Dwyer-White, MPH, Administrative Director, Patient ExperienceKate Balzer, LMSW, Project Manager, Patient Experience

Objectives

• Identify effective patient and family engagement strategies.

• Establish patient experience strategic aims through the utilizing of patient, family and staff input.

• Determine best practices by looking at: patient experiences, personnel, partnerships.

• Determine key tactics for establishing a patient experience office and lessons learned along the way.

Patient ExperienceThe Team Starts With the Patient and Family

Story: The “Medical” Experience

Story: The Patient Experience

Patient Story: Patient Engagement

What is Patient & Family Centered Care?

Seeing the Person Beyond the Patient

Value Model: Patient Engagement

Improved Patient experience with the health system and improved health outcomes

Patient and family experiences influence and accelerate decision making, translation and uptake of new practices

Experienced based design drives user-focused methodology which requires the designing of services, interactions,

processes and environments for the complete care experience

Projects/priorities are identified in areas patients valueHealth system staff and faculty understand the value of patient involvement

Provide input on identifying priorities to improve the patient experience Participate in the design and undertaking of projects

Patients and Families

1000+ Patient and Family Advisors, 25 Patient and Family Advisory Councils, and 142 Patient/Family Peer Mentors Focus groups, committees, observation, surveys, outreach

Patient and Family Engagement• 1000+ e-Advisors

• 400+ onsite Advisors

• PFACs (25+)

• Committee Memberships

• Speakers Bureau

• Peer Mentors (20 groups)

• Focus Groups

• Quality Improvement Projects

• Observations

Patient Experience work - centered around transparency, visibility, and inclusion among personnel and patients/families in the design, improvement and innovations.

•Increase awareness of cultural, social, linguistic barriers that may hinder patient engagement in their care

•Reduce bias of our personnel and system

•Review of Safety and Sentinel Events

•Analyze current state and developing tools, training, resources and processes to reduce harm through patient/family centric approach

•Interdisciplinary and cross-sector teams

•Identifying best practices and tailoring across the continuum

•Skills and Awareness building for continuous QI

•Training for Med Students, Residents, and new MM Nurses

•Researching Patient Engagement in Learning Health Systems and Precision Medicine

•Studying effectiveness of experiential learning Research

and Education

Quality Improvement

Diversity, Equity and Inclusion

Safety

Setting up a new Office of Patient Experience

• Office of Patient Experience – Officially launched in January 2017

• Received broad leadership support

• Three existing departments merged:

– Patient and Family Centered Care

– Service Excellence

– Physician Relations and Outreach

Patients and Families First

The vision of the Office of Patient Experience is to provide the ideal patient and family experience by partnering across Michigan Medicine.

Patient Engagement Framework

By engaging patients and families as partners – and looking at the health system experiences through their eyes, we utilize broad patient engagement through a team-based structure to re-design:

• services

• interactions

• processes

• environments

Office of Patient Experience: Priority Areas

Priority Definition and Goals

AccessPatients have timely and convenient access to information and services across the continuum of care. The health system is easy to navigate, allowing patients to easily identify and connect to needed services and information.

Communication

Information is exchanged between caregivers/hospital staff, referring providers,and the patients and their families in a manner that allows proactive dialogue, problem-solving and active participation in the care processes. All involved gain a comprehensive and clear understanding of the information being communicated.

Respect & Empathy

All caregivers and health system staff interact with patients and each other in a warm, caring, and respectful manner, putting the needs of the patients and families first, and consistently making pro-active efforts to address their needs.

Environment The care environment is clean, quiet and safe, commensurate with the high quality of care expected by patients and families

Access Vision for the Future

“When would you like to be seen?”

“Yes we have epilepsy specialists, would you like me to set up a video visit?”

“For your specific problem, you can be seen in Livonia. Would you like to be seen there or in Ann Arbor? We have immediate availability at both.”

According to patient/provider choice: PHONE     WEB     TEXT     LIVE CHAT TBD

Patient Requests Referral Requests

“You are closer to Ann Arbor, but if you want to be seen sooner, I have immediate access at the East Ann Arbor Clinic.”

Providing the Right Care at the Right Place at the Right Time

Beginning of unparalleled patient experience in ambulatory appointment access

Provide access to care for patients when they need and desire it

Provide patients with an ideal experience including minimal wait times and coordinated hand-offs between care team members

Provide an ideal practice environment for providers and other care team members and clinic staff

Provide clinical and administrative leaders with the tools and information needed to measure and manage performance on an ongoing basis

Ambulatory Access Guiding Principles

1

2

3

4

Enhancing Patient Access

Develop policies to manage clinic cancellations and template editing process Develop dashboards to monitor access performance

• Department guidelines • 46 weeks • Session expectations

• Understanding supply• Defining ambulatory clinical

commitment, growth projections, new providers, locations

• Gap Management• Wait lists best practices• Blocks and Release

• Demand management• Evaluate care model redesign

• Use of APPs, eHealth, visit types (group, virtual)

• Smoothing of schedules to meet space constraints

UnderstandingCapacity

Optimizing Utilization

Performance Management

Patient Access Progress

Assessment Complete

Prototype Finalized New Templates Implemented

Department of Medicine In progress

Otorhinolaryngology In progress

Urology In progress

Neurology In progress

Ophthalmology In progress

Cardiac Surgery In progress

Recognizing and Addressing Challenges – Such as Provider BurnoutThe initial assessment highlighted opportunities to reduce burnout by improving day-to-day operations and the overall work environment for the faculty.

Organizational Engagement

Technology Optimization

CommunicationShort Term Goals: Continue OPE Projects that aim to enhance patient-physician communicationLong Term: Identify best method/training to improve patient-physician communication.

White board project – consistent use of whiteboards in patient rooms

Bedside rounding – improving competency of physicians, ensuring patient are engaged/informed in care plans

Managing patient expectations – identifying opportunities to better prepare patients for process and hospital stay

Managing perceived ‘difficult patients’ – providing training to physicians on how to meet patient/family needs in ED

Empathy and Respect

• No One Dies Alone – partnership with Hospital Elder Life Program – volunteers trained to ensure patients have companionship at end of life.

• Developing training with OHEI to reduce bias, and prevent escalation of frustrated patients due to potential unconscious bias.

• Produced a video with Michigan Medicine Security Department and a patient advisor on how to care for adult patients with autism. Will be used in conjunction with training.

• Worked with the Mott Children’s Hospital Bereavement Committee with support from families to produce a video with a tool kit training caregivers on how to support families during end of life.

Environment of Care

• Launching Poke Program –now called Poke, Procedure and Comfort Plan– in the adult hospital creating a patient-friendly environment during needle sticks and blood draws.

• HOPE Ambassador Program –volunteers assist patients and families with wayfinding in the complex system. Over 12,000 encounters since launch in mid-October.

Celebrating Success

Patient Experience as a visible priority

It’s not about an office

It’s about a system that connects to patient & family stories to continuously improve.

Questions?

Next…

Lunch

12:15 PM

Riverside

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