Webinar | Capturing Value in Patient Voices and Perspectives

Q&A

During the presentation of our webinar, Ellen Noel, MN, RN, CPHQ answered a few questions from participants:

Q: How often do we elicit the patient voice? I worry about fatigue.

A: Our patients are looking for any opportunity to engage in process improvement. Patients feel energized when they’re included in the process and when we implement their suggestions and ideas often and frequently.

Q: What is the best way to get actionable versus un-actionable feedback?

A: Our actionable feedback is dependent on the current structures that are in place. Virginia Mason has multiple structures in place that not only ensure we hear from our patients, but that we also act upon that feedback. We greatly benefit from structures and work toward offering a 360-degree view of the patient experience.

Q: Will you explain a few challenges with employee engagement and how those problems were solved?

A: We implemented our Patient Safety Alert System™ almost 15 years ago now, and over time we realized that the amount of reports we were receiving were stagnating and not reaching the levels we desired. What we really heard from our frontline teams is that we didn’t have the culture of respect that we thought we did. And this wasn’t the outright disrespect in terms of cursing or throwing things, this was really the passive disrespect such as rolling your eyes or walking away when someone is speaking. This led us to begin our “Respect for People” work. The goal was to create a culture of empowering staff to speak up.

Q: What tips can you provide for engaging senior patients to receive feedback?

A: Seniors have a wealth of information and a desire to contribute to their health care experiences. Our ability to listen, take the time to understand their perspective – and understand that their perspective is the source of truth – allows us to design our processes for patients. Having an actionable agenda after the idea is harvested is critical.

Q: How do we integrate patient advocate groups when capturing the patient’s voice?

A: Patient advocate groups are a great resource and patient panels allow consistent feedback while improving healthcare processes. They are an excellent place to start as you develop your Patient-Family Partner Programs. However, you should be aware that there is always a risk of losing objectivity because of the strong ties that advocates have with providers in the conversation.

Q: What is the most critical component when preparing a patient to participate in an improvement event or a Rapid Process Improvement Workshop?

A: In this presentation we talked about experience-based design and our Patient-Family Partner Program. It’s very important to have a flow of preparation, from screening and interviews to orientation. If patients and family-partners know what to expect – and understand what their experience is going be like – they will have a greater opportunity to produce and provide important feedback to the improvement work.

Q: How do we balance patient confidentiality with organizational transparency?

A: In healthcare we are often hesitant because we feel that being transparent is a risk to either our patients of our organization. In any type of interaction we would obviously protect any patient information, but we’ve found that patients are often willing to share stories of their experience as well as their names. We want to ensure we have approval from the patient and family-partners, discuss their participation with them, and only use stories and improvement work that they want to share.

Q: How can leaders empower front line staff to create effective partnerships with patients and their families?

A: Great question, and one that’s close to my heart. In the presentation I spoke about the Family Activated Safety Team. This allows us to include the patient as an equal team member in their care planning. Often times our frontline staff are the interface between our patients, their families and the care team. So having a structure that allows our patients and families to stop the line or raise a concern with an experience that the staff member has alongside of them, as an advocate, is a fabulous way to incorporate frontline staff experience into patient and family-partner engagement.

Q: How do we engage executive management to understand patient voice?

A: In the past, Virginia Mason knew that patient stories were what changed our behaviors and influenced our processes. So early on, our executive leadership team made a clear decision to integrate patient stories into many of our management structures. Integration of the patient stories into things like our monthly manager meetings, daily huddles at local unit sites and board reports was a key element of engaging our executive management team in the patient voice initiative.

Q: How can we achieve engaging patient voice and feedback in urgent care services settings such as crisis management?

A: I think you have to be very aware of the patient’s experience when dealing with crisis management in healthcare delivery. I would say, don’t avoid soliciting that information from the patient, but the timing will be imperative. If someone is going through a deep crisis, it might not be the time to elicit strong emotional response. There might need to be some rest time in between the conversations. A good way to go about this might be to allow your patients to decide whether they would like to contribute, and then accessing their feedback and contributions at a later time in a more reflective approach.

Ellen Noel, MN, RN, CPHQ, is a transformation sensei at Virginia Mason Institute. Her in-depth knowledge of clinical processes, team development, health care outcomes and regulatory performance provides a solid foundation for an extraordinary customer learning experience. Prior to her work at Virginia Mason Institute, Ellen worked as an adult clinical nurse specialist and director of quality and safety. As an improvement leader, she led system-level improvement work in medication safety, nursing and care team workflow efficiencies, pain management and patient safety. Ellen is a Kaizen Fellow graduate certified in the Virginia Mason Production System®. She is also a Certified Professional in Healthcare Quality.

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