NGPX 2019: Creating Necessary Change to the Patient Experience

The 2019 NGPX Next Generation Patient Experience Conference took place during the first week of December in San Diego, California, where America’s top minds in the medical community met to share ideas to create necessary and beneficial change to the patient experience around the country. 

Changing the Patient Experience

 The 2019 NGPX Patient Experience conference began with the Chief Experience Officer from the Cleveland Clinic, Adrienne Boissy, MD, MA, delivering the opening keynote on the future of high touch experiences. Boissy began by discussing patient-centered care and the importance of price transparency, working with insurance companies, and addressing patient preferences, needs, and values. She states that while it is essential to measure what matters to patients, it is even more critical that physicians double down on what is most important to the physician-patient relationship: teamwork and empathy. Patients are more likely to trust their physician when they feel their doctor is on their team and empathetic towards their situation. 

Other highlights from Boissy’s talk include the importance of engaging patients through virtual care and meeting patients where they are presently and not where physicians want or hope for them to be. Another critical piece of knowing and understanding your patients is simplifying the financial process, which can include a single payment portal, insurance verification in real-time, and predictive outreach. Patients are worried about the cost of healthcare, and whether or not their insurance company will cover their required care is more of a concern than ever before. By taking these steps to help patients simplify the financial process, patients will be more likely to engage with their physician and take their physician’s recommendations. 

Shannon Connor Phillips from Intermountain Health discussed the importance of making three experience promises to patients. These promises are 1. Always safe; 2. Always present; and 3. Always together. These three promises are essential to ensuring that the clinician-patient relationship is a human experience. When physicians take the time to learn what the patient wants, needs, or hopes to get out of the physician-patient relationship, the relationship can become one that is built on trust and care. Clinicians need to take the time to ensure that patients feel safe and that they are working with their physicians to ensure positive outcomes. Clinicians should promise patients that they will be providing better care than they have ever seen at a cost that everyone can afford. While these might be lofty and challenging goals to meet, these are critical to ensuring a positive patient experience. 

While these goals might be lofty, they are necessary. In fact, at the Cleveland Clinic, they rolled out a program with three goals in mind: empower, excite, and align. Every month, they have combined Institute Experience Officer (IEO) meetings. Quarterly, they have both IEO and interdisciplinary team meetings where they would encourage leaders. Annually, they have IEO retreats as well as a yearly meeting with the institute chair and IEO. After implementing this program, the Cleveland Clinic found that patients felt that their experiences were more personal, and caregivers felt more connected and engaged to patients. Some of the key takeaways from this program are to develop relationships and true partnership with physicians, secure new executive physician support for critical initiatives, foster physician-peer connections, and utilize and conduct high-quality research. 

It is not just the physicians that make or break the patient experience. Maureen Fagan of the University of Miami School of Medicine found that by empowering the cafeteria staff as well as other behind the scenes staff, they were able to impact patients’ experiences positively. Fagan stated that it was as simple as identifying what was preventing these team members from providing a higher quality of service that made all the difference and increased their patient satisfaction score. 

Communicating with Patients

One of the key themes of many of the speakers was that of communication. Communication is one of the easiest ways to influence superior outcomes for patients. If patients have a hard time understanding what they need to do or what a clinician’s goals are for them, they tend to shut down and not engage with their health. The fundamental principles of purposeful patient outreach are to provide quality communication. In the majority of cases, it is better to communicate effectively, in short, and easy-to-understand sentences rather than giving the patient more information that he or she needs. It is also essential for clinicians to perform a visual sweep of the room to gain situational awareness. By doing this, clinicians will be able to tell whether they need to give more or less information to patients and whether a patient is receptive to the information that will be provided. It is necessary to engage patients and their families in conversation about a variety of topics so that patients feel like their needs are being heard as well as creating transparency within the medical process.

Another part of communicating with patients is by ensuring that patients’ voices are heard. Physicians need to take the time that is necessary to get to know their patients. Getting to know your patients could include creating a patient-family advisory council that helps families navigate the various healthcare processes. If a healthcare facility is thinking about implementing a family advisory council, it is recommended that leadership is engaged in the process, and it is essential to include diverse voices that represent the community so that minority groups do not feel alienated. 

Communicating in a way that is therapeutic also lends itself to better patient experiences. Face to face communication, even when done via a telemedicine application, advances both the physical and emotional relationship as patients are able to pick up on the nonverbal cues from their doctors and nurses.

All clinicians should strive to implement three simple ways to engage in this practice:

1. Active Listening
2. Empathy and Acceptance
3. Self-awareness.

Focusing on these little things can make all the difference in a patient’s experience and can have a positive impact on that person’s day.

The Financial Experience

Paying for care is impacting Americans’ trust in the healthcare system. When patients were asked what concerned them the most about a hospital visit, they said cost, followed by fear of death, and by major or minor complications. Patients now bear more of the financial burden. Patients have a responsibility to pay about 25% of the cost of the care they receive. However, many patients are unaware that there are more options available to pay for the care they receive. For example, there are loans, payment plans, online service payment platforms, credit cards, financial assistance, and, of course, upfront/cash. Health systems are not volunteering this information, which makes the payment structure very stressful for patients. Many patients also struggle to understand their bill, which can lead to them delaying payment or paying the bill and delaying seeing a provider in the future. Having someone on staff who can walk through a patient’s bill in a manner that is easy to understand will allow patients to have a better financial experience as well as make them feel empowered about the choices they are making. 

The Digital Experience

The advent of technology and telehealth means that the patient experience is no longer confined to the four corners of an examination room. The same qualities that enhance in-person care are the same that should be used when conducting an examination via a telehealth application. For example, it is imperative that doctors communicate clearly and effectively with patients. 

One benefit of telehealth applications is that these appointments reduce costs, which reduces the financial stress that patients often feel when seeking healthcare. However, when these telehealth applications are challenging to use, it can lead to patients feeling more stressed and not seeking out the healthcare they need. 

One of the ways to get everyone on board is by engaging clinicians as experts. Clinicians will tolerate the takeaways given to them, but ultimately, they will act on their own and will come to their own conclusions about how things should be done. Based on this, clinicians must know they are valued through awards and recognition. Leading and listening to the needs and wants of the clinicians will ultimately ensure that patients are receiving the quality care that they deserve and will enhance the overall patient experience. Additionally, to achieve sustainability, there must be ongoing meetings to review and to continue implementing the latest and greatest technologies that will allow clinicians to meet patients where they are. 

Supporting Caregivers

NGPX’s focus is on changing the patient experience for the better across the country; however, the only way to effectively do so is if we look at and support the people who are providing the care.

Managing Physician Stress

Amy Friedman from Denver Health and Anna Koerbel from Maryland Patient Safety Center discussed the importance of caring for the caregiver. Up to half of the clinicians are involved in an adverse event at least once in their careers, and some have PTSD from the event. While one adverse event throughout a person’s entire career might not seem like much, clinicians often suffer from being a second victim. The second victim term was coined in 2000 and includes someone who’s involved with patients and their trauma and feels the secondary effects because of it. Primarily what happens is that physicians will hear about a traumatic event that their patient endured and internalizes what the patient went through, which in turn leads to the clinician feeling the effects of trauma. One of the most common causes of this trauma is related to patient death. Fortunately, the RISE (Resilience In Stressful Events) program was created to give physicians the tools to help them through these stressful experiences. RISE is not a hotline, but rather, it is an emotional peer support structure that supports second victims who are emotionally impacted by a stressful patient-related event or unanticipated adverse event. Programs, such as RISE, allow clinicians to be more effective caregivers and further enhances the patient experience.

Management Training

Patients want to feel like they are in good hands when they are seeing a clinician, and part of the way that the patient feels safe is by delivering highly reliable patient/family-centered care. When it comes to delivering patient/family-centered, highly reliable care, it is essential that care facilities work to keep track of their systems that are working. Some ways in which these hospitals and care facilities can do this is by building a lean infrastructure by eliminating waste and improving efficiency. Additionally, developing the people who work in these hospitals and care facilities is vital. Driving continuous improvement encourages clinicians to strive to be their best without fear that they will not be able to meet the needs of their patients.

In addition to cultivating strong clinicians by encouraging them to strive to be their best, Shaw Nason from The Nason Group encourages using Walmart’s foundation of customer service to develop a positive clinical experience for patients. Part of the Healthcare Revolution, according to Nason, is to have healthcare systems as well as clinicians to first and foremost focus on the quality of care and then worry about cost, convenience, and investing in the patient as well as associates and clinicians.

Conclusion

Communication is key. It is necessary to make sure that patients, as well as clinicians, feel their voice is heard and that they are an essential part of the healthcare process. Clinicians serve a significant role in making sure that patients feel as though their experience could not be any better. Healthcare systems should take the time to develop programs with their clinicians so that the patient experience is as good as it can be. Additionally, healthcare providers should make sure to actively listen to patients as well as work with patients so that their healthcare bills are not such a stressor that they avoid seeking care.