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Competitive Strategies in a
Changing Healthcare Market
Why has patient
engagement become
so important?
Suzanne Wheeler, MBA
Director, Patient Experience,
Process Improvement
Adventist Bolingbrook Hospital
Darrell Atkin
Senior Director of Marketing
Skylight Healthcare Systems
The Beryl Institute, April 8, 2014
Why Patient Engagement?
• Reduced reimbursements
• Lower volume - High deductible
health plans- Large corporate
provider choices
92% of hospital executives say reduced reimbursement is top threat. - Health Leaders, 2013 Industry Survey
Reduced Reimbursements
• Reimbursements are only going down
• Max reimbursement under VBP is key
– 1,500 hospitals will take cuts based on VBP
– 1,300 hospitals will get bonuses
The Reality
Survive = prove you are better
– Accessible
– Convenient
– Good Service
– Share of Mind
Winners will “eat” the losers
Competitive Strategies in a
Changing Healthcare Market
Achieving Success – The Role
of Patient Engagement
Imperatives to Success in a Changing Market
• Satisfied patients and families
• Focus on the patient experience
• Shorter length of stay
• Reducing readmissions
• Gathering data and demonstrating outcomes
• Building strategic partnerships
• Improving efficiencies
WINNERS
Patient Satisfaction
Quality Outcomes
Operational Efficiency
Market Awareness
Winning Strategy in a Changing Market
Imperatives to Success in a Changing Market
WINNERS
Patient Satisfaction
Outcomes Data
Operational Efficiency
Market Awareness
Patient Experience
• Cultural change led from top
• Systems to drive change• Substantive & sustainable
• Real-time Feedback & Service Recovery• E.g. Nordstrom
• No time to wait for HCAHPS results
Imperatives to Success in a Changing Market
WINNERS
Patient Satisfaction
Outcomes Data
Operational Efficiency
Market Awareness
Streamline clinical workflow and save nurse time
Quality Outcomes
• Stay connected to patient long term
• Prove effectiveness of treatment
• Functional Outcomes post-discharge
Imperatives to Success in a Changing Market
WINNERS
Patient Satisfaction
Outcomes Data
Operational Efficiency
Market Awareness• Convenience
• Connection
• Communication
• Reputation
Market Awareness
Imperatives to Success in a Changing Market
WINNERS
Patient Satisfaction
Outcomes Data
Operational Efficiency
Market Awareness
Operational Efficiency
• Streamline clinical workflow and save nurse time
Competitive Strategies in a
Changing Healthcare Market
Characteristics of a Patient
Engagement Platform
What’s it really like for the patient?
Waiting for admission
Admitted to Room
Inpatient Stay
Discharge
• Fear & Anxiety
• Frustration over wait-time
• Pain & Discomfort
• Greeting may be less than optimal
• Admission Paperwork
• Sensory Overload
• Loss of Control
• Fear & Anxiety
• Pain & Discomfort
• Inability to Sleep
• Lack of understanding about diagnosis
• Questions about medications & other care needs
• Fear of the unknown
Creating an environment conducive to healing
PREPARING FOR ADMISSION
• What to expect when they arrive?
• What to prepare for their surgery/procedure
• What to expect after surgery
WHILE IN HOSPITAL
• Engage patient and family with information and education staggered throughout stay
• Provide patient with more control over their environment
• Create an environment of healing
• Support relaxation and reduce stress via music and videos
DISCHARGE
• Directly involve the patient in discharge planning efforts:
• Service requests
• Surveys
• Checklists
• Pop-up messages
• Reminders
• Display that discharge will occur
POST DISCHARGE
• Provide access to information/education to help manage care at home
• Support/Remind them of behaviors/actions for healing
• Ensure follow up with doctor’s appointments & medications
Changing the patient experience
Waiting for admission
Admitted to Room
Inpatient Stay
Discharge
• Patient / family can begin watching education videos specific to reason for admission
• Entertainment available to take patient’s mind off of wait time
• Relaxation video playing on TV screen
• Admission paperwork completed incorporating education videos specific to patient safety (falls/HAIs)
• Quiet at Night Initiative implemented
• Patient empowerment through direct messaging of service needs through TV screen
• Patient empowerment with education on disease process
• Creation of healing environment with effective pain management program and quiet, relaxing space
• Giving patient opportunity to request discharge - need assistance with real-time intervention
• Preparing patient to care for themselves after discharge through education on diagnosis, diet and medications
138 Private Bed facility – Level II Trauma
Medical Surgical Units
ICU
Woman Services
Emergency Department
January 14, 2008 - the first new hospital to be built in more than 25 years in Illinois
Regional Midwest system of 4 hospitals
– Staff Responsiveness
– Responding to Patient Concerns/Needs
▪ Empower through Education
▪ Reduce anxiety
▪ Real-time response….with real-time feedback
Executive / Nursing Buy-In
Skylight Education
Dedicated Committee /
Nursing Leadership /
Dedicated Account Manager
Creativity!
Patients Staff
Initial Rounding process
No follow-up system/close the loop mechanism
See EVERY PatientIdentify
Basic Needs
Informal (non-clinical)
advocate
TV Remote Basics
Free Movies, Internet Access, Games
Request A Service Feature
Patient Experience Callback Card
Hello,
Today, your Patient Guide stopped by your room to welcome you
to Adventist Bolingbrook Hospital.
Patient Guides are here to assist you with your non-clinical needs,
which include providing you with extra pillows or blankets, and
introducing you to our Skylight CareNavigator TV. In addition, if
you have a compliment or a concern to share, Patient Guides are
here to listen.
You may contact a Patient Guide by dialing ext. 6262 or 2616, or
by utilizing Skylight CareNavigator TV, which offers direct
contact with hospital services, free cable, movies, e-mail, and
internet access. Please follow the step-by-step instructions on
the back of this card to learn how to contact hospital
departments directly and access FREE movies and internet
through the Skylight CareNavigator TV.
If you have any questions regarding Skylight CareNavigator TV,
or need any other non-clinical assistance, please do not hesitate
to contact our Patient Guide department.
We look forward to being of service to you during your stay.
Sincerely,
Jennifer
Your Patient Guide
Ext. 6262 or 2616
Skylight CareNavigator TV Instructions
TV Remote Basics
1) Turn the TV on by selecting the yellow button on the remote entitled
“TV on/off”
2) Navigate through the menu choices by using the arrow keys
3) Select an icon by pressing the green “OK” button
Request Services
1) Select the Request A Service icon on the Main Menu
2) Once you have selected the Request A Service icon, you are able to
contact the following departments directly:
o Housekeepingo Maintenance o Charge Nurseo Food Serviceso Consultationso Pastoral Careo Patient Guide
3) Select the icon of the department you wish to contact. A list of applicable service requests will appear. Select the appropriate request. Please allow a 30-45 minute turn-around time for your request to be answered.
FREE Movies and Internet Access
1) Select the TV/Movies/Games icon on the Main Menu
2) Select the Watch Movies icon to access FREE movies
3) Select the Web Access icon to access FREE internet
4) Please utilize the wireless keyboard in your room if you choose to
access the internet. If there isn’t a keyboard in your room, please
contact our Patient Guide team (ext. 6262 or 2616). We will ensure
you receive a keyboard.
Front Back
348
275
449
541
473495
666
587
489
632 625
515
573
0
100
200
300
400
500
600
700
Q12011
Q2 Q3 Q4 Q12012
Q2 Q3 Q4 Q12013
Q2 Q3 Q4 Q12014
2011 – 2014 Quarterly Totals
Service Alert Requests
• Housekeeping• Maintenance• No Request• Nutrition/Food Services• Pain/Hygiene• Pastoral Care• Patient Experience
51%
65%62%
69% 67%72% 70% 71% 70% 71%
77%73% 73% 74%
78% 77%82%
79% 80% 79%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Q1
20
09
Q2
Q3
Q4
Q1
20
10 Q2
Q3
Q4
Q1
20
11 Q2
Q3
Q4
Q1
20
12 Q2
Q3
Q4
Q1
20
13 Q2
Q3
Q4
Quarterly Top Box% Trend
2011 - 2013
• Goal:
• Educate Clinical team on system capabilities
• Establish ownership
• October 2010:
• 3 in-service sessions a day/week/Sundays
• Over 130 employees trained
• Nursing Orientation/Competency
• RN’s & PCT’s
Decide on the Measurable Goal(s) Keep it Simple
Original layout: 7 questions
New layout with process:
▪ 3 questions
▪ Better correlation to patient satisfaction
▪ Easy to measure
Real-time Workflow Response
Leader receives
Skylight feedback alert
via e-mail and page
RN Director, CRN or PG listens; apologizes; gathers
info from pt / family member and explains the
hospital’s complaint resolution process
Patient Guide (PG) rounds on patient
(pt) / family member and acknowledges
receiving the pt’s/family member’s
feedback through the Skylight System
PG documents pt’s
feedback
on leader rounding log
RN Director, CRN or PG implements appropriate
service recovery
Reward and recognition hospital protocol is
implemented to acknowledge staff members
involved with providing pt with quality care
NO
YES
RN Director, CRN or PG documents
concern and follow-up details on
leader rounding log
Patient Feedback Alert Process
RN Director, CRN or Patient Guide (PG) rounds
on patient (pt) / family member and
acknowledges receiving pt’s / family member’s
feedback through the Skylight System
Yes
RN Director, CRN or PG follow hospital
complaint resolution protocolNo
Concerns
Resolved?
Patient is satisfied
with care?
Receive Alert
Round on Patient
Request Verbal Patient Feedback
Respond to Patient Feedback
Document Feedback and Staff Response
“I began playing the Tranquility video at the beginning of the day and end at Harmony; it is very helpful w/calming patients!”
~ABH RN
CEO Physician Advisory Council Patient Engagement / Educate!
Families are impressed
Tours –
Community outreach
High school Students H2E
Processes
Resources (people)
Skylight Fair
Ownership