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Using Patient Stories to Create a Culture of Caring The Beryl Institute April 2013

Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

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Experience Mapping is an in-depth qualitative research technique that utilizes a visual cue (the experience map) to help physicians, patients, staff, and other influencers recall specific episodes in their journey. It provides: Assessment of the total experience, expectations- before first encounter, activities and Touchpoints, changes in attitudes, if any Framework for action: experience stewards who are responsible for delivery, steward can appreciate the relationship of their actions to the rest of the journey, interactions or “touchpoints” are categorized at each step

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Page 1: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

Using Patient Stories to Create a

Culture of Caring The Beryl Institute

April 2013

Page 2: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 2

Agenda

1. Background

2. Approach

3. Insights

4. Insights to Action

5. Adapting Practices

Page 3: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

BACKGROUND

1

Page 4: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 4

Our mission is to eliminate cancer

in Texas, the nation, and the world.

With the launch of the Moon Shots

Program, we have committed to

initially eliminating eight cancers.

Patient Care - Research - Education

Our mission is to eliminate cancer

in Texas, the nation, and the world.

With the launch of the Moon Shots

Program, we have committed to

initially eliminating eight cancers.

Page 5: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 5

Enhance

Business

Decisions

Develop and

Manage the

Brand

Understand the

Customer

Manage

Growth

• Financial ROI

• Campaign effectiveness

• Project management & metrics

• Customer, community research

• Voice of the patient

• Customer experience

• Demand generation for

institutional priorities

• Service line marketing

• Global partnerships

• Brand management

• Sponsorships

• Brand advertising

Measure

Success

Global

leader

in cancer

• Market intelligence

• Trends, data, competitive tracking

• Business planning support

Marketing at MD Anderson

Page 6: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 6

We have listened to

20,000+ patients, caregivers,

healthy public,

staff and faculty

Over Eight Years…

Page 7: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 7

Proton Therapy Center

• Overview • What is proton therapy?

• 11 centers in operation across US

• What makes our center unique?

• Strategic goals of our efforts • Marketing: educate, drive demand to

grow patient volume

• Clinically: expand use of proton therapy to help people with a wider variety of cancers

• Embedded marketing support

• Dedicated team of marketers

• More involvement in operational issues

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PAGE 8

Why We Use Experience Mapping

• Evaluates the entire experience

• From the moment someone hears of us

• Through the transition of care back to the community

providers

• Creates a framework for alignment

• Care – How we deliver

• Communication – What we say

• Coordination – How we manage the process

• This framework is then be used to assess and monitor the

experience over time

• Follow-up assessments

• Patient satisfaction monitoring

• Experience dashboards

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Our Partner

10+ year relationship

Works with Nationally-Recognized Institutions:

• 5 “Honor Roll” institutions

• 5 out of the top 10 cancer programs

• 3 out of the top 4 pediatric hospitals

• 2 out of the top 4 cardiovascular programs

Conducts National Benchmarking Studies:

• Patient experience

• Marketing

• Physician relations

• International programs

Page 10: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

APPROACH

2

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Philosophy Culture and your brand promise

are linked through the experience delivered.

Leaders translate customer

expectations to the organization and

reinforce desired employee

behaviors.

This alignment creates an

exceptional experience and a

sustainable competitive advantage.

We call this desired state

enchantment.

EXPERIENCE

EXPECTED BEHAVIORS

Cultural

Alignment

Transformational

Leadership

Brand

Promise

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PAGE 12

Examined practices related to:

• Strategy • Communications • Service Delivery

• Coordination • Technology • Feedback

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PAGE 13

77% link to revenue | 87% word of mouth

Page 14: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

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Current Organizational Challenges

Defining

Experience Mgmt

Only 54% say senior executives

and staff are aligned

in their view of patient

experience

management

Only 43% of respondents report

that their

organization has a

common set of

expected behaviors

to manage the

patient experience

across multiple

functions

Coordination and

Cooperation Meeting

Emotional Needs

Only 20% report having systems

that are designed to

enable each person

who interacts with a

patient to understand

his/her preferences

Source: Gelb / APQC / Beryl Institute Survey

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PAGE 15

Common Challenges

• Balancing costs and experience

management

• Multiple referral flows

• Managing multiple touchpoints

• Aligning all stewards toward common

outcomes

Page 16: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 16

Experience Mapping is an in-depth qualitative research technique that utilizes a

visual cue (the experience map) to help physicians, patients, staff, and other

influencers recall specific episodes in their journey. It provides:

Assessment of the total experience

• Expectations- before first encounter

• Activities and Touchpoints

• Changes in attitudes, if any

Framework for action

• Experience stewards who are responsible for delivery

• Steward can appreciate the relationship of their actions to the rest of the journey

• Interactions or “touchpoints” are categorized at each step

Fitting it All Together

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Planning

• Treatment options

• Knowledge about MDACC PTC

• Educational resources

• Word of mouth

Arrival

• What it’s like to be a patient

• Discussion with patients (diagnosis, referral options)

Treatment

• Clinical interactions

• Staff interactions

• Treatment planning

• Coordination of care

• Self-care

Transition of

Care

• Coordination of on-going care

• Ongoing patient care/support

• Call-backs for assistance

Primary Experience Stewards

• Lay Influencers • MDACC Staff • Online Ads • Community Physicians

• Front Desk Staff • Faculty/Medical Staff

• Faculty/Medical Staff • Support Staff

• Faculty/Medical Staff • Support Staff

• Faculty/Medical Staff • Support Staff

Scheduling

• Initial contact with MDACC PTC

• Timing and ease of process

• Accessing resources for patients and their families

“There is hope for a better quality life”

“Proton Therapy Center is my best option”

“I feel at ease”

“I’m in caring hands”

“I have continued care”

Ideal Outcomes

Key Touchpoints

Page 18: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 18

Physical

Environment

Communications

Review

1.

Interviews

From Data…

Video /

Audio

Recordings

Interview

Transcripts

2.

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…to Insights

Detailed Findings:

• Key themes

• Verbatim comments

• Strengths and barriers

3. Day in the Life

Touchpoint Assessment:

• Key Recommendations

• Illustrate with pictures

• Enrich with clips

4.

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Differences in Needs

What We Do

• Services offered

• Clinical outcomes

• Transfer efficiency

• Scheduling delays

Functional Needs How We Do It

• Inclusion in treatment

• “Feel” of the interactions

• Subjective quality judgments

• Feeling valued

Emotional Needs

NUMBERS STORIES

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Structure

MDACC provides the best care and communication

They are experts, but I need to know more about what it’s

like to be a patient

I an anxious about the travel requirements and changes

to my lifestyle

High performance Moderate performance Low performance

“MD Anderson is the best option to beat cancer”

Ideal Outcome:

Day in the Life:

Touchpoint Performance:

Icons for each stage:

Electronic communications, telephone

communications, facility, written communications,

interpersonal communications

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Proton Therapy Patient (summary)

DESCRIPTORS

• Most are males, approaching

retirement age or older with prostate

cancer or difficult to treat/reach

cancers

• Knowledgeable, independent

individuals who conduct research for

their best chance at a better quality

life; place high value on information

BEHAVIORS

• Research is an important part of

decision-making

• While time is of the essence, they invest a lot of effort on primary (e.g., interviewing patients and physicians) and secondary research (e.g., online information)

• Rely on their physicians, family members and friends to provide insight (e.g. treatment options, providers), but they make their own decisions

“I didn’t realize proton therapy was an option for me until I started

doing my homework. Without a nudge, I probably would have

gone with a more common approach, so I’m glad I took the extra

step. I believe this will provide me with a higher quality of life.”

NEEDS

• Severity of diagnosis and side

effects of traditional cancer

treatments create sense of

urgency and determination to find

best option for a quality life

• Involved and enduring treatment

increases anxiety for patients and

amount of care needed

• Knowledge about Proton Therapy

Center is limited to nonexistent

Page 23: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

INSIGHTS

3

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Many Not Aware of Proton Therapy Option

Please indicate your familiarity specifically with proton therapy for cancer treatment:

Page 25: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

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Ideal Outcome

Patients want overall

“I have the

resources I need.”

Proton Therapy Center Functional Needs

Flexible scheduling

Resources that facilitate process

(shuttle to main campus)

Clear contact information

Timely appointments

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Ideal Outcome

Patients want overall

“They truly care about me

here.”

Proton Therapy Center Emotional Needs

Connectedness with other patients

Feelings of care and ease

Calming environment

Assurance they’ve made the right choice

Page 27: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

INSIGHTS TO ACTION

3

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Translating Insights into Action

Communication Coordination Care

Awareness Need Scheduling Treatment Transition of

Care

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Brand Message Refinement

Message Communicated

Current Interpretation

Desired Interpretation

Best Hope Last Chance First Choice

Top-Rated Cancer Center

Serious/Rare Cancer Only

All Cancers

Research Driven Care Impersonal Care Compassionate Care

International Reputation

Expensive Best Treatment Anywhere

Contact Us Need Physician Referral Can Self-Refer

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Proton Marketing and Outreach Efforts

• Advertising has to educate and create demand • Define proton therapy quickly

• Strong digital component required

• Reach prospective patients at the point of searching for treatment options

• Find ways to raise awareness and educate

more people about proton therapy • Public relations

• Sponsorships

• Partnerships and activities with advocacy groups widen audience reach – ProtonPals

– American Brain Tumor Association

– National Lung Cancer Partnership

– American Childhood Cancer Organization

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Digital Presence

• Expanded online presence

allows prospective patients and

families to find us more easily

• More robust content

• Launched mobile site

• Social media

• Facebook/Twitter serve as a

community of prospective,

current and past patients

• Patient/physician blogging

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PAGE 32

Patients Stories Offer Hope, Inspiration

Website • Goal: At least one patient story for

every disease treated

Facebook, Twitter, YouTube • Share photos and links to patient

stories

• Videos of patient testimonials and tips about their experiences with proton therapy; “graduation” celebrations; profile clinical teams

• Share “case studies” to show the difference between protons and photons to educate about possible side effects

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Patient Stories – Gene

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Patient stories – Addison

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New Standards

• Weekly patient education meetings (some patient led)

• Build out of private area for pediatric patients and families

• Earlier appointment times for young patients who require sedation

• Greater integration and increased hours for child life specialist

• Included specific service standards and communication efforts in staff performance plans

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Insight Sharing

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Process Improvement

• Reaching out to internal stakeholders: education

and relationship building

• Increased information and support to help patients

register for the online patient portal

• New process for patient follow-up appointments

• Education for external referrers: Proton Therapy

Center Conference and other efforts

• Easier access for prospective patients: Create

dedicated online referral form; contact center

coming online soon

Dana will populate the rest of this

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Call Model and Dashboard

1. Align around goals and

objectives 2. Assess current call

center experience 3. Define ideal workflows

and system needs

4. Design call model, call

center system, service

recovery application, and

dashboards

Page 39: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 39

Results

• Strengthen internal relationships and

referrals

• More collaboration among centers;

expansion of diseases treated

• Education and increase in external

referrals

• Staff alignment

• Increase in self referrals

• Patient satisfaction scores

Page 40: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

ADAPTING PRACTICES

5

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Status Quo Vision

Transformation Requires Commitment Employees will travel up a “commitment curve” that defines the stages for building personal commitment to support

the brand; the design of implementation will take this into consideration using a combination of pilots, mandates,

and sharing of practices.

Internalization Individuals make new process their own and create innovative

ways to use and improve

T I M E

CO

MM

ITM

EN

T

High

Contact Individuals have heard

new initiative exists Low

Awareness Individuals are aware of basic scope and concepts of new

initiative

Understanding Individuals understand impacts to organization and their functional

area

Positive Perception Individuals understand new process impacts

and benefits to them

Adoption Individuals are willing to work

with and implement new process

Institutionalization New process is the way work is done -- the

new status quo

While the speed with which an

individual moves up the commitment

curve may vary, the stages themselves

are inevitable

Page 42: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 42

Prescriptions for Your Organizations

• Sell in the concept by linking to revenue potential • Satisfaction => Advocacy => Word of Mouth

• Empowered staff = happier patients

• Start with clinical services lines that are bought in

• Don’t try to tackle everything at once • Focus on “sphere of action”

• Identify quick wins and execute

• Follow-up and refine the process for new areas

• Share best practices across organization

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PAGE 43

Follow-up Assessment Tools

1. a. Caring Environment: Service with a Smile

Caring Environment: Service

with a Smile

Employees do not

provide caring and

friendly services or

service with a

smile and there

are no official

service standards

in place requiring

it

Employees may

choose to be

caring and

friendly, but there

are no official

service standards

in place requiring

it

Employees verbally

encouraged to be

caring and friendly,

but there are no

official service

standards in place

requiring it

All employees are

expected and held

accountable during their

reviews to follow uniform

service standards that

include providing caring

and friendly services with a

smile

Patients report

consistently expecting

and receiving caring and

friendly services from

insititutional personnel

with few to no

exceptions.

1 q 2 q 3 q 4 q

Maturity Continuum

Highlighting Best

Practices

Ratings from

Observations and

Self-reporting

Typical

Evidence

Page 44: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

Benchmarking Your Progress

Source: Gelb / APQC / Beryl Institute Survey

Page 45: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 45

We Celebrate Success…with a Shake

Page 46: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 46

Contact Us

Dana Hoyland Lee

Manager, Marketing

[email protected]

John McKeever

Executive Vice President

[email protected]

Page 47: Using patient stories to create a culture that cares: MD Anderson & Gelb - Beryl Institute

PAGE 47

Endeavor Management is a strategic transformation and management

consulting firm that leads clients to achieve real value from their

initiatives. Endeavor serves as a catalyst by providing the energy to

maintain the dual perspective of running the business while changing the

business through the application of key leadership principles and

business strategy.

The firm’s 40 year heritage has produced a substantial portfolio of proven

methodologies, enabling Endeavor consultants to deliver top-tier

transformational strategies, operational excellence, organizational

change management, leadership development and decision support.

Endeavor’s deep operational insight and broad industry experience

enables our team to quickly understand the dynamics of client companies

and markets.

In 2012, Gelb Consulting became an Endeavor Management Company.

With our Gelb experience (founded in 1965) ,we offer clients in-depth

insights in the healthcare industry and unique capabilities that focus their

marketing initiatives by fully understanding and shaping the customer

experience through proven strategic frameworks to guide marketing

strategies, build trusted brands, deliver exceptional customer

experiences and launch new products.

Endeavor strives to collaborate effectively at all levels of the client

organization to deliver targeted outcomes and achieve real results. Our

collaborative approach also enables clients to build capabilities within

their own organizations to sustain enduring relationships. For more

information, visit www.endeavormgmt.com and www.gelbconsulting.com

2700 Post Oak Blvd., Suite 1400

Houston, TX 77056

+1 713.877.8130

www.endeavormgmt.com/healthcare