Written By: Kristin Baird, RN, BSN, MHA
Setting patient experience improvement goals is easy. Achieving them, however takes perseverance. Healthcare delivery is complex and there is no shortage of competing priorities for your time, attention and other resources. Delivering a consistently exceptional patient experience requires the concerted effort of many people, working together seamlessly. That doesn’t happen without planning, engagement and continued vigilance.
As we enter a new year, let’s take a look at three key steps for jump starting the patient experience:
1) Establish crystal clear goals and a plan with specific priorities
Do you have a crystal-clear goals and specific plans to achieve them? While you may have an overarching goal of raising HCHAPS scores, that isn’t your plan. Your plan should detail the specific efforts you will undertake, who will undertake them, and the results expected within a specific timeframe. It’s important to express both short-term as well as long term goals that you will monitor on an ongoing basis. For instance, suppose you want to improve nurse communication HCAHPS scores. You will want to determine an overall goal as well as interim, short-term goals to help you and your team monitor performance. The long term goal could be stated as: “Increase the mean score for nurse communication from 76 to 80 by December 1, 2018.” Short term goals can be applied to specific tactics instrumental in achieving the long term goal such as:
- Conduct 5 focus groups with nurses to gain understanding of how they currently communicate with patients by February 15, 2018. Use the information gained to customize training.
- Provide Nurse/Patient Partnership training for 100% of nursing staff by April 30, 2018
2) Engage stakeholders
Goals without engagement will never gain traction. Shared ownership is the secret to flawless accountability. Going back to the previous example of improving nurse communication, it’s not enough for administration to state a goal and issue a directive. You need to engage stakeholders in helping to set the goal. After all, they are the ones who must own the goal if they’re going to be committed to attaining it. Ask for their help in setting goals. Believe me—nurses want great patient experiences. It won’t be hard to engage them in the process, but you must make an effort to engage them. That means inviting them to participate in the goal-setting process, listening to them and supporting them in making improvements.
I have worked with several organizations where well-meaning patient experience champions handed out goals and tactics like an edict from above only to be met with resentment and resistance. Don’t be that type of leader—you won’t be respected and you won’t inspire followers. Instead, take the time to connect with stakeholders, listen and support them in order to foster change. This is the secret sauce. It’s not easy, but it’s necessary. In our PXP Advisor course, we help patient experience professionals (PXPs) identify key stakeholders and establish specific strategies and tactics for engaging them to drive improvement. In our example above, you might do this by asking nurses what is going well and finding out where they think there is opportunity to make a more positive impact. Then identify what kind of support—tools, resources and training—they need to get the job done.
I once coached a PXP through this process. Initially, she felt she already knew the solutions and just needed the nurses to do what she told them to do. That’s an exercise in failure and futility. Instead, as part of the coaching, I asked her to take time to listen and learn before handing out the plan. She learned that nurses wanted more training and skill building. Telling them to make hourly rounds wasn’t a first step in this improvement process. These nurses wanted to understand the how and why of rounding first. They also felt valued when administration dedicated resources to their training.
3) Determine how you will stay the course when things go south or slip a bit
Improving the patient experience is an effort to achieve progress, not perfection. You will not see a straight-line path to perfect performance. Instead, you will likely see fits and starts, boosts and bumps. It’s important to establish a process and methods for quickly spotting signs of backsliding so that you can quickly take action or do a course correction. Be prepared to reinvigorate people on the front lines when progress slows or declines. Engage leaders and give them tools they can use to get back on track. Using the right metrics will help you ensure that you’re monitoring the right data to help you take action. For instance, if hourly rounding is a tactic you have instituted to help stay connected to your patients, waiting for HCAHPS scores to evaluate your progress gives you information way too late. Instead, monitoring a metric like daily completion rate of hourly rounds helps identify areas where course correction may be required. Whether or not nurses are rounding on an hourly basis is a leading indicator that will impact HCAHPS scores—a lagging indicator.
Having engaged leaders with useful data is a key to helping them stay on track. Be encouraging. No one wants to be beaten up about scores or slips toward their goals. Remind them that today is a new day with new opportunities to hit the daily goal.
The important thing, here, is that you are monitoring metrics to help you make appropriate adjustments early. Remember, it’s about progress not perfection.