Patient Experience

A Journey to Excellence

Leadership Questions

• What will look different on your calendar related to patient experience?

• How do you connect your staff to the joy of service?

• What can you do to better hear the voice of the patient (customer) on a regular basis?

• What am I missing related to my customer?

Leadership Weekend

• Weekend Overview

• Sunday Work Session

• Break Time Instructions/Design Activity

Leadership Weekend

Overview

• Connect with the Importance of Patient Experience

• Meal Time Instructions

• Need Assistance? – Lorenzo Brown– Marlissa Ledesma– Cristin Repasky

• Program Orientation

Leadership Weekend

Sunday Session

• Team Photo Shoot– 7:30 a.m. - 9:00 a.m.– 12:10 p.m. - 12:20 p.m.

• Business Unit Seating • Commitment Cards

Name: _____________________________________

Title: ______________________________________

Years of Service : ___________________________

LEADERSHIP WEEKEND 2008

Patient Experience Commitment

My Leadership Commitments to Patient Experience in 2009

1. ______________________________________________

2. ______________________________________________

3. ______________________________________________

4. ______________________________________________

Signature____________________________

Leadership Weekend

Break Instructions

• Take Your Belongings

• Badge Number Seating

• Table Captains

• Activity Hosts– Jay Perez– Marla Silliman– Sheryl Dodds

Design ActivityDesign Activity

FH Experience Drivers

• “One Continuous Experience"

• Team Based (Physicians, Employees, Leaders)

• Experience Starts with the “Voice of the Patient” – Experience is created in “Real Time”

• Fundamentals First

• Highly Intentional

• Treated Like Family

Experience Model – One Continuous Experience

Act 1: Arrival Act 2: TreatmentAct 3: Departure

Environment Interaction

CoreProcesses

Patient Experience

• Environment– Front Entrances– Lobby/Waiting Rooms– Clinical Spaces– Sights/Sounds/Smells– Appearance

• Interaction– Communication (Physician/Staff/Patient)– Caregiver Relationships– Trust/Belonging/Hope

• Core Process – Clinical Process– Operational Process

Environment Interaction

CoreProcesses

FH Experience Model

Act 1: Arrival Act 2: TreatmentAct 3: Departure

Environment Interaction

CoreProcesses

Environment Interaction

CoreProcesses

Environment Interaction

CoreProcesses

FH Experience Model

Act 1: Arrival Act 2: TreatmentAct 3: Departure

Environment Interaction

CoreProcesses

Environment Interaction

CoreProcesses

Environment Interaction

CoreProcesses

VOP/VOT/CommunicationVOP/VOT/Communication Service Standards

Service Standards

Rewards and RecognitionRewards and RecognitionService RecoveryService

Recovery

FH Experience Drivers

• “One Continuous Experience”

• Experience starts with the “Voice of the Patient” – Experience is created in “Real Time”

• Team Based (Physicians, Employees, Leaders)

Team Quote

“You can design and create, and build the most wonderful place in the world, but it takes people to make the dream a reality.”

Walt Disney

FH Experience Drivers

• “One Continuous Experience”

• Experience starts with the “Voice of the Patient” – Experience is created in “Real Time”

• Team Based (Physicians, Employees, Leaders)

• Fundamentals First

• Highly Intentional

• Treated Like Family

Activity Activity InstructionsInstructions

Design Activity - Goals

• Identify what matters to patients – through Act I, II & III.

• Specifically Identify the “Must Haves” and the “Delighters” that contribute to the Patient Experience.

• Learn the fundamentals of team engagement.

Acts I, II, III

• Definitions– Act I: Arrival: Pre-Arrival, parking onsite

to arrival at clinical area

– Act II: Treatment – Pre-Discharge

– Act III: Discharge/Departure

5 Step Process

1. Instructions – 2 Minutes

2. Idea Generation – 7 Minutes

3. Review of Ideas – 8 Minutes

4. Ranking of Ideas - 2 minutes

• Action Plan – 7 Minutes

5. Transition

Patient Experience

2009

System Experience Team

• Since we met in July…

• Understanding Performance – Gallup to HCAHPS

• Patient Experience Drivers & Model

• Deployment Model

• 2009 Goals & Strategy

What we said in July…Next Steps

• Formalize Learning– Completion of Research – Patient Experience Pilots

• Planning Process– Development of the Methodology– Focus Week Planning – 2009 Roadmap

• Experience Focus for Leadership Weekend

Gallup Patient SatisfactionHistorical Trend

• Outpatient (Test & Treatment and Surgery)– OP overall satisfaction top box ratings have

consistently been in the top quartile and frequently in the top decile over the past 5 years.

• Emergency Department– Overall satisfaction top box rating has ranged between 42% to

49% over the past 5 years.– Ratings have steadily improved since 2006 with PTD scores for

2008 at the highest level ever achieved.

• Inpatient (Adult and Pediatric)– Overall satisfaction top box rating has ranged between 54% to 57% over

the past 5 years.– Ratings have been in decline since 2005.

Gallup Patient SatisfactionHistorical Trend

• Outpatient (Test & Treatment and Surgery)– OP overall satisfaction top box ratings have consistently been in the top

quartile and frequently in the top decile over the past 5 years.

• Emergency Department– Overall satisfaction top box rating has ranged

between 42% to 50% over the past 5 years.– Ratings have steadily improved since 2006 with

PTD scores for 2008 at the highest level ever achieved.

• Inpatient (Adult and Pediatric)– Overall satisfaction top box rating has ranged between 54% to 57% over

the past 5 years.– Ratings have been in decline since 2005.

Overall Satisfaction Emergency Department

Gallup Patient SatisfactionHistorical Trend

• Outpatient (Test & Treatment and Surgery)– OP overall satisfaction top box ratings have consistently been in the top

quartile and frequently in the top decile over the past 5 years.

• Emergency Department– Overall satisfaction top box rating has ranged between 42% to 49% over

the past 5 years.– Ratings have steadily improved since 2006 with PTD scores for

2008 at the highest level ever achieved.

• Inpatient (Adult and Pediatric)– Overall satisfaction top box rating has ranged

between 54% to 57% over the past 5 years.– Ratings have been in decline since 2005.

Overall Satisfaction Inpatient

Patient Experience Goals2009 - HCAHPS

2009

2010

2011 andbeyond

Basic Performance(50th National Ave.)

Good Performance(+75th Percentile)

PacesetterPerformance

(+90th Percentile)

Tri-County HCAHPS Results

20th10-20th20-30th60thPercentile

74%73%75%80%AlwaysDischarge Information

50-60th30-40th40-50th60thPercentile

55%49%51%56%AlwaysQuietness of Hospital Environment

50-60th10-20th30th60-70thPercentile

67%57%62%70%AlwaysCleanliness of Hospital Environment

30-40th10th30th70thPercentile

53%48%52%59%AlwaysCommunication about Medicines

20-30th10-20th30th60thPercentile

62%60%63%68%AlwaysPain Management

OHFHState

AverageNational Average

Tri-County HCAHPS Results

60-70th20-30th30-40th50-60thPercentile

71%58%62%67%DefinitelyWillingness to Recommend

60-70th20-30th30th60thPercentile

65%56%57%64%DefinitelyOverall Hospital Rating ("9" or "10")

40th10-20th20-30th60-70thPercentile

56%50%53%63%AlwaysResponsiveness of Hospital Staff

20th<10th20-30th60thPercentile

73%66%74%80%AlwaysCommunication with Doctors

40th10-20th20-30th60-70thPercentile

69%62%66%74%AlwaysCommunication with Nurses

OHFHState

AverageNational Average  

HCAHPS: Willingness to Recommend 30th 50th 80th - PPM Goal

GOALS 61% 67% 75%

Orlando (41%) 0 -6 -14

Altamonte (16 %) -8 -14 -22

Winter Park (14 %) 0 -6 -14

East Orlando (14 %) -17 -23 -31

Celebration (9%) +6 0 -8

Kissimmee (4%)

Apopka (3%)

FH System -3 -9 -17

Projected Inpatient HCAHPS Targets

FH Experience Drivers

Drivers to Action

FH Experience Drivers

• “One Continuous Experience”

• Experience starts with the “Voice of the Patient”

• Team Based (Physicians, Employees, Leaders)

• Fundamentals First

• Highly Intentional

• Treated Like Family

FH Experience Drivers

“One Continuous Experience”

• What is your contribution to the Patient Experience?

• Do you understand what is required from your team?

Environment Interaction

CoreProcesses

FH Experience DriversVoice of the Patient

• How do you hear the voice of the patient?

FH Experience DriversTeam Based

• Is your team engaged?

• Do they have a passion to serve?

FH Experience DriversFundamentals First

• Safety

• Clinical Performance

• Communication

• Responsiveness

• Execution of Core Process

FH Experience DriversHighly Intentional

• Did you intend to produce your current level of performance?

• Do you study what actually occurs in your service delivery?

FH Experience DriversTreated Like Family

• Have those you have served been treated like family?

Patient Experience Model

Act 1: Arrival Act 2: TreatmentAct 3: Departure

Environment Interaction

CoreProcesses

Environment Interaction

CoreProcesses

Environment Interaction

CoreProcesses

VOP/VOT/CommunicationVOP/VOT/Communication Service Standards

Service Standards

Rewards and RecognitionRewards and RecognitionService RecoveryService

Recovery

Business Unit Execution

SystemSystemRequiremenRequiremen

tstsPatient Centric Model

(Act 1, Act 2, Act 3)

Business Unit Ownership

Employee Driven

Common Metric Set

System Coordination

FH Wide Solution18-24 Months

HCAPHSHCAPHSNationalNationalAverageAverage

2009 Goal:Meet or Exceed

HCAHPSNational Average

2009 Goal:Meet or Exceed

HCAHPSNational Average

HR Structure/Strategy

Process Improvement

Research/Development

Program Structure

Business UnitBusiness UnitExecution/StrategyExecution/Strategy

System Resource Utilization

Deployment

Disney Children’s Hospital

CernerProject Mgmt Expertise and

Execution

EDThe few and

focus

GinsburgDesign

Philosophy

Disney & PartnersExperience

Children’s HospitalsBest Practices

SIA 1,2,3Internal

Expertise

2009 Road Map

Oct 9–12, 2008Leadership Retreat

Oct 6 - Nov 14, 2008Finalize Campus and System Resources

2008 2009

Operating - Strategy/Deployment

Banks/Silliman & Dodds/Perez

Operating - Strategy/Deployment

Banks/Silliman & Dodds/Perez

GovernanceCummings/Paradis

GovernanceCummings/Paradis

Pt. ExperienceSystem Team

Pt. ExperienceSystem Team

Design Support/Resource TeamDesign Support/Resource Team

TrainingSupportTrainingSupport

Subject Matter ExpertSupport

Subject Matter ExpertSupport

Process ImprovementSupport

Process ImprovementSupport

VOP/VOT/Communication

Role

ServiceStandards

Role

ServiceRecovery

Role

Rewards &Recognition

Role

Campus Lead

VOP/VOT/Communication

Role

ServiceStandards

Role

ServiceRecovery

Role

Rewards &Recognition

Role

VOP/VOTCommunications

System/CampusService

Standards

System / CampusService Recovery

System / CampusRewards & Recognition

System Learning's

2009 Road Map

Oct 9–12, 2008Leadership Retreat

Oct 6 - Nov 14, 2008Commit System and Campus Resources

Oct 13 – Jan 23, 2009 (System & Campus)Current State / Future State Opportunity Mapping/Build TeamsJan 26 – Mar 6, 2009

Design & Develop Service Standards/Campus Programs

Mar 9 – Apr 3, 2009Acquire & Train Instructor / FSE Resources

Apr 6 – Sep 30, 2009Campus-wide Training and

Program Implementation

2008 2009

ENDEND

Overall Satisfaction Top Box and Percentile TrendOP Test & Treatment

Overall Satisfaction Top Box and Percentile TrendOutpatient Surgery

System Experience Team

• Des Cummings - Executive Sponsor • Andy Crowder• Connie Hamilton• David Banks• Eileen Hodgson• Gar Williams• Lorenzo Brown• Jason Wells• Jay Perez• Marla Silliman • Michelle Skubick• Sheryl Dodds• Sy Saliba

What we said in July…

• Starts with Mission• Bring Purpose and Function together• Individual Encounters• Precise Service Standards• An Integrated Approach

– Safety/Quality– Team Engagement– Service – Performance Improvement

Patient Experience Goals

Campus Ownership: Administrator Accountability Campus Excellence Teams Employee Driven

System Resource Assistance: Process Improvement Human Resources

World Class Excellence: Innovation Consistency of Experience Mission Achievement

2009

2010

2011 andbeyond

Basic Performance(50th National Ave.)

Good Performance(+75th Percentile)

PacesetterPerformance

(+90th Percentile)