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The Apple CEP JourneyThe Apple CEP Journey
33 rdrd Operations SummitOperations Summit
Tuesday24 Nov 09
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Remembering the Apple Framework
Core AttributesTreating patients with
Empathy, Care &
Professionalism
to ensureHealthy & Satisfied Patients
Enabled through 7 Habits
1. Measure
- Surveys- Feedback- Audits- Patient & Staff Advisory Group
2. Drill Down
- Patient Experience Map- Patient Focus Groups
3. Improve
- People- Service & Process- Environment
4. Visualise
- Compliment /Suggestion Wall- Achievement Board
- Apple Cards
5. Energise
- Harvest Day- Awards & Recognition- Walkabout
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Communication & Learning
LearningLearningNew Staff Existing Staff Supervisors/
Managers
Apple Basic
(CEP Standards)
Orientation withApple Basic
Refresher (through roll-
call)
Reinforcethrough audits
and roll-call
Apple Intermediate(Service Habits to
WOW)
ServiceRecovery
Service Recovery(through roll-call)
Roll call(Learn from
complaints &compliments)
Training(Practicum based on role play and
case studies)
CEP Note Pad
Communicating the CEPCommunicating the CEP
CEP Posters CEP Cards
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Media Research Consultants was commissioned by TTSH to conduct 2cycles of Customer Satisfaction Surveys and Patient Focus Groups in Jan2009 (762 patients) and Jul 2009 (1,053 patients)
Objectives are To assess the level of patient satisfaction so as to fine tune the level of
service provision To obtain a baseline ratings to be used as a benchmark against similar
surveys conducted by MOH
Following each survey, a group of patients surveyed were invited to attend afocus group. Valuable insights were obtained after each session.
Measure: BackgroundMeasure: Background
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15.9 15.1
48.7 47.8
53.3
26.8
31.4
25.7
3.7 3.3 4.21.1 1.7 1.7
19.5
0.0
20.0
40.0
60.0
Jul 09 (n=1,053) Jan 09 (n=762) MOH 08(n=791)
Excellent Good Satisfactory Poor Very Poor
Q: On the whole, how satisfied are you with TTSH?
Measure: Overall Satisfaction TTSHMeasure: Overall Satisfaction TTSH% Excellent or Good
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81.5
74.5
86.4
76.973.7
78.6
71.2
78.3
68.6
60.0
70.0
80.0
90.0
F acilities C areCoordinationK&S of Doctors K&S of Nurses C&C of Doctors C&C o f Nurses Clear Explanationon
procedures &care
K& S of AlliedHealth C & C o f Allied Health
J u l-0 9 J a n -0 9 M O H 0 8
Measure: Key Service FactorsMeasure: Key Service Factors
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Drill Down: Patient Focus GroupsDrill Down: Patient Focus Groups
I waited from 12pm to 2pmit was the first time I am seeing him.. I went in, I just sat down, and he told
me I cant look at your illness, you can go see someone else better, dont waste your time
he never checked me. The nurse asked me if I need a ward, I told I had to make a call first, ask my parents about it
she just stared at me and rolled her eyes
I waited for nearly 2 hours and was crying from the pain.. I hid in one corner because I dont want anyone to see me cryingeven in all
these pain, they must ask for payment firstthey didnt even offer a wheelchair
...the nurse ask me Why are you outside? I thought you are sponging your
grandmother?I was like am I working for TTSH?I told her, its your job, Im not there
to do it, she just walk away without doing anything.
Almost concurrently, 3 focus groups
discussions were held to gather feedback frompatients about their TTSH expectations.
Respondents were recruited from the thenongoing Customer Satisfaction Survey.
A mixture of satisfied and unhappy patientsfrom A&E, SOCs and Wards were invited toattend the session.
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Drill Down: Patient Focus GroupsDrill Down: Patient Focus Groups
Almost all of the lapses could be attributed to the breakdown of communication in oneor more of the following forms:
Communication between TTSH and the public on processes :
for example, on - Why do you have to wait? (Public communication efforts)
Communication between doctor and patient
Communication between doctor and medical team
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Improve: Recognising Your EffortsImprove: Recognising Your Efforts
Specialist Outpatient Clinics
- Names of staff (PSA or nurses) be placed on the door of the rooms that they are serving
- Billing Staff to use signature board when returning change or credit card- LCD Picture frame with Staff picture and name on running slide show can be used to flash Patient Service Survey
Scores of clinics as well
- Feedback card will be given to patient immediately upon service rendered
- Service Ambassador
Wards
- NOs doing daily rounds to identify and flag problematic cases for enhanced communication and care by team- Nurses doing daily communication updates during visiting hours
- Nurses doing post discharge call to all patients the day after discharge
Non Subsidised Services
- Service Improvement Boards for staff improvement ideas
- NSS Patient Satisfaction Survey
- Teambuilding Retreat on 31 Oct 09
- Improvement of NSS Amenities and Ambience- Establishment of NSS call Centre (in progress)
AHS & CSS
CSS
- Bi-weekly audits
- Mystery Shopper Audits
- Walkabouts
- Fun & creative roll calls
-Training of managers to motivate the team usingdifferent modes of persuasion: pathos, ethos andlogos- Internal service quality audits- Role plays
- Individualized self motivating quotes- Service role models
AHS
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Improve: Sharpening Your SawImprove: Sharpening Your Saw
Roving CEP Quiz- To proactively spread the Apple Philosophy andCEP standards to more frontline staff- 32 frontline units covered: SOCs, AHS, CSS,Wards, ED
Apple Bites Newsletter
- Monthly newsletter to share snippets of servicerelated information with the staff
- Contents include: Service messages penned byTTSH staff, audit findings, service activity updates etc
- Recommend using it as a roll call material tokeep up the momentum of good service
Doctors Service Kits
- Kit consists of a personally penned letter from apatient and a thumb drive containing CEP messages
- Content of letter contrasts the different levels ofservice experienced by one patient
- Adds a personal touch and element of reality good
service does make a difference to patients overall wellbeing
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Visualise: Embracing New MediaVisualise: Embracing New Media
Be Exceptional Intranet: http://beexceptional- CEP Training Materials- Best Practices- Chat Roll- CEP Blog
Be Exceptional You Tube Account- To upload videos taken during Apple Activities
- CEP Activity Videos Uploaded: 17
- Video Views: 2,214
Be Exceptional Facebook Account- Set up on 2 Oct 09
- No. of Friends: 38, No. of Fans: 18
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Visualise: Show That You Are Good!Visualise: Show That You Are Good!
TTSH Service Quality Challenge 2009
- Aim to b oost staff spirits for the MOH CSS Survey
scheduled for 26 Oct 09 6 Nov 09
- A fun and energising activity to inject some positive
competition and variety in the staffs daily routine work
- Total of 10 246 compliments received over 2 weeks
TTSH CEP Roll Call Video Contest
- Aim to e ncourage and reward frontline units toconduct their service training in fun and creative ways
- Total of 14 submissions from: SOCs, AHS, CSS,Wards & NSS
- Engaged hospital wide participation through:- Social Media : Videos posted on YouTube
- Intranet : Videos on YouTube linked to theIntranet for staff to view
- Staff Voting : All staff can vote for the MostPopular Video on the Intranet
Total of 8256 votes gathered
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Apple Refresh Launch:- Reinforce Apple Philosophy following first launched in Oct 08- Gear staff up for the MOH CSS from 26 Oct 6 Nov 09
Energise: Time to Celebrate!Energise: Time to Celebrate!
Apple Refresh Launch The Roadshow: - Road show activities are planned with CEPstandards in mind:
CEP Exhibition : know more about CEP
CEP Quiz : test your CEP knowledge
Makeover by Jean Yip : how to look good
Origami : follow through instructions from yourbuddy
Wii: exercise to feel good
Spot the Smiles : differentiate between thereal and fake smiles
Active & Harvest Day- Celebration of both Active Day & staffs achievements inservice quality- Rationale: Apart from keeping up their strength andenergy to take on a demanding patient workload, they arealso professionally fit in upgrading their skills and raisingthe bar of their service quality standards, as well as fit inbalancing family, social community and personalresponsibilities
- Awards for CEP Roll Call Video Contest & TTSH ServiceQuality Challenge were given out
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Measure and Benchmark
More frequent and systematic feedback and audit framework
Real time feedback solutions
Patient Feedback Survey on Consulting Doctors
Training and Improvement Exceptional Service Habits by HRD
Learning Trips to Service Leaders of various industries
Reward and Recognition
Formalise and standardise Service Award Systems
Service Competencies to be incorporated into Total Performance Management
Accreditation with National Standard Body
Collaborations Across Units
Service Day
Moving ForwardMoving Forward
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Moving ForwardMoving Forward
Service Training Certification for Doctors
Uses the handwashing certification approach
Set up the basic process of what is minimum service standards andexpectations
Sharing Focus Groups Recordings Through Podcasts
Using Be Exceptional Intranet as a platform
Can be shared through training sessions, Hospital Conferences etc
Clinician Participation in Focus Groups Engage clinicians more actively in listening to patients