Patient Experience Alpa Vyas Vice President, Patient Experience

Vizient Global Executive Services Consortium

SHC Mission & Vision

SHC Mission: To care, to educate, to discover

SHC Vision: Healing humanity through science and compassion, one patient at a time

SHC Patient Experience: Aspirational Vision [Do whatever it takes to]

Enable and empower patients and families to focus on health, healing and recovery

Patient Experience Pillars

Show Me The Way

Know Me Coordinate For Me

Anticipate my needs and status

to deliver effective care

Own the complexity of my

care through coordination

Guide and prompt my actions to arrive at

better outcomes and better health

Navigation Services Fouzel Dhebar Admin Director

Special Patient Services

International Medicine

Medical Center Development/Relationshi

p Management

Clinical Advice Service

Ground Navigation

Enterprise Contact Center Steven Alexander Executive Director

Radiology Scheduling

Access Operations Contact Centers

(PATH, SPARC, MD Relations)

Guest Services Call Center

UHA Contact Centers (Emeryville)

Service Excellence Mysti Smith-Bentley

Admin Director

Patient Satisfaction Feedback ,Reporting &

Deployment

Physician Coaching

C-I-CARE & Service Programs

Health Education, Engagement & Promotion

Marissa Duswalt Admin Director

Health Library

Supportive Care

Health Education

Product & Service Design

Finance & Operations Khatra Latifi

Director

Retail Programs

Music, Massage, & Art Therapy

Interpreter & Translation Services

Finance & Business Analytics

Shared Services

Patient Experience Alpa Vyas

Vice President

Volunteer Services

Includes support for the Administrative Fellows program

Patient & Family Partner Programs

Patient Relations

Prog

ram

s & S

ervi

ces

Marketing, Communications

Expansion Strategy, New Facility Planning

Busin

ess

Uni

ts

Second Opinion

ACO Integration

CareCounsel Tom Tang

Operations Director

Contact Center Operations – SHC Alliance,

CareCounsel

CareCounsel Service Excellence

Contact Center Operations – Affinity, SHC

Advantage

HR/Benefits

Client Services

6

Provide International Patient & Visitor Logistics

• 24/7/365 in-person access to services

• Information – general and health/medical

• Intake & Visas • Financial arrangements • Compliance & regulation oversight • Cultural competence • VIP Patient Services • Language capabilities in house

(10) • Referring Physician coordination • Physician record review / specialty

second opinion • High Touch Navigation Services

Develop/Maintain Long-Term Relationship for

Stanford Medicine

• Maintaining international network with patients, families, and healthcare professionals

• Liaison to hospitals, government, and business entities in selected countries to strengthen local and regional presence for Stanford

• Promoting marketing and branding effort customized for region and culture

Enhance Professional Training/Education for International Providers

• Clinical observerships including administration and faculty- driven clinical research

• Hosting on-campus visit for int’l guests (only if relevant to patient services, educational program, marketing, development, consulting /advisory services)

• Regional conferences, domestic or overseas, for training and education

Support Global Strategic Programs

• Evaluation of business opportunities (e.g. speech request, collaboration request from patient referral services and education agencies) based upon Stanford Medicine strategic criteria

• Partnering with SoM/SHC/LPCH leadership to develop infrastructure and resourcing to operationalize programs, including faculty communication, compensation model, monitoring mechanism, etc.

International Medicine Services

The Patient Experience Team at Stanford Health Care

C-I-CARE

Patient Need Access to SHC Visit/Stay Post-Discharge Home/Community • Contact Center • Navigation • Access Support • Clinical Advice

Service • Health Education,

Engagement and Promotion

• Products & Services

• Amenities • Navigation • Interpretation • Real Time Feedback • Wellness Programs • Volunteer Resources • Health Education,

Engagement and Promotion

• Products & Services

• ED Call Back • Clinical Advice Service • Patient Satisfaction

Surveys • Complaints/

Compliments • Health Education,

Engagement and Promotion

• Products & Services

• Health Education, Engagement and Promotion

• Products & Services

C-I-CARE Behavior & Communications Framework

8

C-I-CARE: Background

Program Components

• C-I-CARE practices (standard, department specific)

• Department rounding

• Recognitions

• Training & Onboarding

• Service Recovery*

• Management rounding C-I-CARE is a framework for structuring best practice communications and developing relationship-based care approaches with patients, families, and our colleagues

Local accountability

*For complex issues and formal complaints and grievances the Patient Relations team offers support and follow up for the organization

C-I-CARE: Background C-I-CARE is a framework for structuring best practice communications and developing relationship-based care approaches with patients, families, and our colleagues.

Onboarding & Training

• C-I-CARE Recruitment • New Employee Orientation • New Leader Onboarding • Training Videos • HealthStream Module • Badge Cards • C-I-CARE Practices &

Templates • Press Ganey Training

Active Daily Management

• C-I-CARE Department Rounding

• C-I-CARE Management Rounds

• Rewards & Recognition • Service Recovery • Web Application • Message of the Month • C-I-CARE Intranet Site • Press Ganey Data Analysis

Supporting Programs

• Physician Coaching & Communications Workshops

• Public MD Star Ratings • Likelihood to Recommend

Celebrations • Stanford Storybank • Real Time Feedback • Patient Experience Week • Centralized Press Ganey

Reporting & Support • Improvement Work

MD C-I-CARE Program support includes: • Advancing Communications Excellence at Stanford (ACES) Workshops • MD C-I-CARE Video • Physician Communication Coaching & Consultation • MD Star Ratings Program

Stanford Storybank

Patient Experience Week

MD Profile – Star Ratings

C-I-CARE: Leader Standard Work

• C-I-CARE in Huddles and on Vis Walls • Rewards and Recognitions (2 per month)

• Service Recovery Daily

• C-I-CARE Department Rounds (every employee rounded on once per month) Weekly

• C-I-CARE Management Rounds (1 daytime session per month, 1 evening session per quarter) Monthly

• C-I-CARE Template Refresh (2 times per year)

• C-I-CARE HealthStream Training (100% of staff) Annually

Routine & Ongoing: Sharing Message of the Month during daily huddles and posting on vis walls, onboarding new employees to department and role specific C-I-CARE expectations

Quarterly LTR Recognitions

C-I-CARE Spirit at Management Rounds

Navigation As A Service

12

SHC Navigation Model

The Complexity & Burden

Their experience often includes interactions and activities that happen before, between and after these events of care

Outpatient Emergency Department

Diagnostics & Treatments

?

? ?

? ?

?

Events of Care

?

?

Inpatient

Tiered Navigation Model

CLINCIAL NAVIGATION

Clinical and administrative resources that provide after-hours medical advice, inpatient discharge follow-up, emergency department discharge follow-up to patients and families 3

SPECIALTY/HIGH TOUCH NAVIGATION/CONCEIRGE

An administrative single point of contact to act as a liaison who assists in activities such as finding a physician, scheduling an appointment, facilitation of communications between and among physicians, amenities as appropriate *High-profile patients, international patients, corporate partners, etc.

2

GENERALIST/GROUND NAVIGATION

Generalist navigator based at various inpatient, outpatient and call center locations. Provides general information, courtesy visits, service recovery and amenities as appropriate 1

Reflections

• Human Glue

• Feedback Improvement

• Behavior/Communications

• Metrics – Acuity Standards/Unit of Service

• Partnerships • Operations: Access, Coordination of Care, Financial Services • School of Medicine/Faculty: Clinical Trials, Research, Global Strategy • Strategic Partnerships • Development: Grateful Patient Opportunities, Culture of Philanthropy

C-I-CARE 2.0 How do you scale?

Service: C-I-CARE 2.0

ILLUSTRATIVE ONLY

Recruitment

Onboarding

Contribution Management

Coaching & Training

Career Planning

Succession & Transition

• Clear value proposition and culture • Screening and interviewing for

service orientation and fit

• C-I-CARE overview • C-I-CARE practices for

role/department • Empathy: Through the eyes of our

patients/families • How do I personally contribute to

the patient and people experience vision?

• Rewards and recognitions • Department rounds for individual feedback • Competencies aligned to service

orientation/expectations • Moments of Truth • Proactive Responsibility • Sense People’s Needs Before They Ask

• Annual training and reinforcement

• Improvement methods & tools • C-I-CARE communications

• Alignment to patient experience vision through

leadership progression

• Transitions with respect

C-I-CARE 2.0 Awareness/Recruiting Onboarding Contribution Management Coaching & Training

Enterprise (T5/4) • Clear value proposition around mission, vision, strategy

• Employees are custodians of the brand and work to deliver the brand promise

• Service orientation assessment • Culture/C-I-CARE acknowledgement • Staff stories/Storybank • C-I-CARE expectations in all job

descriptions

New employee orientation • “Delivering the Stanford Difference” or “Being

Uniquely Stanford "program • C-I-CARE overview – service culture at SHC • Empathy: Through the eyes of our

patients/families • Name badge refresh

New leader orientation • How to deliver feedback, importance or

rewards and recognition • Translating organizational goals to your area • Incorporating service rituals

• Reporting of organizational performance in management meetings

• Rewards and recognition • C-I-CARE Spotlight Award • Physician Award for Excellence in

Service • Annual employee awards celebration

• Annual HealthStream training • C-I-CARE Management Rounds • C-I-CARE Message of the Month • Annual SHC Patient Experience

Conference/Collaborative

Department (T3) • Clear articulation of how department contributes to patient experience goals

• Welcome and reinforcement of department goals and contribution to patient experience from department leader

• Reporting of departmental performance • Service rituals

• Sharing patient comments, feedback, stories

• Performance improvement activities

• Tier 3/Tier 2 leader linked check-ins/rounds

Business Unit (T2)

• Hiring managers trained in behavioral interviewing

• Clear reinforcement of roles/expectations

• Clear articulation of how department contributes to patient experience goals

• C-I-CARE practices for role • Practices • Behaviors • Words that Work

• Role specific training completed • Demonstration and modeling of excellent

service (see one, do one, teach one)

• Reporting of business performance • Design role based competencies for service

orientation/expectations • Service rituals

• Sharing patient comments, feedback, stories

• Performance improvement activities

• Rewards and recognitions • Department rounds for individual

feedback • Competencies aligned for service

orientation/expectations

Individual (T1) • Assess personal culture fit to that of Stanford Health Care

• Commit to service culture

Commitment to Organization: I personally contribute to the patient experience every day through _____.

• Monthly department rounds and feedback • Monthly department rounds and feedback

Relationship-Centered Communication Programs

at Stanford

The Physican Partnership Program

Establish a shared model of communication amongst all physicians and APPs at Stanford Health Care.

Improved Likelihood to Recommend Care Provider

Heightened Physician Wellness (i.e. burnout, professional fulfillment, self-compassion)

Measurable Self-Reported Behavior Changes (measured longitudinally)

Create a relationship-centered culture at SHC to improve the well-being of our patients and providers.

Available to all Stanford Physicians, Trainees, and APPs

Facilitated by 12 Stanford Faculty & Staff 1:6 ratio of facilitators to

participants One day – 8 hours long Free for all providers to attend Interdisciplinary Establishing a shared provider

communication framework at SHC

ACES Workshops Are… Work to Date

ACES is a foundational, evidence-based workshop designed to help clinicians advance their fundamental communication skills with patients, families, and colleagues.

Advancing Communication Excellence at Stanford ACES

Inclusion in Funds Flow reimbursement

61 workshops completed (since Sept. 2017) 636 providers attended 124 providers registered to

attend 20 additional workshops

scheduled (through Feb. 2019) 91% Likelihood to Recommend

ACES to a colleague (n=319)

Testimonials From ACES Participants

"ACES helped me learn more communication skills than I have in my 30 years of practice.”

“I took the ACES course yesterday and I wanted to congratulate you on a really great experience. The openness and shared learning, not just about patient communication but about each other, was really a gift. How often do we get a chance to reflect, introspect, learn and practice something that we normally rush through the same way every day? The course structure was very helpful, and the focus on specific skills and “words that work” was very effective. I learned a lot, and made some new friends in the process. Right after the class, I made an old fashioned house call, and I practiced the skills I learned, and I’m pretty sure it made a difference. Thank you.” Sang-ick Chang MD, MPH Associate Dean for Clinical Affairs

"I thought this degree of communication would slow me down, but now I realize it makes me more efficient.”

*Testimonials were collected anonymously unless otherwise noted.

ACES Outcomes

Decrease in Interpersonal

Disengagement and Burnout

Improved Self-Reported

Communication Behaviors

Increase in Compassionate Self-

Improvement

Increase in Professional Fulfillment

*Calculated using data from Pilot Workshops (Sept. – Nov. 2017). Data collected 1 week before and 3 months after attending ACES. N = 37.

After attending ACES, the following statistically significant improvements were observed in Physicians and APPs*…

p=0.02, n=37

p=0.01, n=37

p=0.01, n=37

p=0.003, n=37

Summary & Next Steps

SHC Patient Experience: Aspirational Vision [Do whatever it takes to]

Enable and empower patients and families to focus on health, healing and recovery

Patient Experience Pillars

Show Me The Way

Know Me Coordinate For Me

Anticipate my needs and status

to deliver effective care

Own the complexity of my

care through coordination

Guide and prompt my actions to arrive at

better outcomes and better health

Summary & Future Work

Show Me The Way

Know Me Coordinate For Me

Anticipate my needs and status

to deliver effective care

Own the complexity of my care through

coordination

Guide and prompt my actions to arrive at

better outcomes and better health

• Implementing core behaviors and principles of C-I-CARE 2.0

• Designing the digital experience for specific archetypes

• Reimaging patient/family experience measurement

• Leveraging technology beyond traditional CRM

• Implementing core behaviors and principles of C-I-CARE 2.0

• Developing caregiver support programs and services

• Leveraging technology to enable and engage patients/families in their care

• Implementing core behaviors and principles of C-I-CARE 2.0

• Focused operational improvements on response times, access

• Continued trials of care navigation models in oncology

• Leveraging administrative and clinical contact center capabilities

THANK YOU

Questions?