Transforming Experience: Structure, Strategy & Sustainment

Sven Gierlinger, Chief Experience Officer

Agnes Barden, DNP, RN, CPXP – VP Patient Experience

Northwell Health | March 2018

Patient Story

• 23 hospitals (6 tertiary)

• Children’s hospital

• 2 psychiatric hospitals

• 4 nursing/sub acute facilities

• Over 600 ambulatory locations

• 15,000 affiliated physicians

• 3,900 member physician medical

group

• Broad geographic coverage

• 10.8 million population

• Provides care to 4 million persons

• 28% inpatient share

• $11 billion revenue

• “A” rated

• 63,500 employees*

• Largest private employer NYS

• Major academic &research

center

• Comprehensive and full

continuum of care

• A continuously growing

footprint*Inclusive of affiliates, 58,000 Northwell Health employees

© 2017; Northwell Health, Lake Success NY 11042

© 2017; Northwell Health, Lake Success NY 11042

© 2017; Northwell Health, Lake Success NY 11042

Consumerismin health care requires new

thinking , new culture and new

practice.

“We must realize we are now in

the customer service business.”

“We are in competition for the

customers’ attention and

satisfaction.”

“What they want versus what

we provide.”

“We have a technologically

empowered new generation of

customers.”

Leadership Rally |Madison Square Garden Theater, NYC

Call to action

Focus on patient experience, innovation & leadership

4,000+ leaders gathered to drive healthcare forward

Governing Structure of Patient & Customer Experience

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Office of

Patient &

Customer

Experience

• Chaired by CEO & CXO

• Senior leaders: COO, Regional SVPs, CHRO, CMO, CNO, CLO & other key stakeholders

Senior Patient & Customer Executive Steering Committee

• Culture Leader Council

• Data Owner Council

• Support Service Council

• Patient & Family Partnership Council

Office of Patient & Customer Experience • Executive Directors

• Medical Directors Committee

• Chairs Council

• System Nurse Executive Council

• System PICG/Quality

• Digital PX

• Diversity & Inclusion Council

• Collaborative Care Councils

Collaborations, Partnerships &

Advisory Functions

© 2017; Northwell Health, Lake Success NY 11042

© 2017; Northwell Health, Lake Success NY 11042

© 2017; Northwell Health, Lake Success NY 11042

PX Composite MeasureA Comprehensive Approach to Service Accountability

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Standard ReportingInternal Dashboards

CMS HCAHPS Star RatingsForecast Reporting

Month Day, Year 17

Getting From Good to GreatDeep Dive Patient Interviews: A Pragmatic Approach

Background

• The healthcare landscape is shifting from pay-for-performance to value based

purchasing; focus is on achieving Top Box

• Northwell OPCE wanted to explore why a patient would rate ‘definitely recommend’

vs. ‘probably recommend.’ Q: What impacts that decision?

Methodology

• Interview discharged patients who rated HCAHPS ‘probably recommend the hospital’

and ‘definitely recommend the hospital’

• Perform sentiment analysis and collated reoccurring themes

Findings

• Overall experience is influenced by many factors

• Reoccurring themes: behavior, processes, environmental factors

• Individual interaction can overshadow collective experience

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© 2017; Northwell Health, Lake Success NY 11042

Culture LeaderNetwork of 57 PX Leaders & Influencers

Selection Criteria

Report directly to CEO/VP

Monthly meetings

Ongoing development

Shared Work Teams

Patient & Family Partnership Council Our true North

The “voice” of former patients and families

Hospital and Service Line Councils

Corporate Council (Brand, Webpage, Billing, Innovation)

© 2017; Northwell Health, Lake Success NY 11042

Education & Research

Relationship Centered

Communication

PX Research

Culture of C.A.R.E.

Education, Policy &

Competency

Physician PX EngagementA Novel Physician Structure

Office of Patient & Customer Experience

System Medical Director, Patient

Experience

Physician Leadership

Medical Directors

NWHPP

Residents

CLI

Zucker School of Medicine at

Hofstra Northwell University

Local Physician Leaders &

Influencers

Train-the-Trainer Model

Vision CascadeAlignmentPartnershipsLeadership

Relationship Centered Communication (RCC) A Comprehensive Strategy

Buy-In & Commitment Organizational & Leadership

Train-the-Trainer ModelSelection; local leaders , influencers & role models

Evidence-based CurriculumZucker School of Medicine at Hofstra/Northwell & AACH

Program DeploymentSmall groups; role-play with coaching model; research

SustainmentCommunities of Learning & Practice

RCC Sustainment Maintaining Skills & Building Upon Momentum

Communities of Learning & Practice

Dedicated time at local site-level

- Led by local RCC faculty

- Skills practice

- Open discussion

- Real-time coaching & mentorship

- Peer-to-Peer support

+ 6 percentile pointsBiggest HCAHPS domain

increase for Northwell

’16 – ’17

Research Studies

IRB Study #1

Hypothesis: Facilitators who successfully complete the training

program will demonstrate improvement in their ability to teach

relationship-centered communication skills to colleagues.

Findings: Facilitator communication skills showed significant

improvement for 2 of the 3 subscales.

IRB Study #2 (2018 Beryl Institute Research Grant Recipient)

Hypothesis: subjects who successfully complete the educational

program will self-identify a decrease in burnout and an increase in

patient-centeredness orientation and engagement.

Implementation: November 2017 and ongoing throughout 2018

© 2017; Northwell Health, Lake Success NY 11042

Innovation

Food Transformation

Real-Time Feedback

dPX

Digital Front Door & Access

Turning Hospital Food from Liability to AssetA Collaborative Structure

Fiscal

ResponsibilityCulture of

C.A.R.E.Wellness

Brand Promise

Our Food Transformation A Holistic Strategy

Partnerships: Vision & Leadership

Engagement: Talent & Development

Operations: Focus on quality & consistency

Procurement: Fiscal responsibility

Communications: Education, Promotion & Recognition

Measurement: Dashboards & Performance Improvement

Northwell Health

All PG Database Rank

© 2017; Northwell Health, Lake Success NY 11042

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Thank You

Northwell Health

Office of Patient & Customer Experience

2000 Marcus Avenue | New Hyde Park, NY 11042

experience@northwell.edu

www.northwell.edu/patientexperience