One System’s Approach to a Consistent Patient Experience

Abstract

The mission of the nonprofit Carolinas HealthCare System, based in Charlotte, North Carolina, is improve Health, elevate Hope, and advance Healing-for all. To fulfill this mission, 60,000 teammates and 3,000 providers must create a consistent experience for our consumers through 11.5 million encounters annually at more than 900 care locations.In early 2013, as our corporate patient experience department structure was being developed, patient perception metrics indicated an inconsistent experience across care locations. At the same time, the organization's brand was being repositioned: The word was introduced in organizational internal messaging to drive unity of purpose, strengthen teamwork, and promote inclusion among our diverse teammates and patients. Using The Beryl Institute's (2016) definition as the foundation and playing on the concept of One, Carolinas HealthCare System adopted the following definition of patient experience:The sum of all interactions, shaped by the One culture of Carolinas HealthCare System, that influences patient perceptions across and at each point of the continuum of care.With an organizational definition in place, we created an organizational framework for supporting patient experience concepts and tactics. Many Carolinas HealthCare System locations had adopted an established care delivery or customer service model (e.g., Studer, Planetree, Magnet, patient-centered care), resulting in wide variations in practice and culture. To create One culture, the patient experience department team, in collaboration with internal corporate support departments, operations, and clinical partners, created the One Experience model with four components. Each component comprises concepts and tactical tools to drive improvement:1.Foundations of Caring-using consistent, evidence-based methods to enhance the experience (e.g., purposeful rounding, starting and ending each interaction with empathy, clearly completing patient handoffs)2. Teammate Engagement-demonstrating that we respect, value, and recognize each other as our system's greatest assets3. Healing Environments-offering nurturing and therapeutic spaces that reduce stress and foster well-being4. VOICE (Values, Opinions, Information, Compassion, Engagement)-inviting, listening, and responding to patient and family voices for continuous improvementIMPLEMENTATION STRATEGIESusing the one Experience model to drive one culture, four key strategies guide our patient experience efforts:1. Set common goals. An annual quality and patient experience goal-setting session allows both administrative and physician leaders from each location to vote on priorities for the coming year. This all-in approach affirms the connections among experience, quality, safety, and outcomes.Patient experience goals are cascaded across the organization annually via a series of physician-led calls with each hospital's administrative team, including quality and patient experience representatives. Facilities are given their goals for each reported area, and each site is aware of its contribution to the overall performance goals for the coming year. Annual incentives for all teammates are determined by common metrics.2. Deploy standard work. Specific tactical components of the one Experience model are defined as nonnegotiable standard work. The patient experience team works with leaders, providers, and other teammates to confirm that these tactics are in place consistently. For example, the tactical nonnegotiables in the Foundations of caring component of the model include deploying established standards of behavior and executing purposeful rounding, and they are continually validated and reinforced at every level. Another Foundations of Caring tactic-providing health-literate patient education-is supported via a corporate structure to ensure patient educational documents meet basic health literacy requirements. …