enhancing the patient experience in an ambulatory setting
TRANSCRIPT
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Enhancing the Patient Experience
in an Ambulatory Setting
Joshua Miller, DO, Regional Operation, Patient
Experience Officer and Medical Director, Willoughby Hills
Family Health Center, Cleveland Clinic
YORN ID: 505
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Dr. Josh Miller Regional Operations Experience Officer,
Cleveland Clinic
Medical Director,
Willoughby Hills Family Health Center
Cleveland Clinic
The Operational Journey to
Our Ambulatory True North
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Cleveland Clinic Family Health
Centers
27 locations in 7counties
411 Physicians
& Providers
1,895
Caregivers
36 different specialty
services
1.5 Million Patient
visits per year
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What Were Our Patients
telling us?
• “The nurse did not know a thing about me! She
was rude & insensitive”
• “The doctor was extremely condescending
towards me and never listened to my concerns. I
will not see her again”
• “The receptionist was flossing her teeth when I
arrived and appeared irritated that she had to
check me in.”
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Our Patient Experience Journey
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Pati
en
t
Exp
eri
en
ce
Car
egi
ver
Exp
eri
en
ce
Cleveland Clinic Experience
2010
Excellent patient satisfaction
Highly engaged caregivers
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Experience
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Ambulatory
Patient Experience 2011
• In partnership with Press Ganey,
developed standardized, transparent
patient experience reports.
- Family Health Center views
- Physician views
- Individual desk views
- Verbatim reports
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Experience
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Good to Great Campaign
• Defined Current state
• Desired Future State
• Right people on the bus
• Behavioral Interviews
• Improve Teamwork
• Stop us vs. them
• One Cleveland Clinic
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Leadership Team
Developed Strategies
• Reemphasized Cleveland Clinic
Experience - Expected Service Behaviors
• Emphasis on Teamwork
• Executive Rounding
• Caregiver Education
- Shared local data
- Heart training
- Caregiver orientation revised
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“I’ve learned that people will forget
what you said, people will forget
what you did, but people will never
forget how you made them feel.”
Maya Angelou
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Good to Great II Tools for Leading
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Follow Up Tool:
The Stop Light Report
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Good to Great II Tools for Leading
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Characteristics of high-performing
Teams
• Shared problem-solving
• Mutual aid
• Experimentation
• Diversity of ideas
• Participation
• Mistakes are learning opportunities
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THINK OUTSIDE THE BOX
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Experience
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Good to Great III
- empowered sites to developed
action plans
• Themes for all sites
• Employee behavior and
attitudes
• Accountability
• Local leadership
• Individual Caregiver
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Individual Behavior and
Accountability
• Everyone must feel responsible for
helping the organization succeed
• Share why patient experience is
important and what part each
individual plays
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Think of an outpatient
visit you (or a family
member) have had and
what made it a great
experience?
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Individual Behavior and
Accountability • Everyone must feel responsible for helping the
organization succeed
• Share why patient experience is important and what
part each individual plays
• Empower and engage front line staff
- Front Line Leader Project
-Clinical/Clerical teams facilitating local
patient experience plans
-Professional Development and Training
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Teamwork 2011 - 2013
69.2 73.2 74.3
77.1 75.8 77.7
50
60
70
80
90
Staff Sensitivity Staff Worked
2011
2012
2013
76.3
65.2
84
73.1
%
Top
Box
50th percentile 90th percentile
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Courtesy 2011 - 2013
69.8
76.9 73.7
70.4
78.2 75.1
75.2
80 78.6
50
60
70
80
90
Check in / Regi Nurse / MA Check Out
2011
2012
201381.2
70.4
83.5
73.5
68.3
78
%
Top
Box
50th percentile 90th percentile
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What about the Physicians?
“THESE PATIENT
EXPERIENCE SCORES
ARE BOGUS. I HAVE A
WONDERFUL BEDSIDE
MANNER!!”
“Dr. X was rude and
treated me like I was
stupid. I actually
cried in the office.”
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Patients Choose Experience
“What factors are the influence on your choice of hospitals?”
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Transparency
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Physician Communication
Course
• Required for physicians and Residents
• Relationship-centered communication
• Empathy
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20
30
40
50
60
70
80
90
CP1p = .241
CP2 p=.457
CP3 p=.087
CP4 p=.246
CP5 p=.019
CP6 p=.079
CP7 p=.146
CP8 p=.017
CP9 p=.001
CP10p =.001
CP16p =.028
CP19 p=.007
%ile Rank
Ambulatory Provider Communication Pre/Post Comparison Pre
Post
* Benchmark reference, Press Ganey all client medical practice survey scores Oct 2012 - March
2013 from 843 U.S. medical practices
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20
30
40
50
60
70
80
90
CP1p = .241
CP2 p=.457
CP3 p=.087
CP4 p=.246
CP5 p=.019
CP6 p=.079
CP7 p=.146
CP8 p=.017
CP9 p=.001
CP10p =.001
CP16p =.028
CP19 p=.007
%ile Rank
Ambulatory Provider Communication Pre/Post Comparison Pre
Post
* Benchmark reference, Press Ganey all client medical practice survey scores Oct 2012 - March
2013 from 843 U.S. medical practices
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Experience
Cleveland Clinic Experience
Family Health Center leadership
Individual Family Health Centers
Individuals
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“Staff are very kind, caring &
compassionate & really listen.”
“Every visit was treated
well. On phone & in office.”
“Friendly assistant who checked me in.
Courteous medical assistant who took my
information and helpful physician who
listened carefully and made knowledgeable
inquiries followed by thoughtful
suggestions.”
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