Executive patient experience rounds
put patients first
Most people would agree that the last place they want to be is in the hospital. But unfortunately, there comes a point in everyone’s life when they need to be treated in hospital for health-related issues. Here at St. Joseph’s Health Centre, our focus is on finding ways to give patients the best experience possible when they come to us for care.
With the launch of our Executive Patient Experience Rounds (EPER), this is one more way we are reaching out to our patients and their families to hear how they feel about their experience while they are in hospital.
The Executive Patient Experience Rounds, which have been in place for over a year, bring members of our Senior Leadership Team, including the President and CEO, to our patients to conduct on-the-spot interviews at the bed side. This face-to-face conversation provides an immediate opportunity to talk about the care experience and/or ask any questions that may be on their minds.
Richard Edwards, Director of Patient, Family and Community Engagement at St. Joseph’s explains that this initiative – having senior leaders involved in rounds with our patients and families – demonstrates commitment from our leadership team that listening to patient and family input is critical in establishing ways to enhance the patient experience.
“Through the usual measure of patient satisfaction (surveys), our results are usually pretty high,” explains Edwards. “Satisfaction data show that 80-90 per cent of patients in hospitals across the province are pretty satisfied (with their hospital care).”
“The issue,” Edwards explains, “Is determining what the reference is that individuals have in their mind when thinking about satisfaction – and if it’s a true reflection of how they feel about their overall patient experience.” Satisfaction tends to be related to expectation, so satisfaction can be easy to achieve if expectations are low.
“For example, a patient might say ‘yes I’m satisfied that I got the care I needed’, the implicit reference being ‘without having to sell my house to pay for my treatment’. Given the alternative, of course they are satisfied. So while they have answered yes on a survey to say they were satisfied with their care, it still doesn’t necessarily reflect (how they felt about) their experience overall,” he adds.
“We want to know more than just if a patient was satisfied, to give us a fuller sense of what it means to be in the hospital,” says Edwards. And while conventional satisfaction surveys do ask questions about specific aspects of care, the results may be significantly delayed so that follow-up is difficult. “So that’s where the Experience Rounds come in. It’s an opportunity to explore the patients’ experience in some detail when it is still fresh in their minds: Did they feel anxious? When? What caused, but also what helped to alleviate, the anxiety? Did they feel things were explained to them properly and in a way they could understand? How were they involved in the decisions made about their care, and how would they have preferred to be involved?”
Each week, two members of the Senior Leadership Team, plus a scribe, visit various units in the hospital to interview patients and their families. Standard questions posed to patients and families that start the conversation include:
• What’s gone well in your experience here?
• What’s not gone well in your experience here?
• What are the one or two things we would recommend to improve your experience?
The conversation can extend into questions that come from each patient and/or areas in which the Health Centre is seeking specific feedback. With patient consent, anonymous responses from their interviews are tracked in our Patient Relations database and reviewed quarterly to identify common themes that could be potential areas of focus where improvements could be made.
Edwards explains that some of the feedback gathered through the Experience Rounds to date includes patients saying that being cared for is important, not just in a “technical” way but as one human being to another. Patients have said that they understand the pressures we are under in the hospital, and they appreciate staff doing the little things to make their time at St. Joseph’s the best possible under the circumstances. Patients have also told us that it is important to them to be met with courtesy by staff in all circumstances.
Other areas patients identified that would help improve their experience include food customization and menu options that are tailored to each patient’s preferences or dietary requirements. Patients have said that just giving them the option for their meals would be a big improvement.
Another key theme involves communication and how much patients value knowing what they can expect with their care, what will happen to them and having someone explain the process to them. “Think about how you feel when you have to repeatedly ask for information, versus having information provided freely and thoroughly without asking. Communication plays a huge part in a patient’s care experience,” says Edwards.
The launch of the Executive Patient Experience Rounds is one of several initiatives in place which form the foundation of the Health Centre’s work in Building Genuine Partnerships with Patients and Families. That work encompasses well-established programs that provide other opportunities for patients to give us their feedback, such as our patient satisfaction surveys through NRC Picker Canada, our formal patient relations process, and the Population Panels (advisory groups with patient/family representatives who provide input into to the workings at St. Joe’s) associated with Health Centre programs. Collectively, the feedback we get from all of these helps us to identify areas for improvement.
“Through Building Genuine Partnerships planning we are Putting Patients First; determining what that really looks like from the patients’ perspective and what it is that we as an organization want to aspire to when we talk about being patient-centred and enhancing the patient experience,” says Edwards.