Five Ways to Improve the Patient Experience

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Patients arriving at Cleveland Clinic’s Taussig Cancer Center are shielded from rain and snow by a 350-foot long awning that hangs over the building entrance. They are greeted at the door by an employee who walks with them to their appointment. In waiting areas, they are surrounded by artwork and soothing natural light that flows in through the windows.

A patient-centric approach is also at play in the design of the exam rooms, where patients are situated in the center of rooms, surrounded by monitors that display their lab and imaging results and their care plans. 

Cleveland Clinic developed this new cancer center, which opened its doors in 2017, by consulting a panel of former cancer patients who provided feedback on specific ways the space could create a welcoming and healing experience, says Adrienne Boissy, MD, chief experience officer at Cleveland Clinic Health System.

The center brings all outpatient cancer treatment services (such as radiology and the lab) to one location, reduces wait times, improves patient flow, and provides patients with a healing environment, says Boissy. Clinical teams include surgeons, nurses, genetic counselors, and social workers. The center also provides patients with access to yoga classes, free wigs and hats, and art therapy and music therapy appointments.

Cleveland Clinic’s Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score has improved 16% since 2015 because of this and other efforts to improve the patient experience, says Boissy.

If you are hoping for similar results at your healthcare system, it’s time to consider making similar changes. Here are five more to consider.

• Think beyond patients’ clinical needs

Patients undergoing drug withdrawal experience symptoms such as anxiety, depression, vomiting, and seizures. What patients need is a good night’s sleep.

Danville, Pennsylvania-based Geisinger Health System, a large healthcare system in Pennsylvania and southern New Jersey, has implemented “leadership rounds,” during which administrative and clinical leaders observe and ask about patients’ experiences.

While rounding one day, a member of the leadership team heard from a patient at one of the health system’s drug rehab facilities that he couldn’t sleep because his face kept getting stuck to his plastic pillow.

Immediately, the member of the leadership team went to a local Bed Bath & Beyond and put 77 comfortable pillows for the rehab center’s patients on her credit card, says Greg Burke, MD, chief patient experience officer at Geisinger. The employee was later reimbursed by the health system.

Geisinger also recently started using a platform from Cipher Systems, which allows hospital leaders to enact virtual real-time fixes to problems. For example, if a nursing supervisor sees a dirty bathroom, she can use the platform to notify the facilities department.

As a result of this and other efforts to improve the patient experience, according to its HCAHPS scores, 73.3% of Geisinger patients were likely to recommend the health system in the second half of 2018, an increase from 69.6% in 2015.

  2.  Support pediatric patients with telehealth

To help support one of its college-aged patients, Lucile Packard Children's Hospital Stanford facilitated ongoing behavioral health sessions with his psychologist via its telehealth platform.

“This patient had a very tight therapeutic relationship with his psychiatrist,” says Natalie Pageler, MD, chief medical information officer. “He wanted to go away to his top-choice college in southern California, but the family was very fearful because of the distance between the college and the student’s psychiatrist.”

The hospital also provides access to telehealth visits for patients with chronic conditions. For example, a young female patient with diabetes has taken part in telehealth sessions with her physician. The patient also uses a digital glucometer to monitor A1c levels. This data is used in conjunction with her telehealth visits to better manage her diabetes, says Pageler.

Pageler says extending the reach of providers to patients-whether they’re in a dorm room, in an after-school program, or at summer camp-allows for the continuation of the care patients need.

“The alternative isn’t great,” she says. “[Patients with diabetes, for example] end up missing a lot of visits, and because they miss their visits, they may feel uncomfortable reaching out to their doctors. And that can lead to bad outcomes, such as ketoacidosis for patients whose diabetes is wildly out of control.”

  3.  Create a formal program

“Healthcare should always, at its core, be about human relationships and relieving suffering,” says Geisinger’s Burke. But ensuring this is always top of mind for all employees can be challenging.  That’s why the health system organized an employee training program called C.I.Care, which stands for:

• Connect
• Introduce
• Communicate
• Ask and anticipate
• Respond
• End with excellence

How does this translate to daily work? Take, for example, a patient who enters the health system and doesn’t know how to get to his doctor’s office. An employee will walk that patient to the office, rather than simply directing him.

“Everyone has to be a part of this mission. We’ve tried to emphasize that it doesn’t matter what your role is,” says Burke. “Whether you’re the chief patient experience officer or a cardiologist, you just deliver on what the patient needs.”

  4.  Coach physicians to connect

Primary-care doctors typically have approximately 20 minutes to see each patient, reportsReuters-and that doesn’t leave a lot of time for physicians to establish a personal connection.

Because strong patient-relationships can result in better health outcomes, New Orleans-based Ochsner Health System, Lousiana’s largest nonprofit health system, trains physicians in what it calls “caring communications.” This course, which provides CME credit, includes a didactic session during which physicians learn to communicate better with patients. Next, physician-coaches play the role of patients in various scenarios, and other physicians react, observe, and provide feedback about how physicians should react.

For example, in one scenario a patient shows up late to an appointment because she has small children and her mother, with Alzheimer’s, falls shortly before the patient is supposed to leave for the appointment. Physicians are coached to handle this situation by saying something like, “That must be tough to manage all of that. Don’t worry about being late,” says Kim Pyles, system vice president of patient experience and service excellence.

Pyles says expressing empathy doesn’t require any additional time for physicians. She also says physicians should be aware of their own emotional intelligence triggers, such as feeling stressed and overwhelmed. “Once you recognize that trigger, you can decide to use emotional intelligence in your response,” she says.

As a result of this and other efforts to improve the patient experience, 77% of patients rank Ochsner’s hospitals as “exceptional” in HCAHPS, and 94% are likely to recommend their provider office in the Clinical Group Consumer Assessment of Healthcare Providers and Systems Survey.

  5.  Provide healthy food

Leaders at Dignity Health’s Sequoia Hospital in Redwood City, California, discovered during “happy hour” rounds, during which they go to patients’ rooms to inquire about their experience, that patients were looking for healthier food options, says Sherie Ambrose, RN, vice president of patient care services.

In the San Francisco area where the hospital is located, many patients prioritize eating seasonal, fresh foods. They also tend to be concerned with reducing the carbon footprint, another reason they prefer locally-sourced food.

Since February, Sequoia Hospital has purchased fresh fruits and vegetables from a distributor that sources from local farms in nearby Salinas and Watsonville, and those changes are reflected in menus, says Michael McBride, director of food and nutrition services.

As a result of this and other efforts to improve the patient experience, the hospital has witnessed consistent increases in all HCAHPS scores, in some cases more than 20%.

Aine Cryts is a writer based in Boston.