The Patient Experience Toolbox


Providing healthcare leaders with valuable patient experience insights

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The Science Behind a Smile

Have you ever thought about what happens to your brain when you smile?  Smiling stimulates our brain’s reward mechanisms in a way that even chocolate, a well-regarded pleasure-inducer, cannot match. 

Smiling changes our brain chemistry because it keeps track of your smiles, kind of like a smile scorecard.  So consider that patients can experience hundreds of greetings from your employees and that their perception of this acknowledgment has a cumulative effect. 

Scientific research shows that the smile rates as the symbol with the highest positive emotional content according to scientist Andrew Newberg.  He goes on to teach us how to create a genuine smile.

He says that before you engage in a conversation with someone else, visualize someone you deeply love, or recall an event that brought you deep satisfaction and joy.  It’s such an easy exercise to do.

And since smiling reduces stress that your body and mind generates, similar to getting a good night’s sleep, it generates positive emotions within you.

So it stands to reason that we feel happier around children - they smile an average 400 times a day!  In contrast, genuinely happy adults smile an average of 40-50 times a day and the rest of you about 20 times a day.

Based on a three month Patient Emotion Study, I recently completed for one of the country's largest healthcare systems, one of the top contributors to anxiety was anticipating whether the clinical staff would be nice or not.

If a patient is already nervous about meeting the doctor for the first time, the frontline employee represents the first impression of what is to come, and that could lead to calming the patient down or fueling their anxiety. 

So imagine how a stressed patient who doesn’t feel well and is anxiously waiting at a desk feels after a minute or more, while employees are busy behind the desk ignoring him or her.  With a genuine smile the frontline staff can set the stage for the entire experience.

Think of the power you have by using a genuine smile with your patients, co-workers and friends.  That smile will add years to your life, enhance someone else’s life, and create a positive experience for you!

We know from our mystery shopping research that a poor greeting can have a substantial impact on the overall experience. 

For example, on a large mystery shopping study for a Midwestern hospital, all of the mystery shops that were rated mediocre or below began with no immediate acknowledgement by an employee or a greeting without a smile.

Our mystery shopping benchmark data indicates that healthcare employees immediately acknowledge our shoppers 92% of the time.  However the follow up behavior of offering a warm and friendly smile dropped to 83%. 

While these scores may seem reasonable to some, we always recommend a goal of 100% for acknowledging customers.

Mother Teresa’s said it best, “We shall never know all the good that a simple smile can do.”

 

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Gathering Competitive Intelligence

Gathering Competitive Intelligence in Support of the Patient Experience - the 10th in the Patient Experience Toolbox series - makes the case for understanding your competition's patient experience culture in order to fine tune your own.

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Gathering Competitive Intelligence - Text

Lets say you work in the C-Suite of a hospital and a relative says to you, "A couple of weeks ago I was in an accident and spent two nights at one of your competitor hospitals.  Would you like to hear about it?"  Without hesitation you say of course you would!   You would listen carefully to your relative’s story and undoubtedly compare this experience to what you know about your own organization. 

I’m assuming you would then ask a series of questions related to your own responsibilities, for instance, what was the relative’s perception of the quality of care or perhaps how the competition performed specific processes related to safety and noise. 

Then the value of this opportunity sinks in and you dig a little deeper and ask her how she felt she was treated.  How did they communicate with her?  How did they seem to treat each other?  Was their obvious teamwork?  Did they seem distracted and unhappy, or were they cheerful and knowledgeable. 

And perhaps most important, were they consistent in what they did or were they different from department to department, or nurse to nurse?  In short, you?re wondering if they have managed to hard wire their patient engagement culture.

You’re thinking to yourself, wouldn’t it be great if we could get this kind of information on a regular basis?  Well the answer is you can and we call it competitive mystery shopping.

Let me share a case study.  For over ten years we conducted an intensive study with a large, metropolitan physician referral service that always included calling their top three competitors.  We could always tell when the competition had a shake up in management or when a new initiative was underway because their scores would fluctuate widely, while our client used their mystery shopping scores to support an objective performance evaluation and remain constant and on top. 

This information allowed our client to do three additional things:  First, it reaffirmed that they were the best and it allowed them to use this information to motivate staff and support ongoing organizational marketing efforts. 

Second, they used mystery shopping to keep abreast of whatever strategic changes competitors were making in real time. 

And lastly, mystery shopping proved that the program delivered a competitive advantage, which was in turn used to support continued investments in the program.

If you’re still wondering why you would want to check out the competition, consider this, there is no better way to understand where your patient experience is weak compared to competitors, and there is no better way to share with staff where you are clearly better. 

It also appeals to an employee’s competitive spirit when they realize how they stack up.  You want to arm them with the incentive to say, “We are every bit as good as they are.  We can do that.  With a little tweak, we can be even better."

And the incredible thing about this type of competitive intelligence is that you can decide ahead of time what you specifically want to know and then measure it? 

This information will lead to a better understanding of what patients are responding favorably to, and the things that are contributing to a culture of excellence and increased market share.

 

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No Time for Quiet Leaders - Video

In this the 9th Toolbox video blog, Brooke Billingsley says, "If managers fail to constantly emphasize the positive actions they are taking on behalf of their staff, they can be assured staff will remember all of the things he or she hasn’t done and view this as a lack of leadership."

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No Time for Quiet Leaders - Text

As managers learn how to take their rightful place at the forefront of the patient experience movement, it’s important to make sure that when they communicate with staff, they go out of their way to verbalize the positive actions they are taking on behalf their team and patients.

Clifford Nass, Professor of Communication at Stanford University says that almost everyone remembers negative things more strongly and in more detail. 

In fact, he says that we also tend to see people who say negative things as smarter and therefore give greater weight to critical reviews.

So if managers fail to constantly emphasize the positive actions they are taking on behalf of their staff, they can be assured staff will remember all of the things he or she hasn’t done and view this as a lack of leadership.

We think this is one of those instances where it is important to talk in the first person.  “I did this for you.”  it is a way to reinforce to staff in a fast-paced healthcare environment that the manager is listening and fully engaged.

Let me provide an example.  In working with an orthopedic unit conducting deep dive audits with staff, we realized that among other issues, the staff perceived that the unit manager was not listening to their needs.  

This manager’s passive style was clearly contributing to a lack of respect by staff and undermining her leadership.   

In further conversations with the manager we discovered that she was making subtle changes but failed to take credit for them.

We saw this as an avoidable barrier, so we asked the manager if there were any changes expected in the near future such as equipment purchases or scheduling improvements – with an emphasis on things that had been requested by the team. 

She told us there were, so we coached her on how to handle this for an upcoming staff meeting.   We instructed her to be assertive in taking credit for the changes.  

In her next unit roundup, she announced, “We will be getting three new blood pressure cuffs that I ordered because you indicated we needed them.”

The manager is now aligning with her team as they move together to improve the patient experience.

However, it is not enough to only communicate successes.  It is also important to keep staff updated on the progress of requests or meaningful information the manager previously communicated.  

Explaining is a critical form of communication, but only if it is not perceived as an excuse.  An explanation is factual – while an excuse seeks to defend or justify.  

Taking credit for action or faithfully keeping staff informed is the type of leadership necessary to keep teams focused on patients.

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Stick Your Neck Out - Video

What if you asked patients to tell you what was most important to them before they started their hospital stay?  In this Patient Experience Toolbox video, we think asking "If you could choose one thing that would contribute to your being calm and feeling cared for, what would that be?" is an effective way to proactively target patient expectations.  It helps healthcare providers focus on achieving the patient's desires and increase loyalty.

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Stick Your Neck Out - Text

How confident are you about your staff's ability to deliver great care? Well here is a real time idea that puts your confidence to the test. Consider asking patients when they are admitted, "If you could choose one thing that would contribute to your being calm and feeling cared for, what would that be?"

Registration personnel would record and acknowledge the patient's desires and add it to the patient's instructions. Nursing could then reinforce the patient's desire by saying, "I see you indicated at registration that you would like it as quiet as possible at night. I want you to know we will do everything in our power to make that happen."

You might ask yourself, why would we set ourselves up like that? The answer is that there is power in the asking. There is also tremendous value in showing that you care enough to ask.

And by having Registration ask the question, you give them a role in the patient experience that is often missing. You also gain a greater sense of who the patient is and what his values are.

Do healthcare providers run the risk of making patients even less satisfied if expectations aren't met? Maybe, but we think the focus it puts on achieving the patient's desires is worth the potential failure. After all, what are patients going to say? You are likely to hear - I want good food, I want the noise kept down, I want less interruption at night, or I want more communication from the doctor.

Aren't those also standard patient satisfaction questions? So the expectation of your organization is that these issues are already being met.

Think about it for a second - You're a nurse and it is communicated to you that it is important to Mr. Davis that it is quiet outside his room at night. It's even on the white board in his room. You now begin to see things from his perspective - "Mr. Davis said he wanted it quiet at night, and it clearly isn't. I need to see what I can do about that."

So you take a step further - You take action to remove staff congregating outside Mr. Davis' room before it becomes an issue for the patient. You ask Mr. Davis the next day, "How did you sleep last night? Was it quiet enough for you? There were a few staff talking outside your room so I asked them to do it somewhere else."

The idea of honoring a specific request is common in customer service. For instance, when I'm travelling and I know I'm going to have a long day ahead, I will often request a room away from elevators and heavy traffic. Most hotels are happy to accommodate because it reinforces loyalty.

Of course patients can change their minds and decide something else is now more important. And we all know that family and visitors can also influence patients with expectations of their own.

But when the experience is over, your staff is in a position to ask, "How did we do with your specific request regarding noise" instead of the generic "how was everything?" which signifies that they had no idea what was important to him.

Proactively targeting expectations beats surprises at the end every time.

 

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Interviewing 'Before' the Exit

This video, the 7th in the Patient Experience Toolbox series, questions why organizations wait until employees are heading out the door to ask exit interview-type questions, especially when disengaged employees can significantly hinder efforts to develop a patient-centered culture.

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Patient Perception Research takes Front Stage on New Perception Strategies' Website

Staying innovative is imperative in today’s competitive healthcare market.  The new Perception Strategies’ website launched this week better reflects the perception research services needed to support healthcare clients as they strive to improve the patient experience.

 “There are many angles from which the patient experience can be studied,” said Perception Strategies’ CEO, Brooke Billingsley, “but at the core of what we do is to help healthcare providers understand, manage and improve the perception patients have of them.”

For nearly 16 years, Perception Strategies primary focus has been healthcare mystery shopping.  “That won’t change,” Billingsley said, “Its just that we now have the ability to study other facets of the patient experience like employee satisfaction barriers, patient environments, and direct observation of staff communication with patients in the clinical setting.  We are equipped to apply the appropriate research discipline to achieve the client’s desired results.”

Exclusively serving healthcare clients since 1998, Indianapolis-based Perception Strategies has conducted over 100,000 healthcare mystery shops.  

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Putting the Spotlight on Shining Stars

Every patient or customer interaction is preceded by employees subconsciously asking themselves, "What do I believe I am responsible to do in this situation?"  This video uses a story in which an employee is recognized for going above and beyond to illustrate how simple exceptional service can be.  In this video Brooke Billingsley also provides suggestions for increasing shining star moments.

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My Tolerance is Equal to Your Expertise

In this, the 5th video in the Patient Experience Toolbox series, Brooke Billingsley shares her philosophy that patient tolerance is measured by the clinical and/or service acumen of the staff at each encounter.  ’My Tolerance is Equal to Your Expertise’ uses a personal experience with a surgeon to illustrate that patients can put up with a lot – 3 1/2 hours in the office – if they ultimately have confidence they are in good hands.  However, the lesson from this story is that without a star performer, mediocre clinical and/or service acumen will not be tolerated by patients without repercussions.

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Perception Strategies has Answer to Price Transparency Readiness

According to a new report issued by PwC on the Top 10 Issues Facing Healthcare in 2014, price transparency ranks as the most important issue.  Perception Strategies stands ready to support healthcare organizations with a program specifically designed to assess their pricing transparency readiness.

“We have been conducting mystery shopping focused on pricing for many years,” said CEO Brooke Billingsley, “and this report just confirms that there is no more important time to utilize unbiased consumers to make sure providers are successfully delivering pricing information.”

Perception Strategies’ use of healthcare mystery shopping to test pricing transparency is an effective and timely way to determine not only the pricing information being communicated by healthcare employees, but it can provide a systematic and reliable way to get real time information on your competitor’s pricing.

Contact us today at 877-546-0970 or brooke@perstrat.com to discuss implementing a Pricing Program.

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Would Satisfaction Scores Change if Healthcare Employees Received Tips Instead of Paychecks?

The fourth video in the Patient Experience Toolbox series Tips Instead of Paychecks? poses the question, “What if healthcare employees were forced to rely on tips for their income?”  The question appears non-sensical on the surface, but the same values customers are seeking from restaurants and hotels do not automatically change because it’s healthcare.  Brooke Billingsley, CEO of Perception Strategies, walks the viewer through how this concept could be transforming for a healthcare organization.  Contact Brooke Billingsley at 877-546-0970 or brooke@perstrat.com to get her thoughts on other patient-focused ideas.

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Mystery Shopping on a Tight Budget

The latest entry in the Patient Experience Toolbox video series – Mystery Shopping on a Tight Budget – features CEO Brooke Billingsley sharing the types of healthcare mystery shopping studies clients are conducting that will quickly achieve the insightful and tangible results needed to meet the budgetary needs of healthcare providers in today’s environment.  Patient access, ambulatory services, and Emergency Services studies are just some of the ways healthcare providers can identify patient satisfaction problems and opportunities. Contact Brooke Billingsley at 877-546-0970 or brooke@perstrat.com to hear how Mystery Shopping can improve the patient experience.  Also, be sure to go to Perception Strategies’ You Tube Channel to see the entire Patient Experience Toolbox series.

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Utilizing Anxiety Mapping

This 3-minute video on Patient Anxiety Mapping is the second in The Patient Experience Toolbox series that follows last month’s Employee Perception Deep Dive video. This new video focuses on the power of patient anxiety mapping as a way to improve the patient experience.  It asks healthcare providers to consider identifying the points in their care where patients are most anxious and vulnerable, asking patients to help isolate those emotions, and then staffing those critical times with employees who are best equipped to handle them.  Brooke’s knowledge comes from 15 years as a healthcare consultant and healthcare mystery shopping expert, and her 16 months of cancer treatment starting in 2011.

Contact Brooke Billingsley at 877-546-0970 or brooke@perstrat.com to hear how Anxiety Mapping can help improve your patient’s experiences.

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Employee Perception Deep Dives

With this inaugural video on Employee Perception Deep Dives, Perception Strategies is launching a series of videos designed to improve the patient experience called The Patient Experience Toolbox. Long known for its work in healthcare mystery shopping, Perception Strategies is making healthcare providers aware of a proven process that dives deep into the barriers that cause healthcare employees to veer off course and not deliver expected service. Employee interviews, a focus on engagement, process and style, an accountability plan for managers, and weekly action reminders are a hallmark of the Deep Dive program.

As CEO Brooke Billingsley explains in the video, “The number one most important thing to employees is meaningful work. So if you can take barriers away, you can create a more focused, receptive and contented workforce.”

Contact Brooke Billingsley at 877-546-0970 or brooke@perstrat.com to hear how Employee Perception Deep Dives will benefit your organization.

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The 'Perceptive Patient' Takes to the Stage in Nashville

On September 12, Perception Strategies CEO Brooke Billingsley premiered a live version of The Perceptive Patient at the Beryl Institute’s Regional Roundtable in Nashville.  Brooke shared the emotional details of a patient on a 16 month cancer journey, while also giving the audience her consultant’s perspective on improving the experience. The Beryl Institute provided a great recap of the hour-long presentation:

The event opened with a powerful keynote presentation by Brooke Billingsley, business entrepreneur and breast cancer patient, who was pushed onto stage covered by a sheet, lying on a stretcher. She sat up and started an emotional reenactment of her experiences as a patient; from the moment she heard her diagnosis to her first chemotherapy to surgeries and port placement. The audience was impacted by the vulnerability she shared and felt her pain as she described in detail the emotional toll of losing her hair, among other experiences.

The overarching theme in Billingsley’s message was the significance of every single interaction she encountered – every word, question, comment, head nod, smile and grunt – from her caregivers and anyone she interacted with during her frequent treatments. She shared the story of one cold, disgruntled front-line employee who’s attitude was so disheartening that it caused her to change care facilities, transferring her treatments to a hospital 20 miles away – a move ultimately costing the original hospital over $250,000.

She offered a powerful, and so important, perspective of care and a reminder of how important every single detail of the experience is to the patient and family. She considers her cancer experience her “Amazing Race” including the chemo, surgery, radiation and infusions. In sharing the journey of her race, she’s helping to make those encounters better for future patients around the globe.

To see a full recap of the Beryl Institute’s Roundtable click on the link.

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Transforming the Patient Experience Through 'Deep Data'

An excerpt of a Guardian article reprinted in FierceHealthcare today entitled 5 steps healthcare leaders can take to nurture innovation highlighted as its fifth step a feature of leadership we applaud because, well, it’s what we do.  In the article, Dr. Peter Thomond shares that “deep data about the experiences and expectations of your service users” should be used to transform the patient experience.

While we couldn’t agree more that answers do lie in “patient, family and public insight,” we somewhat take exception with Dr. Thomond when he writes, “You’ve probably captured the insight, now it’s time to use it.” Unfortunately not every healthcare organization has on staff people with the expertise or the appropriate data to make these transformative changes.  It takes someone with the ability to read between the lines and discern from the patient’s perceptions what actions and resources will create meaningful change.

Our healthcare mystery shopping clients use a focused approach to control what they want to know by drilling down to uncover the who, what, and why of a particular issue.  For instance, is the system’s registration process causing patients to go elsewhere, resulting in lost revenue?  What other form of patient research can answer that question?  Certainly nothing generated internally.

While clients may use other data such as patient satisfaction surveys or financial information to identify and track trends, they look to healthcare mystery shopping to test and validate the reasons for those trends.  We believe healthcare mystery shopping is the ultimate in “deep data.”

Give Brooke a call today at 788-546-0970 to discover how you can benefit from DEEP DATA.

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Brooke Billingsley is Named to Global Patient Council

Brooke Billingsley, Perception Strategies’ CEO, has been named to The Beryl Institute’s newly created Global Patient & Family Advisory Council (GPFAC). Comprised of 14 patient and family members across five countries who exemplify a commitment to elevating the conversation on patient experience, the (GPFAC) provides guidance and input on the direction of The Beryl Institute.

“As a recent cancer patient, it is a privilege to be part of something bigger than me, “ Billingsley said. “Participation on the council allows me to have a positive impact on the exciting patient experience movement.”

A critical commitment of the Institute is to serve as the hub for all voices impacting and influencing the patient experience movement. The GPFAC complements the Institute’s boards by ensuring the voices of patients and families are a central consideration in the strategic direction and offerings of the Institute. The Council reviews the Institute’s areas of focus and current resources and offers suggestions on new opportunities, topics of interest, etc., ensuring the perspective of the patient is part of all Institute efforts.

 

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