Through its vision: “Barnes Jewish Hospital, along with our partner Washington University School of Medicine, will be national leaders in medicine and the patient experience,” BJH makes a powerful testament to their belief in trailblazing the patient experience. The journey began in 2010 through the creation of a Patient Experience Steering Committee. In 2011, the office of patient experience was formed and is comprised of a director, project manager and three coaches. Through forming this team to guide the patient experience, Barnes Jewish Hospital demonstrated a commitment to their vision of improving the patient experience and has seen substantial improvement.
To begin the patient experience journey the Office of Patient Experience was created; the team included a director, patient experience Partners and a project manager. This team initially provided education on the patient experience data. With full access to the most current data available, the Patient Experience Team educated all leaders on the results and how to use the data to improve the experiences of all patients and guests. As the journey continued, teams and departments that support patient care needed a way to connect their work to the patient experience. To create organizational accountability to the patient experience the employee incentive program was revamped. The intent of the change was to create cohesion and collaboration that resulted in an improved experience for the patients and guests. The program, called Employees Exceeding Expectations (EEE), linked patient experience results to financial rewards. With the EEE program, all team members are eligible to receive a payout when their aligned areas achieve their patient experience target.
In mid-2010, Barnes-Jewish Hospital embarked on a journey to transform the culture, by implementing a new set of values called ICARE (Integrity, Compassion, Accountability, Respect and Excellence). The roll out of ICARE was very systematic using multiple methods of communication and educational tools. During this same period, Barnes Jewish Hospital introduced Values Conversations where annually leaders review team member performance related to the mandatory behaviors associated with each ICARE value. Additionally, bi-annual ICARE Leadership Institutes were initiated and 700 plus leaders all meet off site for a full day of leadership development and inspiration. One of the most popular sessions is the Patient Panel which features patients and caregivers sharing stories about their care and experience at BJH. The patients’ stories instill pride and inspiration which provides meaning for the rest of the day.
In order to provide this inspiration to the team member level, we invited Marcus Engel, a former BJH patient, national speaker and author to share his story with our staff. Marcus spoke to nearly 3000 team members and shared the story of his darkest hours. While speaking, Marcus spoke about one of his caregivers whom he still remembered 20 years later. The team member was not one of the surgeons who saved his life but a student nurse named “Jenny” whom he remembered for holding his hand, speaking softly to him and reassuring that “I’m here Marcus” on the night he was brought to our emergency department following a life threatening motor vehicle accident. Jenny, now a Clinical Nurse Manager, reconnected with Marcus following one of his sessions. Many tears were shared and as a result of the profound impact Jenny had on him, Marcus created a “Jenny” award supported by his I’m Here Foundation. Jenny was the first recipient of this award.
At the heart of patient experience journey has been the collaboration of the Patient Experience Team and their client groups. Each patient experience partner is assigned client groups with whom they work. Often the work of a patient experience partner starts by collaborating with the human resources department to assess the leadership skills of the team. Starting with leadership development assures that the leader has all the tools necessary for success and understand their role in the success of the team. Many times, the Office of Patient Experience is pulled into additional departments, because others have heard about their work and they want to be part of the success. The best example of this pull is many of our physician groups, they hear and see the work and want to be a part of the change.
There have been significant improvements in patient experience over the past few years at Barnes-Jewish Hospital. In 2010, on the IP side, there were only 2 top decile and 2 top quartile performing units but over the past 12 months on the IP side there are 6 top decilie and 6 top quartile performing units. HCAHPS dimensions have also improved dramatically from 2010 – 2013 with an average dimension (overall rating, nurse communication, responsiveness of staff, etc.) increase of 5 points. In the Emergency Department in 2010, BJH was at the 14th percentile nationally and in 2013 we ended the year in the 53rd percentile showing significant improvement.
In addition to improvement in patient experience performance, the Office of Patient Experience has had a lot of pull for surveying additional areas and for assistance. When the group initially started unit leaders were hesitant to work with the team and now it is difficult to balance all of the requests for work.
With the addition of the unit-based metrics for our Employees Exceeding Expectations program – we saw a dramatic increase in improvement from 2012 – 2013. In 2013, 56% of direct surveyed areas were above the 50th percentile, and at the end of the year, 69% of the direct surveyed areas were above the 50th percentile.