By Katherine A. Kalthoff, Division VP, Patient Experience, Methodist Healthcare
Some years ago, I took a position as service excellence department leader at a large community hospital struggling with its patient experience scores. The leadership team had recently purchased an electronic rounding tool for the nurses to capture patient feedback on hospital-issued iPads. I’d not previously used anything but paper and pencil, so I had to quickly get up to speed on how it worked and how we were to use it before we went live.
Patient rounds were being designed to capture complaints and concerns, track the actions we were taking to remedy them, and include a focused set of yes/no questions on our lowest-scoring areas on the patient experience survey. By asking patients if it was quiet at night, if their doctor explained things in a way, they could understand, or if their nurse had been in every hour to check on them, we could get a better handle on where we needed to focus our attention. We were sure that a precise focus and streamlined issue resolution would surely lead to better scores.
The thought of capturing these issues and generating reports electronically instead of manually was incredibly appealing. Results could easily be tracked, the progress of issue resolution could be color-coded red, yellow, or green, and we could compare the real-time feedback with our survey scores. We were ready to dive in.
When it came time to introduce the tool to the staff, we gave out a bunch of iPads, showed the bedside nurses where to click and how to escalate an issue to leadership, and expected them to love it as much as we did. We imagined our scores would soar.
They didn’t. Patient experience decreased and staff morale plummeted.
Rather than scrap the whole project, we wanted to find out where we went wrong. Here’s what we learned before we went back and relaunched:
Always involve the end-user in the planning process.
We had so much faith in this company’s product. We didn’t think to ask the bedside nurses what ideas they had for improvement or a smooth implementation. We assumed that since the company had such impressive client testimonials and results with this tool, they’d thought of everything and our team would love it just as it was. We were wrong.
Allow the end-user to use their critical thinking skills.
When you give professionals a script to follow with no latitude to change it to suit the unique circumstances of the individual patient, you create resentment in the staff and mistrust in the patient. Patients want genuine, sincere interaction with a person, not simply to answer a set of questions that they don’t feel relevant to them. It defeats the whole purpose of improving the patient experience if they think everyone is merely reciting what they’ve been told to say. Trust your staff to capture the intent behind the question and ask it in a way that feels natural.
Offer an abundance of training opportunities and practice before you go live.
The time to learn is not when you’re in the middle of patient care. Users should feel very comfortable with the new tool, know some initial troubleshooting, and who to call for help. By doing some practice runs ahead of time, you increase the chances of a smooth implementation and reduce the anxiety many of them will feel while using a new tool.
If there’s a new piece of technology, explain it to the patients.
Patients lying in a hospital bed are afraid. They’re afraid of dying, of getting an infection, of getting the wrong medication, of being ignored; they’re even afraid of a lot of the equipment. If we’re going to be bringing in a shiny new object, even as something as common as an iPad, we must tell the patients what it is and why we’re using it. They need to know we’re not ignoring them. We may be looking down and typing, but it’s because we’re capturing what they’re telling us so we can make things better for them.
Always, always explain the why behind the what to the staff.
This might be the most important one. It’s not enough to have a cool new shiny thing. Unless the staff understands why they’re being asked to change the way they do things, they’re not going to be excited about changing. Change is hard, but when they know why it’s important and what we hope to gain by making the change, they’ll be much more likely to get behind it.
When introducing any new technology to medical professionals, it’s easy to forget some or all of these steps. We, as executives, can often get so excited about the new thing, we forget to slow down and lay the crucial groundwork that’s essential for a successful launch. Patients should be at the center of the why with staff at the center of the how.