Reimagine The Patient Experience
A Miron Construction Case Study

AttAchment – it’s the new measurement for patient and...
Reimagine The Patient Experience

                                                     Three Tough Questions Were Asked...
Experience Ecology

How do you build a healing environment?
What happens if. . . ?
What happens when. . .?

Experience eco...
Reimagine The Patient Experience

The ‘Typical’ Stay

                                                                             Copyright © 2008 by Mi...
Reimagine The Patient Experience

                                                        Just Imagine

Concierge - Services to assist every step of the way (including elderly

Flex Room – Nurses move patients less ...
Reimagine The Patient Experience

                                                 Reverse Outcome Modeling

said Ritzow. To create this revolutionary new process, the experience tool of
Rapid Access Prototyping was implemented. Th...
Reimagine The Patient Experience

                                                         to go and look for their pat...
Experience Innovation

When we were able to identify what to change – when, where and how – The
Institute was then capable...
1471 McMahon Drive
    Neenah, WI 54956

   P 920.969.7000

 F 920.969.7393
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Miron Construction - OSI Patient Experience


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Case Study detailing the unique details of the patient experience and what it should be at the Orthopedic Sports Institute in Appleton, WI. Miron Construction Co., Inc's Steve Tyink used the C5 process to define the goals of what OSI wanted the patients to experience during their stay, and the building was constructed around those definitions.

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Miron Construction - OSI Patient Experience

  1. 1. Reimagine The Patient Experience A Miron Construction Case Study AttAchment – it’s the new measurement for patient and staff success in today’s highly competitive health care environment. Attachment leads to a deeper, more meaningful connection between patients, providers, and staff members that results in lasting and prof itable relationships. Orthopedic & Sports Institute physicians and administrators understand that the winning differentiator is no longer the product or service, but the level of patient attachment – the extent to which an organization creates an intimate, enduring relationship with the patient. Research shows that attached customers are important to the life blood of any organization. In a recent survey, 79% of executives state that customers who are engaged or attached recommend products and services to others, 64% say engaged customers are frequent purchasers, and 61% believe they provide frequent feedback on products and services. In addition, almost 55% of executives claim that engaged customers are less price sensitive. 1 1 The Economist Intelligence Unit, March 2007
  2. 2. Reimagine The Patient Experience Three Tough Questions Were Asked “Are patients ever attached to a Are we proud of the patient experience The Institute provides? building? At Miron Construction, Are we confident that we are the provider of choice in our community? we realize that simply to build is not Do we provide the experience we would want for our family members enough. For our projects to be highly or friends if they were hospitalized? innovative and supremely successful, they must transform how people feel, Together, The Orthopedic & Sports Institute and Miron wanted to answer take their thoughts and emotions to these three questions. To assume we knew the answers was simply not enough. an entirely new level.” To guess, was living in the past. We realized that in an emerging age of change David G. Voss, Jr. within the healthcare setting we needed to reexamine the traditional practices President, Miron Construction of Orthopedic care and provide greater sensitivity and responsiveness to our services. Reimagining the experience was our only choice. This case study draws lessons from the experience of a highly innovative Orthopedic Clinic in Appleton, Wisconsin. One that illustrates how the integration of the ideal patient experience and innovative technology is possible. Outlined are the strategies put in place, the roadblocks they faced and overcame, and the key successes. ◂2▸
  3. 3. Experience Ecology How do you build a healing environment? What happens if. . . ? What happens when. . .? Experience ecology requires that each and every element of the facility is designed to create a unified and cohesive environment based on patient and clinician outcomes. These actions form a greater balance, which is consistent with the diagnostic and therapeutic activities taking place. More importantly, this balance must enhance, not tear apart patients, families, employees, and providers varying self-identities. Ideal patient experiences must trigger, not close down, creative innovations and identify the purest form of patient feelings. Environments should sustain positive thoughts and not provoke boredom, anger, apprehension or apathy. Three critical elements were required to build this type of transforming healing environment. • Physical • Behavioral “We used the expected emotional outcomes from process users • Informational connected with the optimized patient flow from functional owners, to create Each area communicates independently, yet strongly to all end users as they value for patients, staff members and join together in understanding and creating the ideal patient experience. These physicians alike. What was once a elements are often forgotten or executed erroneously. At best, their uniqueness sacred space was up for discussion. remains unappreciated and separated. In answering the three tough questions Anything was possible.” for The Institute, all three elements were uncovered, understood, mapped and ultimately brought to life. Curt Kubiak Executive Director, The Institute Physical Physical elements include all aspects of spatial integration. These include furnishings with an understanding of the fabric pattern and color, illuminations, textures, scents, temperature, flora, sounds, taste and apparel worn by participants. Is the physical space creating the desired outcomes? A Miron Construction Case Study
  4. 4. Reimagine The Patient Experience Behavioral Behavioral elements include all movement sequence interactions between the patient Physical and clinicians determining how they advance through the space and the time required to do so. Are the behavioral elements aligned to the outcomes desired? Is there transparency throughout the setting, between departments, from one day to another? ECOLOGY Behavioral Informational Informational elements include all forms, documents, communication collateral, spoken words, gestures, posture, impressions, signage, technology, or other forms of Informational media exchange. Is there integration between the informational elements and the behavioral? Are the informational elements based on the patient or the clinic? “Patients and staff need to work collaboratively to reimagine and design the ideal experience based on all three elements – without this understanding, the unique and personalized patient experience will be lost. ” Steve Tyink Vice President Business Innovation, Miron Construction ◂4▸
  5. 5. The ‘Typical’ Stay Copyright © 2008 by Miron Construction Co., Inc. All rights reserved. Why does the nurse have to wake me up throughout the night? “The ‘typical’ hospital stay; the entire Why do I have to wear an open-back gown exposes me? healthcare continuum, is experiencing Why do I have to eat ‘hospital food’? a revolution in how care is delivered. It is time to change all aspects of the delivery.” The Institute eliminated patient concerns f rom the very beginning by understanding what patients don’t like in a ‘typical’ surgery center. In the Dave Kuplic, MD research conducted over a 4-month period, the above six items caused 76% of the Orthopedic Surgeon, The Institute respondents surveyed felt additional stress and anxiety during the their stay. The typical orthopedic stay is a profoundly stressful experience. You arrive already in discomfort only to be subjected to a litany of indignities: patients are poked and prodded, reduced to wearing flimsy gowns, and dependent on strangers for information, food and help going to the bathroom. The typical surroundings only aggravate the situation. Just when you need home comforts the most – perhaps a quiet sunlit space, some soft cotton sheets – you are thrust into a dreary cinder-block room, set under the glare of florescent lights, and left writhing on a sea of antibacterial fabrics and hard plastic surfaces with an endless sound track of disembodied voices emanating from an intercom over your head. Is this a positive, healing experience? A Miron Construction Case Study
  6. 6. Reimagine The Patient Experience Just Imagine A friendly concierge at reception smiles and welcomes a patient by first name. Boutique, hotel-style amenities including flat-screen televisions, which can be used to access the Internet, patient-education materials, water features, natural “Much like great art, colors, fabrics and elements, and even room-service menus. All overnight rooms have wireless style can represent a different feeling phone systems and monitoring devices so that patients can have direct contact for each participant. We do understand with their caregivers rather than going through the reception desk. With less that if the patient experience comes phone calls and overhead paging, patients and overnight guests experience a first, positive patient sensations better night’s sleep. Each room has a wireless laptop computer so that nurses will be brought to life; enabling the and caregivers retrieve patient charts only steps from the bedside. Since family participants to feel completely special within their healing process. What is members often stay for long shifts, why not offer day beds for ease of rest. the overall experience attempting to Patients enjoy pre-selected music and movies from iTunes (asked by their represent? Like a great novel, you are physician in the last consultation before surgery). compelled to keep reading.” The bottom-line is this: People from all walks of life have an innate desire to Angie Laux, R.N. feel a part of something special, to believe and understand that their thoughts Administrative Coordinator, and feelings matter. At The Orthopedic Institute they do matter. Patients can The Institute enjoy the following, everyday, every time, without fail- this is our vision... Prescriptions - Filled immediately through physician interaction. ◂6▸
  7. 7. Concierge - Services to assist every step of the way (including elderly guidance). Flex Room – Nurses move patients less often when all rooms have equipment that folds out to provide critical systems such as anesthesia gases, and heart monitors. This design feature cuts down on noise and the infections that may pass from patient-to-patient in shared rooms. Recovery Room – Private pre and post-surgical patient rooms for comfortable and seamless recovery, enhanced infection control and greater privacy. Modeled after a Ritz-Carlton hotel room. Atrium - Visitors enjoy comfortable surroundings to remain connected to their family and friends being treated. Hospitality Center – Institute concierge assist you in preparing the coffee of the day. Juices, coffee and snacks are available as well. “Health care delivery needs to change. The Institute Room Service - Patients order their meals through a 24-hour The old thoughts that helped to create staffed room service department via telephone or by request. the patient experience of the past are no longer valid. From the beginning, Therapeutic Bodywork – Feature a variety of alternative medical services our extended stay process must be such as yoga and palates. designed in a unique way, based on how our patients feel with outcomes In-room Scheduling – Rather than sending the patient to another sub-waiting that exceed industry standards.” area, patients are scheduled for diagnostics and imaging in the exam room. David Eggert, MD Soundscapes – Personal choice of music is offered and available through Orthopedic Surgeon, The Institute headphones. Institute Gowns - Designed with the patient, not the clinic in mind. Easy to use ‘tear-away’ pants and shirts that create comfort, ease of use, warmth and respect. Blissful Bedding – 300 count thread linens, choice of pillow softness. A Miron Construction Case Study
  8. 8. Reimagine The Patient Experience Reverse Outcome Modeling So how do you reimagine the patient experience? How do you build an ideal healing environment? What should happen if. . .? What should happen when. . .? Miron, along with 52 staff member of The Institute identified the experience areas, attachpoints, outcomes and actionable items that realign and transform how patients experience and feel Orthopedic care. Incorporating the patient experience Reverse Outcome Modeling process, evidence-based design can be achieved. The objective of ROM is to translate the design elements established to directly impact patients’ physical and psychological health, thus reducing patient stress and promoting rapid recovery. Without beginning with outcomes in mind and working backwards, the behaviors required to ground swell change would not have realized. The Miron healing design process focuses on three primary ways in which the “We started with the outcomes – how a patient feels – and moved environment can influence patient outcomes: backwards. Very non-traditional, but incredibly important. The key to a Medical Care healing environment involves every The environment can support or impede caregiver actions and medical interventions. aspect of the The Institute.” Is the environment easy or diff icult for providers to do their jobs facilitating helpful or harmful impacts? David Ritzow, MD Orthopedic Surgeon, The Institute Miron Experience Tool: Rapid Access Prototyping HealthCare Example: 23-Hour Stay Process “We realized that many of our patients wanted to avoid the traditional stay for partial knee replacement” commented David Ritzow, MD, Orthopedic Surgeon of The Institute. “In fact, once we began asking, we became aware of the possibilities.” From the beginning, The Institute utilized Miron’s unique experience tools, systems and methodologies to create the extended stay process. “We started with the outcomes – how a patient felt – and moved backwards. Very non-traditional.” ◂8▸
  9. 9. said Ritzow. To create this revolutionary new process, the experience tool of Rapid Access Prototyping was implemented. The Miron experience based design team challenged traditional thought processes. Health Status An environment has the ability to strengthen or impair a patients’ health status by reducing or encouraging existing conditions and feelings. Miron Experience Tool: Barrier Observation Health Care Example: Patient Greeting & Way finding Typically very little thought or experience based design energy is focused on issues related to the patient greeting. In understanding the current flow and barriers to the ideal experience, 5 experience barriers will exist. What are the physical barriers to the ideal outcomes? What are the communication barriers to the ideal outcomes? What are the sight barriers to the ideal outcomes? “Just as evidence-based medicine is What are the spatial considerations to the idea outcomes? revolutionizing health care treatment, What is the movement sequence (behaviors) to consider? evidence-based design is transforming the healthcare environment. We now In many hospital or clinical settings, barriers to the ideal experience must have at our disposal proven methods for improving patient outcomes, safety, be identified, understood and corrected. We recently discovered that the attachment, as well as staff retention average greeting and patient way finding time was reduced by over 4 minutes and service efficiency.” through the integration of the barrier observation tool. This tool resulted in the understanding and need for a pre-surgical welcome packet. “Our patients Dennis Lynch were often confused, lost and frustrated. Although we assumed they understood, VP Health Care Services, the opposite was often the case,” commented Angie Laux, ASC Coordinator. Miron Construction Co., Inc. “Due to the protocols established long ago, the patient outcomes of feeling cared for, welcomed, respected and acknowledged were lost and patient anxiety increased from the moment they entered the facility. It had to change.” Due to this process, patients now understand how to enter the building and where A Miron Construction Case Study
  10. 10. Reimagine The Patient Experience to go and look for their patient services representative, a familiar face from our pre-surgical conference and welcome packet. Causes of Illness The environment can protect patients from, or expose patients to their subsequent healing. Miron Experience Tool: Impression Areas & Attachpoints Health Care Example: Sounds Heard During Postoperative Recovery What are the main impression areas that affect a patient’s experience? What are the specif ic attachpoints that make up the impression area? W hat ar e the outcomes that you want the patient to f eel about the attachpoints? “By simply altering processes, By identifying the main impression area (postoperative surgery center) and the modeling impression areas and attach many attachpoints associated with the selected impression area (recovery room), points, understanding outcomes and patient feelings and outcomes can be determined. Without this breakdown, the shifting behaviors, the experience task is unmanageable and generally focuses efforts on the transactional portions at The Institute now closely reflects of care. Outcomes become integrated within the behaviors of the providers, our vision and commitment to patients. The Result? An experience creating a transparent delivery system. that is unforgettable. The ultimate healing environment and ideal patient What if a caregiver raises their voice, receives a cell phone call or a recovering experience have been created and are patient hears an overhead page? Patient recovery time is extended and the well underway.” healing environment of the patient is not ideal. Chris Weinlander, MD By simply altering processes, modeling impression areas and attachpoints, Anesthesiologist, The Institute understanding outcomes and shifting behaviors, the experience becomes unforgettable. The ultimate healing environment and patient experience is created and underway. ◂ 10 ▸
  11. 11. Experience Innovation When we were able to identify what to change – when, where and how – The Institute was then capable of designing a unique experience filled with efficiency and effectiveness. With the assistance of the experience-based design team, the tools allowed The Institute to: • Observe the current employee and patient experience through fresh eyes • Enhance the current experience to achieve desired patient outcomes • Intentionally orchestrate experiences which achieve business results. Innovation comes to life through the eyes of the patient and helps to ensure desired outcomes happen every time, everyday, without fail, no exceptions. The statement “that’s the way it’s always been done,” simply no longer acceptable… …reimagine the experience with Miron Construction. Steve Tyink, VP Business Innovation Miron Construction Co., Inc. ☎ 920.969.7047 � A Miron Construction Case Study
  12. 12. 1471 McMahon Drive Neenah, WI 54956 P 920.969.7000 F 920.969.7393