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Patient experience: Implications for management (EN)


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Dr. Eduard Portella, International consultant

Published in: Health & Medicine
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Patient experience: Implications for management (EN)

  1. 1. The patient experience in health services State of art Eduard Portella
  2. 2. The patient has always been our reason for being... so? 2
  3. 3. Social changes have changed the population's perception of health services 03 Expected quality Desired quality Perceived quality Provided quality Patients Health professionals Patient satisfaction Performance • Integration • The immediate • Personalization • Platforms... • Information • Decide on my life project • Participate • …
  4. 4. The patient has always been our reason for being … • Co-design of services • The patient partner • Health literacy • Know your opinion • Fostering participation 4 … but this situation has evolved considerably!
  5. 5. What are the characteristics of today's patient? Interested in health Stays informed 5 Demanding, as a consumer Participates in the decision-making process
  6. 6. For what and how should we monitor the evolution of patients' expectations...? A State of Art on patient eXperience to try to answer two questions... 06 To know the evolution of patient orientation in health services and to benefit from these lessons
  7. 7. The evolution of trends... Reengineering (TQM) Measuring satisfaction Empowerment The patient expert Accessibility Patient eXperience 07
  8. 8. 8
  9. 9. Satisfaction questionnaires... value analysis or a trap? 9 Satisfaction surveys bring value when dealing with patients' real expectations satisfaction +-
  10. 10. Satisfaction questionnaires... value analysis or a trap? 10 Satisfaction surveys bring value when dealing with patients' real expectations satisfaction importance - + + -
  11. 11. Satisfaction questionnaires... value analysis or a trap? 11 Satisfaction surveys bring value when dealing with patients' real expectations satisfaction importance - + + -
  12. 12. Not integrating patient expectations involves risks,... 12 … for example, making efforts without any perceived value! Importance of expectations Efforts of the organization + - +- • Discharge from hospitalization • Noise at night • Know the planned itinerary • Coordination of professionals • Knowing who I'm talking to • Explain the purpose of the visit • Pain management • …
  13. 13. 13 The implementation of informed consent has not guaranteed real understanding for informed patient decision making From the desire to create a culture of empowerment to the implementation of an administrative and defensive form The first debate on patient empowerment was frustrated …
  14. 14. The active participation of patients started very early in some situations... but without creating a trend 14 Mental health Diabetes
  15. 15. • Understand the offer • Access to information • Use common terms to explain the offer • Different entry points: telephone, face-to- face, internet... • Time slots • Quality of communication to patients and families • Consistency of the information provided • Patient flow of care pathways • Appropriate spaces 15 Readable Available Welcoming Accessibility is a term from the 1970s, which today has become a multidimensional concept Accessible • Response times • Queue management
  16. 16. As a result of these evolutions, the emergence of the patient eXperience means a new paradigm The evolution of improvements in care and its facilitators 16 Patient eXperience Reengineering (TQM) Measuring satisfaction Empowerment The patient expert Accessibility
  17. 17. Patient eXperience is... Patient eXperience is the sum of all interactions within an organization that influence the patient's perception of the provided services. Improving the patient eXperience means working on... It is an expression of the organizational culture • The people with whom the patient must interact • The care or administrative processes organized by the institution • Space design 17
  18. 18. Patient eXperience A perception A sum of interactions Throughout the patient’s journey A manifestation of the organizational culture … and also implies an update of the Quality concept 18
  19. 19. In the new care model, the objective is to change the paradigm of relationships Yesterday Asymmetrical information Passive contact person Paternalism Patient doctor Tomorrow Symmetrical information Active partner Participation Consumer-Care Team 19 Source : La participation des patients : Pour quoi est-ce important et comment l’obtenir ?, Santé en Devenir, Institut d'analyse stratégique et d'innovation du Centre universitaire de santé McGill (IASI- CUSM), mai 2015
  20. 20. In this evolution, ICTs play an increasingly important role in changing patients' values 20 About 2 out of 3 people have done health research, before or after an episode of use. Doctors are beginning to recommend the sources of medical information on the Internet. Social networks are increasingly playing a role as a gateway to health information. Currently, more than 200,000 health applications are available. Source: IMS Institute for Healthcare Informatics
  21. 21. How do we get this ? • Reduce information asymmetry • Patient participation in the design of services / flows / space design /..... • To know the expectations of the population which makes it possible to inform the patient in a constant way and to promote the personalization of the management 21 Patient eXperience involves a profound organizational transformation, which involves....
  22. 22. At this moment we already have tools, a metric under construction and many examples • Shadowing • Always events • Patient Journey Maps • Value-Stream-Mapping • Design thinking • Mystery shopping • … 22
  23. 23. At the Cleveland Clinic, the first response to a request for assistance is immediate 23 Assigned number Patient research Appointement the same day if you call before 12pm Appointment the next day if you call after 12pm
  24. 24. The MyCare program informs the patient in a constant way on an essential question in the management of expectations 24 Results of the MyCare program at the Mayo Clinic 1. Better predictability 2. Reduced variability 3. Shorter stays 4. Cost reduction 5. Better health outcomes 6. Better patient satisfaction Posters or online videos for new patients can also be useful to describe the hospital's environment and procedures. Source: Cook DJ, Thompson JE, Dearani JA, Prinsen SK. How Mayo Clinic Is Using iPads to Empower Patients. Harv Bus Rev. 2014 February 24 Source: Merlino JI, Raman A. Health Care’s Service Fanatics. Harv Bus Rev. 2013 May;91(5):108-16
  25. 25. In the cultural change to be undertaken, it is necessary for all staff to understand what it is like to be a patient 25 Interactive videos encourage nurses, physicians and staff to think empathetically and creatively about the attention they could develop with patients, list patient preferences and explore best practices. Source: Cass D. Bringing the Customer’s Voice into Medicine. Harv Bus Rev, 2014, November 24. Available at: Lee TH, Cosgrove T. Engaging Doctors in the Health Care revolution. Harv Bus Rev. 2014 Jun;92(6):104-11
  26. 26. Co-creation and living labs 26
  27. 27. 27
  28. 28. Initiatives that generate significant benefits for institutions: low cost - high impact • A positive impact on clinical outcomes • Provokes the need for action • Better consideration of the human dimension • Awareness of patient expectations • Partnership between patient – professionals • United team around the patient • Valorization of the hospital • … 28
  29. 29. Today we need to focus on health outcomes rather than volume, Value Based Healthcare 29 From volume to value Source: The strategy that will fix healthcare, Michael E. Porter and Thomas H. Lee, October 2013 Issue, Harvard Business Review Improve one or more of the results without increasing costs Reduce costs without improving results « Value is defined as the health outcomes achieved in relation to the costs of achieving these outcomes.
  30. 30. 30 Eduard Portella Thank you very much for your attention