Experience Mapping is an in-depth qualitative research technique that utilizes a visual cue (the experience map) to help physicians, patients, staff, and other influencers recall specific episodes in their journey. It provides: Assessment of the total experience, expectations- before first encounter, activities and Touchpoints, changes in attitudes, if any Framework for action: experience stewards who are responsible for delivery, steward can appreciate the relationship of their actions to the rest of the journey, interactions or “touchpoints” are categorized at each step

1. Using Patient Stories to Create a
Culture of Caring
The Beryl Institute
April 2013

2. PAGE 2
Agenda
1. Background
2. Approach
3. Insights
4. Insights to Action
5. Adapting Practices

3. BACKGROUND
1

4. PAGE 4
Our mission is to eliminate cancer
in Texas, the nation, and the world.
With the launch of the Moon Shots
Program, we have committed to
initially eliminating eight cancers.
Patient Care - Research - Education
Our mission is to eliminate cancer
in Texas, the nation, and the world.
With the launch of the Moon Shots
Program, we have committed to
initially eliminating eight cancers.

5. PAGE 5
Enhance
Business
Decisions
Develop and
Manage the
Brand
Understand the
Customer
Manage
Growth
• Financial ROI
• Campaign effectiveness
• Project management & metrics
• Customer, community research
• Voice of the patient
• Customer experience
• Demand generation for
institutional priorities
• Service line marketing
• Global partnerships
• Brand management
• Sponsorships
• Brand advertising
Measure
Success
Global
leader
in cancer
• Market intelligence
• Trends, data, competitive tracking
• Business planning support
Marketing at MD Anderson

6. PAGE 6
We have listened to
20,000+
patients, caregivers,
healthy public,
staff and faculty
Over Eight Years…

7. PAGE 7
Proton Therapy Center
• Overview
• What is proton therapy?
• 11 centers in operation across US
• What makes our center unique?
• Strategic goals of our efforts
• Marketing: educate, drive demand to
grow patient volume
• Clinically: expand use of proton therapy
to help people with a wider variety of
cancers
• Embedded marketing support
• Dedicated team of marketers
• More involvement in operational issues

8. PAGE 8
Why We Use Experience Mapping
• Evaluates the entire experience
• From the moment someone hears of us
• Through the transition of care back to the community
providers
• Creates a framework for alignment
• Care – How we deliver
• Communication – What we say
• Coordination – How we manage the process
• This framework is then be used to assess and monitor the
experience over time
• Follow-up assessments
• Patient satisfaction monitoring
• Experience dashboards

9. PAGE 9
Our Partner
10+ year relationship
Works with Nationally-Recognized Institutions:
• 5 “Honor Roll” institutions
• 5 out of the top 10 cancer programs
• 3 out of the top 4 pediatric hospitals
• 2 out of the top 4 cardiovascular programs
Conducts National Benchmarking Studies:
• Patient experience
• Marketing
• Physician relations
• International programs

10. APPROACH
2

11. PAGE 11
Philosophy Culture and your brand promise
are linked through the experience
delivered.
Leaders translate customer
expectations to the organization and
reinforce desired employee
behaviors.
This alignment creates an
exceptional experience and a
sustainable competitive advantage.
We call this desired state
enchantment.
EXPERIENCE
EXPECTED BEHAVIORS
Cultural
Alignment
Transformational
Leadership
Brand
Promise

12. PAGE 12
Examined practices related to:
• Strategy
• Communications
• Service Delivery
• Coordination
• Technology
• Feedback

13. PAGE 13
77% link to revenue | 87% word of mouth

14. PAGE 14
Current Organizational Challenges
Defining
Experience Mgmt
Only 54%
say senior executives
and staff are aligned
in their view of patient
experience
management
Only 43%
of respondents report
that their
organization has a
common set of
expected behaviors
to manage the
patient experience
across multiple
functions
Coordination and
Cooperation
Meeting
Emotional Needs
Only 20%
report having systems
that are designed to
enable each person
who interacts with a
patient to understand
his/her preferences
Source: Gelb / APQC / Beryl Institute Survey

15. PAGE 15
Common Challenges
• Balancing costs and experience
management
• Multiple referral flows
• Managing multiple touchpoints
• Aligning all stewards toward common
outcomes

16. PAGE 16
Experience Mapping is an in-depth qualitative research technique that utilizes a
visual cue (the experience map) to help physicians, patients, staff, and other
influencers recall specific episodes in their journey. It provides:
Assessment of the total experience
• Expectations- before first encounter
• Activities and Touchpoints
• Changes in attitudes, if any
Framework for action
• Experience stewards who are responsible for delivery
• Steward can appreciate the relationship of their actions to the rest of the journey
• Interactions or “touchpoints” are categorized at each step
Fitting it All Together

17. PAGE 17
Planning
• Treatment options
• Knowledge about
MDACC PTC
• Educational
resources
• Word of mouth
Arrival
• What it’s like to be a
patient
• Discussion with
patients (diagnosis,
referral options)
Treatment
• Clinical interactions
• Staff interactions
• Treatment planning
• Coordination of care
• Self-care
Transition of
Care
• Coordination of
on-going care
• Ongoing patient
care/support
• Call-backs for
assistance
Primary Experience Stewards
• Lay Influencers
• MDACC Staff
• Online Ads
• Community Physicians
• Front Desk Staff
• Faculty/Medical Staff
• Faculty/Medical Staff
• Support Staff
• Faculty/Medical Staff
• Support Staff
• Faculty/Medical Staff
• Support Staff
Scheduling
• Initial contact with
MDACC PTC
• Timing and ease of
process
• Accessing resources
for patients and
their families
“There is hope for a
better quality life”
“Proton Therapy Center
is my best option”
“I feel at ease” “I’m in caring
hands”
“I have continued
care”
Ideal Outcomes
Key Touchpoints

18. PAGE 18
Physical
Environment
Communications
Review
1.
Interviews
From Data…
Video /
Audio
Recordings
Interview
Transcripts
2.

19. PAGE 19
…to Insights
Detailed Findings:
• Key themes
• Verbatim comments
• Strengths and barriers
3.
Day in the Life
Touchpoint Assessment:
• Key Recommendations
• Illustrate with pictures
• Enrich with clips
4.

20. PAGE 20
Differences in Needs
What We Do
• Services offered
• Clinical outcomes
• Transfer efficiency
• Scheduling delays
Functional Needs
How We Do It
• Inclusion in treatment
• “Feel” of the interactions
• Subjective quality judgments
• Feeling valued
Emotional Needs
NUMBERS STORIES

21. PAGE 21
Structure
MDACC provides the best care and communication
They are experts, but I need to know more about what it’s
like to be a patient
I an anxious about the travel requirements and changes
to my lifestyle
High performance Moderate performance Low performance
“MD Anderson is the best option to beat cancer”
Ideal Outcome:
Day in the Life:
Touchpoint Performance:
Icons for each stage:
Electronic communications, telephone
communications, facility, written communications,
interpersonal communications

22. PAGE 22
Proton Therapy Patient (summary)
DESCRIPTORS
• Most are males, approaching
retirement age or older with prostate
cancer or difficult to treat/reach
cancers
• Knowledgeable, independent
individuals who conduct research for
their best chance at a better quality
life; place high value on information
BEHAVIORS
• Research is an important part of
decision-making
• While time is of the essence, they
invest a lot of effort on primary (e.g.,
interviewing patients and physicians)
and secondary research (e.g., online
information)
• Rely on their physicians, family
members and friends to provide
insight (e.g. treatment options,
providers), but they make their own
decisions
“I didn’t realize proton therapy was an option for me until I started
doing my homework. Without a nudge, I probably would have
gone with a more common approach, so I’m glad I took the extra
step. I believe this will provide me with a higher quality of life.”
NEEDS
• Severity of diagnosis and side
effects of traditional cancer
treatments create sense of
urgency and determination to find
best option for a quality life
• Involved and enduring treatment
increases anxiety for patients and
amount of care needed
• Knowledge about Proton Therapy
Center is limited to nonexistent

23. INSIGHTS
3

24. PAGE 24
Many Not Aware of Proton Therapy Option
Please indicate your familiarity specifically with proton therapy for cancer treatment:

25. PAGE 25
Ideal Outcome
Patients want overall
“I have the
resources I need.”
Proton Therapy Center
Functional Needs
Flexible scheduling
Resources that facilitate process
(shuttle to main campus)
Clear contact information
Timely appointments

26. PAGE 26
Ideal Outcome
Patients want overall
“They truly care about me
here.”
Proton Therapy Center
Emotional Needs
Connectedness with other patients
Feelings of care and ease
Calming environment
Assurance they’ve made the right choice

27. INSIGHTS TO ACTION
3

28. PAGE 28
Translating Insights into Action
Communication CoordinationCare
Awareness Need Scheduling Treatment
Transition of
Care

29. PAGE 29
Brand Message Refinement
Message
Communicated
Current
Interpretation
Desired
Interpretation
Best Hope Last Chance First Choice
Top-Rated Cancer
Center
Serious/Rare Cancer
Only
All Cancers
Research Driven Care Impersonal Care
Compassionate
Care
International
Reputation
Expensive
Best Treatment
Anywhere
Contact Us Need Physician Referral Can Self-Refer

30. PAGE 30
Proton Marketing and Outreach Efforts
• Advertising has to educate and create demand
• Define proton therapy quickly
• Strong digital component required
• Reach prospective patients at the point of
searching for treatment options
• Find ways to raise awareness and educate
more people about proton therapy
• Public relations
• Sponsorships
• Partnerships and activities with advocacy
groups widen audience reach
– ProtonPals
– American Brain Tumor Association
– National Lung Cancer Partnership
– American Childhood Cancer Organization

31. PAGE 31
Digital Presence
• Expanded online presence
allows prospective patients and
families to find us more easily
• More robust content
• Launched mobile site
• Social media
• Facebook/Twitter serve as a
community of prospective,
current and past patients
• Patient/physician blogging

32. PAGE 32
Patients Stories Offer Hope, Inspiration
Website
• Goal: At least one patient story for
every disease treated
Facebook, Twitter, YouTube
• Share photos and links to patient
stories
• Videos of patient testimonials and tips
about their experiences with proton
therapy; “graduation” celebrations;
profile clinical teams
• Share “case studies” to show the
difference between protons and
photons to educate about possible side
effects

33. PAGE 33
Patient Stories – Gene

34. PAGE 34
Patient stories – Addison

35. PAGE 35
New Standards
• Weekly patient education meetings
(some patient led)
• Build out of private area for pediatric
patients and families
• Earlier appointment times for young
patients who require sedation
• Greater integration and increased hours
for child life specialist
• Included specific service standards and
communication efforts in staff
performance plans

36. PAGE 36
Insight Sharing

37. PAGE 37
Process Improvement
• Reaching out to internal stakeholders: education
and relationship building
• Increased information and support to help patients
register for the online patient portal
• New process for patient follow-up appointments
• Education for external referrers: Proton Therapy
Center Conference and other efforts
• Easier access for prospective patients: Create
dedicated online referral form; contact center
coming online soon

38. PAGE 38
Call Model and Dashboard
1. Align around goals and
objectives 2. Assess current call
center experience 3. Define ideal workflows
and system needs
4. Design call model, call
center system, service
recovery application, and
dashboards

39. PAGE 39
Results
• Strengthen internal relationships and
referrals
• More collaboration among centers;
expansion of diseases treated
• Education and increase in external
referrals
• Staff alignment
• Increase in self referrals
• Patient satisfaction scores

40. ADAPTING PRACTICES
5

41. PAGE 41
Status Quo Vision
Transformation Requires Commitment
Employees will travel up a “commitment curve” that defines the stages for building personal commitment to support
the brand; the design of implementation will take this into consideration using a combination of pilots, mandates,
and sharing of practices.
Internalization
Individuals make new process
their own and create innovative
ways to use and improve
T I M E
COMMITMENT
High
Contact
Individuals have heard
new initiative exists
Low
Awareness
Individuals are aware of basic
scope and concepts of new
initiative
Understanding
Individuals understand impacts to
organization and their functional
area
Positive Perception
Individuals understand new process impacts
and benefits to them
Adoption
Individuals are willing to work
with and implement new
process
Institutionalization
New process is the way work is done -- the
new status quo
While the speed with which an
individual moves up the commitment
curve may vary, the stages themselves
are inevitable

42. PAGE 42
Prescriptions for Your Organizations
• Sell in the concept by linking to revenue potential
• Satisfaction => Advocacy => Word of Mouth
• Empowered staff = happier patients
• Start with clinical services lines that are bought in
• Don’t try to tackle everything at once
• Focus on “sphere of action”
• Identify quick wins and execute
• Follow-up and refine the process for new areas
• Share best practices across organization

43. PAGE 43
Follow-up Assessment Tools
1. a. Caring Environment: Service with a Smile
Caring Environment: Service
with a Smile
Employees do not
provide caring and
friendly services or
service with a
smile and there
are no official
service standards
in place requiring
it
Employees may
choose to be
caring and
friendly, but there
are no official
service standards
in place requiring
it
Employees verbally
encouraged to be
caring and friendly,
but there are no
official service
standards in place
requiring it
All employees are
expected and held
accountable during their
reviews to follow uniform
service standards that
include providing caring
and friendly services with a
smile
Patients report
consistently expecting
and receiving caring and
friendly services from
insititutional personnel
with few to no
exceptions.
1 q 2 q 3 q 4 q
Maturity Continuum
Highlighting Best
Practices
Ratings from
Observations and
Self-reporting
Typical
Evidence

44. Benchmarking Your Progress
Source: Gelb / APQC / Beryl Institute Survey

45. PAGE 45
We Celebrate Success…with a Shake

46. PAGE 46
Contact Us
Dana Hoyland Lee
Manager, Marketing
dhlee@mdanderson.org
John McKeever
Executive Vice President
jmckeever@endeavormgmt.com

47. PAGE 47
Endeavor Management is a strategic transformation and management
consulting firm that leads clients to achieve real value from their
initiatives. Endeavor serves as a catalyst by providing the energy to
maintain the dual perspective of running the business while changing the
business through the application of key leadership principles and
business strategy.
The firm’s 40 year heritage has produced a substantial portfolio of proven
methodologies, enabling Endeavor consultants to deliver top-tier
transformational strategies, operational excellence, organizational
change management, leadership development and decision support.
Endeavor’s deep operational insight and broad industry experience
enables our team to quickly understand the dynamics of client companies
and markets.
In 2012, Gelb Consulting became an Endeavor Management Company.
With our Gelb experience (founded in 1965) ,we offer clients in-depth
insights in the healthcare industry and unique capabilities that focus their
marketing initiatives by fully understanding and shaping the customer
experience through proven strategic frameworks to guide marketing
strategies, build trusted brands, deliver exceptional customer
experiences and launch new products.
Endeavor strives to collaborate effectively at all levels of the client
organization to deliver targeted outcomes and achieve real results. Our
collaborative approach also enables clients to build capabilities within
their own organizations to sustain enduring relationships. For more
information, visit www.endeavormgmt.com and www.gelbconsulting.com
2700 Post Oak Blvd., Suite 1400
Houston, TX 77056
+1 713.877.8130
www.endeavormgmt.com/healthcare