From the Society

Everything We Say and Do: Hospitalists are leaders in designing inpatient experience


Editor’s note: “Everything We Say and Do” is an informational series developed by SHM’s Patient Experience Committee to provide readers with thoughtful and actionable communication tactics that have great potential to positively affect patients’ experience of care. This column highlights key takeaways from the SHM track of the upcoming 2017 Cleveland Clinic Patient Experience Empathy and Innovation Summit, May 22-24. Three hospitalist leaders describe their approach to leading the design of the inpatient experience.

What we say and do, and why

Like many forms of care improvement, we have found that health care providers and patients alike engage most proactively when they are directly involved in codesigning an approach or intervention for improving the experience of care. Here are some examples of how hospitalists can be effective leaders in cocreating the inpatient experience with patients and interdisciplinary colleagues.

Dr. Diane Sliwka of the University of California, San Francisco

Dr. Diane Sliwka

Dr. Diane Sliwka: Design principles and systems improvement. Inspiring and sustaining effective improvement in patient experience and the work experience of the care team warrants rethinking of how we design our leadership, goals, and engagement of the people doing the work. Deliberate application of several principles has transformed improvement from being “another thing we have to do” to “the effective and engaging way we do things.” Effective improvement design has included visibility walls, streamlined goals and targets, access to real-time data, dyad leadership, huddles, and executive leader rounding. Through these methods, we nurture a culture of support for – and problem solving by – the people doing the work.

Dr. Patrick Kneeland of the University of Colorado, Aurora

Dr. Patrick Kneeland

Dr. Patrick Kneeland: User-centered design retreats. We have implemented experience cocreation through user-centered design workshops that bring together patient voices, nurses, physicians, case managers, social workers, and pharmacists from a specific inpatient unit. Over half- or full-day sessions, the interdisciplinary team follows a facilitated “design thinking” approach to brainstorm, prototype, and refine new ideas. The outputs are brought back to the unit for implementation and ongoing refinement. Not only do innovative ideas emerge for enhancing the experience of care for both patients and providers, but there is also a measurable impact on unit culture and interdisciplinary collaboration.

Dr. Robert Hoffman of the University of Wisconsin-Madison

Dr. Robert Hoffman

Dr. Rob Hoffman: Partnering with patient and family advisers. Working in close partnership with patient and family advisers (PFAs), we redesigned and implemented interdisciplinary bedside rounding in a way that puts the patient and family at the center of the care team. A multidisciplinary group including physicians, APPs, case managers, pharmacists, and PFAs created daily “care team visits” that bring, at a minimum, the nurse, provider and case manager to the beside daily. Key concepts we learned from our PFAs include having the nurse initiate the visit, minimizing the number of participants, clear introductions every time and focusing explicitly on what is most important to the patient that day. Our PFAs also actively participated in our training sessions for nurses and providers. Their stories and feedback at these trainings motivated attendees and helped everyone understand “why” we bring our conversations to the bedside. We have seen significant improvements in provider and nurse satisfaction with collaboration and unit level decision making and trends toward improved patient satisfaction with communication and teamwork.

Dr. Sliwka is medical director of patient and provider experience at University of California, San Francisco, Health; Dr. Kneeland is medical director for patient and provider experience at University of Colorado, Aurora, Hospital; Dr. Hoffman is medical director for patient relations at University of Wisconsin-Madison, Health.

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