Identifying and Improving the Patient Experience in Your Practice

Grand Rapids, MI—Getting to the root of what patients really want begins with abandoning assumptions, according to Kari Kalgren, LBC, LSSGB, Director, K2 Health Training Solutions, Charlotte, NC.

As healthcare gradually becomes more personalized and more em­phasis is placed on value as opposed to cost, understanding the patient experience will only continue to increase in importance. Therefore, striving to capture that experience is vital to delivering true value-based care.

“Often, healthcare providers assume what their patients want,” Ms Kalgren said. “But what we assume may not always be correct.”

At the 14th annual National Organization of Rheumatology Man­agers (NORM) conference, Ms Kalgren discussed implementation tools that can be used to add value to the patient experience in rheumatology.

K2 Health Training Solutions and Value-Based Care

“I think value-based care means different things to different people. Sometimes people are excited about it because it means better outcomes, or potentially better contracts or opportunities with their payers,” Ms Kalgren said. “But some people are intimidated, overwhelmed or frustrated with it because value represents more policy, more regulation, more data collection, and more data entry.”

Ms Kalgren and her colleagues at K2 Health Training Solutions are focused on helping organizations understand how to build a better, more sustainable workflow. She pointed out the importance of finding practical and feasible ways to implement ideas, without getting overwhelmed by the logistics of getting from point A to point B.

Quality programs in healthcare may be valuable in theory, but if no one actually teaches organizations how to implement them, unnecessary pressure is put on practices and healthcare providers.

“It’s just one more thing they’ve got to think about, on top of a full-time job of seeing patients,” Ms Kalgren said. She teaches clients to start with small, incremental steps that will equate to “a mountain of difference down the road.”

She noted that groups, such as NORM, are vital to rheumatology practices going through the same struggles, and can provide invaluable resources, support, and opportunities for collaboration.

Identifying What Patients Really Want

Efforts at improving the patient experience should begin with identifying exactly what the patient is trying to achieve and acknowledging that previously held assumptions may be off base.

Various methodologies can help to pinpoint patient desires and, in turn, improve the patient experience. Ms Kalgren recommends starting by talking to patients directly and involving them as team members in improvement events. Utilize patient satisfaction data reports, and directly observe patients “on the front lines” (in the clinic), she urged.

Experience-based design surveys can delve even deeper into the patient experience by documenting the “roller coaster of emotions” involved in the patient experience of care. In these surveys, patients answer a series of questions by choosing the emotion that best describes the way they feel about a certain event. For example, “How do you feel when you call the clinic between visits?” The patient circles the word that best describes how they feel, in this case, either “frustrated,” “confident,” “disrespected,” “resentful,” “okay,” “happy,” or “satisfied.”

Three positives responses, 3 negative responses, and 1 neutral response are provided for a number of different scenarios in the patient experience (ie, “How do you feel when you are in the waiting area? How do you feel during the visit with your doctor?”). After the questionnaire is completed, the patient experience can be mapped out on a graph, often resembling the ups and downs of a roller coaster.

“This shows, from a different perspective, how your patients are experiencing being at your practice,” Ms Kalgren said.

Capturing Patient Value and Experience

Understanding value is integral to understanding the patient experience. Identify the processes, products, or services that patients value and are willing to pay for. In addition, identify what they are not willing to pay for, and brainstorm ways to make these more appealing to patients, Ms Kalgren advised. Internally, identify the waste in your organization, such as defects, overproduction, waiting, nonutilized talent, transportation, inventory, motion, or extra processing.

Ms Kalgren provided a case study in which practice managers at a rheumatology practice mapped out their entire inpatient infusion process. Creating a value stream map—identifying value-add activities versus non–value-add activities—helped them to differentiate their lead time from valuable process time. As a result, the practice managers were able to identify areas in need of improvement, and most importantly, the lack of time allotted for infusion appointments.

They noticed that time was being wasted on drawn-out staff tasks and superfluous activities, such as movement and setup of the infusion suite. However, by mapping out their value stream and subsequently improving their processes, they were able to accommodate a 44% increase in infusion appointments. This not only allowed for increased choice, access, and satisfaction on the patient side, but also led to an increase in revenue through the addition of 9 daily infusions.

She said this increase in efficiency was liberating to the staff and motivated them to look for other areas that could also be streamlined.

“The user experience is a big deal right now,” said Ms Kalgren. “Not just in healthcare; everywhere.” Although tools such as value stream maps, focus groups, and experience-based design surveys are helpful, really understanding what patients want simply involves getting out and asking them.

Some may argue that this is common sense, but according to Ms Kalgren, there is a big difference between common sense and common practice. The real challenge lies in implementation.

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