Auditing the Patient Experience to Target Improvements

Noelle Wysocki: Good afternoon, everyone. Thank you so much for joining me. My name is Noelle Wysocki with Healthcare Business Insights. I‘m so excited to take you through our webinar today, Auditing the Patient Experience to Target Improvements. A couple of months ago many of you might have joined me for a webinar on how HBI is currently measuring the non-clinical patient experience. We want to share with you today how we‘ve been able to apply some of those different measurements to an organization that we were working with this summer. I‘m joined today by Matt Wollbrinck of Children‘s Hospital Colorado, and together we‘re going to take you through the training initiative that we put in motion over the course of eight weeks in Colorado. here to continue

For those of you who haven’t met me yet, I’m Noelle Wysocki. I’m the learning product lead at HBI. So I’m responsible for working with my team to develop and deliver different kinds of training content that you see at HBI with our e-learning library, or different face-to-face workshops, and other learning initiatives that are being put in place.

You might have seen me speaking at our retreat with Matt here who I will allow to introduce himself in just a moment. I’ve also been in California talking about some other things at the recent annual CAHAM conference. And for those of you who are joining the HFMA Conference in Tunica at the end of January, I’ll be excited to meet you all face to face.

I’ll let Matt introduce himself. Hey Matt, how’s it going?

Matt Wollbrinck: Hey, good Noelle. Thank you very much. Thanks for inviting me to the webinar here. My name is Matt Wollbrinck, I am with Children’s Hospital Colorado. I’ve been here for about two years and a couple of weeks. Overall I have about 24 years plus give or take of customer or guest service experience, 10 years of those were working with the Walt Disney World Resort with a myriad of different roles, varying scopes of responsibility. I was a certified trainer, a show observation specialist, entertainment coordinator, coordinator of training.

I moved out to Colorado. Actually, I’m from Colorado, I’m Colorado born and bred. So one of the few unicorns out there. Then I moved back in 2008 and established a service program with Aurora Public Schools. I was there for about nine years and then took a leap into the healthcare side of things and I got certified in Epic. I’ve been training Epic for the past four years now, and now I’m really excited about this new venture that I’ve got with Children’s Hospital.

So again, thanks for having me on Noelle. I appreciate it. Looking forward to discussing our accomplishments with you guys.

Noelle: Really excited to get into this. Matt was with us out in Nashville for our annual retreat and we had a lot of fun talking everybody. So excited to dig in here.

I want to go through our agenda for today’s discussion. I’ll give a little bit of background on who HBI is. This webinar is available to people who are not yet current members of HBI Research or Learning platforms. So I want to make sure that I’m giving everybody a little inside view of who HBI is and what we do. We’ll go over the customer service landscape at Children’s Colorado, HBI’s approach to the challenges that we understood, the customer service workshop itself, and the results that we’ve seen so far.

HBI exists to help organizations better understand, measure, and improve the end-to-end patient experience. We do that in several different ways: through best practice research, data and analytics, different customized services. And of course Learning and Development. We are part of a larger organization called Decision Resources Group that combines all of the different resources to help life sciences, U.S. revenue cycle spaces, serve their clients and their patients better.

We do that in several different ways. At HBI we provide different services and analytics, like operational assessments or denials intelligence analytics. With Learning, we do face-to-face workshops. We have a revenue cycle e-learning library of over 130 web courses and custom competency assessments. And of course our best practice research, including market overviews, cost and quality best practices, revenue cycle benchmarking, and of course webinars just like this.

We’re currently operating with organizations in all 50 states. I’m still looking at you Hawaii. If you ever need an on-site workshop, you let me know, excited to get out there. Maybe March or so this year during winter in Milwaukee. That would be awesome. We serve just over 2,000 hospitals so far and that includes 20 of the 30 largest nonprofit health systems in the country.

I’ll pass it off to you Matt. Tell us about Colorado.

Matt: My pleasure. I’ll tell you specifically about Children’s Hospital Colorado here. So we’re all about advocacy, for not only our patients or families but the community. That’s kind of the underpinning of what we are. What you see here is our mission statement. So we are a caring community called to honor the sacred trust of our patients, families, and each other through humble expertise, general service, and boundless creativity.

This is the moment. It’s the moment for action. This is the moment for everything really. We have a total of 18 different locations that span Colorado, the Front Range area, four of which are regional hospitals. We have approximately 5,600 hospital staff members, 564 beds, we get about 842,000 outpatient visits a year. We were number nine in the U.S. Newsranking. We have nine Epic gold stars. Although we could be getting close to 10. I’m not quite sure about that number but once upon a time we actually got the HIMSS Davies Award. So I’m very, very excited. We’ve come a long way, baby.

Noelle: We’re excited to get involved here. As we go through our presentation today, we want to get interactive with some live polling with all of you. So if you would like to participate in some of the surveys that Matt and I have throughout our presentation, please send a text message to 22333 and send a message of noellewysock830 just like you see on the screen there. This was a tool that we used to train the staff at Children’s Colorado to get them to engage with the material a little bit differently. You know, not everybody in a training environment feels comfortable raising their hand or shouting out answers or participating in some group discussion in front of a large group. So we wanted to give them opportunities to participate with the material in ways that made them most comfortable, and we found that this live polling tool was a really successful and useful way to do that. So we’d love to survey all of you with a few questions as we go today, and you can participate by texting in right now. To get set up text 22333 and send the message of noellewysock830. Let’s see if this will work here. Let’s try one.

So I’d love to hear from you. What would be your top reason for launching a patient experience initiative in 2020? What would be your top reason for launching a patient experience improvement initiative in 2020? Text that into 22333 after you join and responses should populate here on the screen. Give it a moment.

Excellent. Improving overall survey scores, patient satisfaction, improve the patient experience. Yes. To stay competitive. Absolutely. Matt can touch on that, with a new player moving in not too far away. Reputation and growth. Improve those survey scores. Yes. Price transparency in government requirements. Absolutely. Improving patient loyalty.

These are all great reasons. You know, as regulations are changing, we’re going to have a whole lot more responsibility to talk about how we can improve the patient experience here. Get the results of where we need to work on more. Yes. Having insight into what certain challenges might be and how we can address them. Returning patients to our facilities. Absolutely.

Thank you so much for sharing all of this. We will have a few more surveys as we go along.

Let’s try one more right now. How does your organization currently track the non-clinical patient experience? Can you tell me what you are doing right now to track the non-clinical patient experience? Go ahead and text that in.

Press Ganey. Electronic surveys, real-time surveys. Management audits employee performance. Excellent. NPS survey. Call audits. Yes, lots of call recordings happening lately. “Make your day” cards, I like this. Lots of surveys. We love to survey our folks, right? We’ll talk a little bit about some blind spots in some of those surveys that organizations are using momentarily. Great. Thanks so much, everybody for participating in these surveys.

All right, let’s keep going. Matt, I’ll pass it to you.

Matt: Thank you. So it looks like there’s a lot of the same techniques that we were using here at Children’s Hospital for trying to gather information and feedback from our patients and our families here. And as Noelle had mentioned before, we found that there were some definitive blind spots. So we also came up with some of our own here as well.

So we do have a patient-family survey that goes out to all patients and families upon either their discharge or whenever they’re done with their outpatient ambulatory visit. I would say probably about maybe 70% of them decided not to take it, but out of the others that do take it, we do take that feedback very very seriously, and a lot of that information gets passed directly to me.

So what we noticed was that these patient-family survey results were starting to reflect poor customer service experiences. Not necessarily with the providers, with their nurses, but with the front-end staff, with like the what we call the PFSS, patient-family service specialists here, or the inpatient service specialists, ISS as we call them. So people say that they love the providers, they love their nurses, they come back religiously for these folks, but they were noticing a decline in the service we were providing on the front end.

We had a decline in returning patients as a result of that. We had a few one-star reviews praising the docs and the nurses again, but blasting the front desk staff, the revenue cycle staff, for a noticeable lack of social sensitivity from some of the front desk staff, some of which was actually escalated right up to our CEO.

So a lot of different feedback. You know, people are always very much willing to tell you what went wrong. They don’t tell you what went right, but they will always tell you what went wrong. So for that, we appreciate it. So then we called Noelle.

Noelle: Yep, sure did. We wanted to gain a little bit further insight into what was going on, and to do that we needed to understand what the surveys were actually capturing. We did some research on various surveys that organizations do employ, do send out to patients, and learned that most of the time it’s not capturing any non-clinical experience. So when we’re sending out things like HCAHPS or monitoring our HCAHPS scores in order to guide the patient experience to see how we’re doing in the non-clinical patient experience, research has shown that about 96% of patient complaints are related to their overall experience. Only 4% are actually clinically related.

HCAHPS and other surveys are really focusing in on those clinically related questions, not diving into non-clinical interactions. There’s an HCAHPS survey breakdown here on the screen where you can see 62% of those questions are regarding clinical information, 19% are regarding patient background information, and another 19% on the organization’s overarching items, like cleanliness, or the likelihood to recommend the organization. There aren’t any questions that talk about your interaction with schedulers, or your interaction with front desk staff, or PFS, or anything like that.

Satmetrix has done some studies that said a 2% increase in customer retention has the same effect as decreasing costs by 10%. If we can increase the number of loyal patients, we’ll be able to make a significant financial impact on the organization.

Because there are these blind spots in patient surveys and different things, we needed to ensure that we were hearing from the patients, that we were somehow capturing that information to make sure that we could speak to the specific challenges experienced by staff. So we could start to limit some of those one-star reviews, you know when the clinical staff is incredible and provides the best treatment the best care possible, but they’re less pleased with their interactions with revenue cycle staff.

So what did we do about it? HBI approaches our engagements of this nature in three steps. We assess we create and deliver, and then we conduct follow through.

First, we want to assess what’s going on, understand and identify the critical transformational opportunities that exist at the organization. We’re going to use that information to then create and tailor an interactive workshop with learning objectives specifically tied to those challenges that we identified through our assessment. We come on-site to deliver that to staff. And then we’re going to measure again through our follow-through phase. We want to launch all of the different assessments that we conducted to see if we’ve moved the needle. How are we doing? How is our staff retaining the information that we gave them? Is it giving the improvement that we were hoping to effect?

I’ll take you through our assessment phase first. First, we needed to understand the patient experience landscape at Children’s Colorado. We knew that there were HCAHPS scores, that the patient-family experience team sends out information, but we wanted to know what it was like from a prospective patient or prospective family point of view. So we did some secret shopping. We conducted 105 secret shopper phone calls to 18 different departments throughout the organization to understand the service quality provided to those customers.

Each call is assessed on five call elements: phone access or the ease with which we were able to reach the desired department, courtesy and professionalism, empathy and caring, inquiry and resolution, and their overall impression or our likelihood to recommend the organization to others, or to continue to seek care for our own families or ourselves.

We also launched a staff challenge and needs survey. We sent this out to all revenue cycle staff. We wanted to hear from them. How do they feel about the level of customer service that they provide to patients? How are they impacting the patient experience? How are they interacting with one another? Do they feel that they each deserve and deliver empathy and respect among colleagues and patients and family members that they’re interacting with? We were able to understand the patient experience from the lens of prospective patients as well as the lens of staff that delivers it.

Our secret shopper results showed us an opportunity for improvement in showing empathy. Really that was number one, solving problems, and providing an experience that builds trust and confidence in the organization. You can see here the scores of all five of those call elements. Empathy and caring, inquiry and resolution, and overall impression were the lowest scores, with empathy and care to give us the lowest score at 56%. So this means that just over half the time the person on my staff, our secret shopper, felt like the other person on the other end of the line cared about them.

We want to make sure that we can improve that because patients and families that are calling in should always feel cared for when they’re calling into the healthcare organization. We needed to be able to give staff tools to provide that level of care for the people that they’re talking to, as well as turn them into confident problem-solvers for the people on the phone. Hopefully by doing that then, we would be able to improve the overall impression of the likelihood to recommend.

Staff survey results showed similar needs, opportunities for improvement in showing empathy and solving problems for one another internally. We have our internal customers and our external customers, and we wanted to develop materials that would help enhance relationships with both. They were often managing very high-stress situations and we needed to give them tools to provide an experience that built trust and confidence among their colleagues.

The survey allowed us to take some free-text responses from respondents as well. We found three major themes that stood out among these free responses. Challenges experienced by staff included that they feel rushed at the front desk, which makes it hard to provide friendly customer service. Or they’re dealing with irate customers and trying to keep them calm, and that families are often rude and upset and take it out on the front-line staff. So we knew that the tools we were going to teach them needed to speak to these specific challenges and allow them to have effective empathetic conversations with one another and the patients that they’re caring for.

Matt: Yeah, so we had some pretty obvious needs here when it came to investing in the soft skills, or as we’ve started calling them out here, our power skills, because soft or not, they’re very powerful skills. Even on a front end, they lead to obviously really dissatisfied customer service experiences. So the patient experience obviously tied directly to customer service. Customer service includes service quality, relationships, and effective communication both internally and externally. So we put together some modules that were geared to not only patient-facing roles, but also roles for people that are not patient-facing at all, but still interacting with folks internally here.

The hypothesis as stated here on the slide was when staff could sharpen their tools for effective, empathetic communication and learn to treat each other as customers, the outcome would be more empathetic service for the community as a whole, thus positively impacting the overall patient experience.

We built-in, we delivered the soft skills that the staff was needing. So we launched some face-to-face workshops with learning objectives and activities that were designed to enhance the ability of the staff to have empathetic and effective communication both internally and externally. This was an investment in them as people, not just as employees, the emphasis was on personal development in addition to professional development aspects of it.

It was a grand total of about eight weeks of training where we trained a total of 849 staff members. We had three train-the-trainer sessions with 40 different managers from various different departments who came in wanting to be champions for this, wanting to be sort of proprietors if you will. It was a really good buy-in. We actually had a lot more people than that. They wanted to be on board with us. Unfortunately, just because of the space constraints we had to limit it to about 40, but we had an overall 36 train-the-staff sessions with 809 staff members there.

And we did this over a couple of different locations. As I mentioned, we have 14 different locations all over Denver in the Front Range area here. So most of the training took place in Aurora, which is where kind of the main hub is for the Children’s Hospital. We also did some out in Colorado Springs, and then for those folks that are a little bit more demographically challenging, or geographically challenged rather, they couldn’t actually make it, because we do actually have a healthy amount of staff members that work out of state. They work on permanent work from home basis. We were able to offer a WebEx for those.

I’ll toss it back over to Noelle and she can give you another Insight survey.

Noelle: Excellent. So let me hear from all of you. What soft skills do you think are most important when delivering a great patient experience?

Listening. Yes, absolutely. Having a friendly voice. Having compassion. Yes. Listening skills coming in again. Very welcoming. Absolutely. Yeah, eye contact, tone of voice, being a warm welcoming person who is very calm. Absolutely. Being a problem solver. Yes.

Matt: Double problem-solving.

Noelle: I love it. Body language, having empathy and patience. Yes, all of these things are so important. Commitment to assist, I really like that one. Listen to hear and not just respond. Yes. So many times patients just want to be heard. This is wonderful. Having a welcoming attitude. Very good. Thanks for sharing everybody. I’ll move on to the next slide here.

Matt: Now so these are all really really good, as Noelle pointed out. I think every single one of these plays a part in the overall customer service satisfaction. The big one though was empathy, that’s kind of what we thought and that’s where we kind of based all of the instructor-led workshops.

What you’re looking at right now are the three different workshops that we devised to kind of break it all down here. So each one of these themes was broken down into a separate, like a 90-minute module, roughly two hours, kind of depends on the size of the class and the interaction. These were all very very audience participatory. So there was like kind of an equal amount of instructor-led versus what people were throwing in as far as their own personal stories.

But the first module really focused on your thoughts, feelings, and behaviors, and how they interact amongst themselves, and how just about every interaction you have with any person at any given time throughout the course of your day is going to trigger any one of these. So it could be a thought that then provokes a feeling, which then triggers the behavior. It could be a feeling that triggers the behavior that then triggers a counter thought. But it’s a cycle.

So the first module kind of talked about that cycle and it talked about how you need to be kind of consciously aware of how you’re perceiving different things, and how by changing your thought process, or at least kind of looking at things through a different lens, you may be able to take negative feelings or negative thoughts and turn them around to produce more positive thoughts.

The second module focused on what we call the listening pyramid. So everything from ignoring, too distracted or pretend listening, to selective listening, attentive listening, then we get too empathetic listening at the very very top there. And how at different stages of your life you’ve sure been at any one of these stages here. I don’t think there’s a single person out there that can’t say that they have either purposefully or maybe not so purposefully ignored somebody. When you have your distracted listening, your pretend listening, when it might be appropriate to practice selective listening, sometimes putting filters on things can help you filter out the actual message if somebody’s very long-winded as I tend to be sometimes.

Then your attentive listening, which is kind of really what we’re striving for. And then the very tip-top of the pyramid there, which is your empathetic listening, which is where you’re actually putting yourself in your customer’s shoes, really trying to understand what it is they’re going through, really kind of placing yourself in that position so that you can fully grasp the situation and help them to the best of your ability.

The third and final module focused on effective communication. The four different keys of communication, which are non-verbal, which some of you had mentioned on that previous slide there when you said eye contact and body language there. We talked a lot about that because people aren’t always going to tell you what they think, but their posture and their body language will never lie.

Paraphrasing what you’re hearing. So that way you understand, you’re getting the correct content and getting good takeaways, what we call the WIIFM, which is what’s in it for me. So again kind of paraphrasing things, or saying things so that instead of saying well, this is what I’m getting in return, it’s what are you going to get in return? If I pay my bill on time, how is that going to benefit me as opposed to just benefiting the company, right?

And then your balanced response. So more often times than not if we can’t provide a service, it’s very easy to say well, I’m sorry we just can’t do that, and we just leave it hanging. So by providing a balanced response, you’re saying I can’t do that, but I can do this. So maybe if you’re able to offer an alternative.

These modules were a huge hit, everybody really enjoyed them. Some of the measurements that we have from our staff members here, the content and the delivery were adopted systematically based on queries and the identified needs of the participants. The most common questions from the participants were, so when are the docs going to have to take it? Just because there appears to be a kind of a disconnect between what’s going on on the clinical side versus the non-clinical side.

So some of the questions that we had there were many many survey questions that went out to the staff members about how they felt about these different modules. These are three of the most popular ones here. So how clear was the presentation of the information? As you can see over 71% thought that it was very clear, very well given.

How do you feel about the amount of information that was presented? Over 87% felt as though it was a good adequate amount of information, people didn’t feel like they were bombarded with it. People didn’t feel like it was not enough. In some cases, people said that they would like to have had more because they really enjoyed kind of getting into things. In fact, one of the pieces of feedback that we did get when asked about the overall impression was that some of our folks said that they would really love to go out and have a beer with the HBI trainers because they were so cool to talk to.

How was your instructor? Obviously, they were very engaging, as you can see there over 75% said they were highly engaged. Some people said it was actually the absolute best training that they’ve ever had here at Children’s Colorado. So kudos to HBI for doing a fantastic job.

Noelle: Thank you. We had a really good time doing it.

Matt: Yeah, and the staff loved you. Here are just some of the comments that we have. These are actual photographs taken from some of the actual classes there. So if you guys wanted to see, I’ll let you read those there. My favorite one here is in the lower right-hand corner. “This was a good reminder of why we do what we do for the betterment of the community.” Overall that’s really what it all came down to in some cases. Just reminding people why they are here and why they took the job.

Noelle: Yeah, we had a really good time. The Colorado staff were so interactive and really joined in all the different activities that we had created for them. So we had a really fun time facilitating these workshops to everybody because everybody was so excited to take in this information and put it into use.

Of course, we want to now measure. How did it go? What did we do? Did we move the needles that we set out to move? The needles that we identified through our assessment phase that we really wanted to impact were the empathy and caring, inquiry and resolution, and the overall impression.

After launching the second round of secret shopping phone calls, we learned that we did in fact move the needle. We improved our score for empathy and care by 10%, inquiry and resolution by 16%, and the overall impression or the likelihood to recommend by 9%. You can see here on the bottom of the screen the before-and-after scores. We’re really proud of the movement that we have here.

Here you can see the breakdown for each of the departments. The blue bar that you see is the pre-workshop scores. The orange diamonds are the post-workshop scores. In those three buckets that we set out to improve—empathy and caring, inquiry and resolution, and overall impression—you can see that we moved up in almost every single department.

There are a couple of outliers. For example, in the child health clinic, the score went down in empathy and caring. It was because it was very difficult for us to have somebody answer the phone. So it’s hard for us to feel empathy or that we’re cared for if we couldn’t get somebody on the phone when we called. We talked to a couple of people, but that does impact that score there. But for the most part, everyone else went up, which was great news, and we’re very proud of that.

What else did we see? We were able to take out some trends. What did the numbers show from our caller sheets? I really like these specific data points that jumped out at me. The percent of shops in which caller stated that they felt the Colorado staff member was actively listening to them. Before the workshop scored 62% after the workshop scored 79%.

The percent of shops in which the caller stated that the Colorado staff member’s tone of voice made them feel comfortable and assured before the workshop was 43%. After 57%.

The percent of shops in which callers reported the Colorado staff member asks questions to better assist the caller, 55% before, 70% after.

And while we didn’t set out to affect phone access, I did want to point this one out. The longest hold time that was recorded prior to the workshop was about 51 minutes. The longest hold time that we recorded after the workshop was only 14.

We didn’t just do secret shopping on Children’s Hospital Colorado. We also did it on five other similarly sized pediatric organizations across the country. We wanted to see where they ranked in terms of some of their national competitors. You can see here on the screen now the different scores for each of those five buckets for our blinded study.

The gray boxes represent those scores of those other organizations that we conducted secret shopping phone calls in similar apples-to-apples departments. You can also see Children’s Colorado pre-workshop scores in that orange color and their post-workshop scores in the blue. I really am excited to point out that pre-workshop empathy and caring, inquiry and resolution, and overall impression, Children’s Hospital Colorado was among the lowest if not the lowest scoring in those three buckets. After the workshop, however, they shot up to the top.

I think that’s a tremendous improvement and shows that the staff is really motivated by the learning objectives that we achieved and able to retain and put the information that they learned to use.

So I’d like to ask you for another survey. Which of those five call elements do you think your organization struggles with the most? I’ll put up multiple-choice options here. Which of these five elements does your organization struggle with the most? Text in A B C D or E for us here.

Phone access surging ahead out of the gate. Inquiry and resolution, second place here. Turning people into problem solvers. Inquiry and resolution coming out ahead. I think that makes a lot of sense. You know, there’s been a lot of focus on empathy these days, which I think is fantastic. The next step is empowering our staff to turn them into problem solvers. Partners who are problem solvers for the people that they’re working with, they’re working for, and the community that they’re serving.

I want to share with you some post-workshop secret shopper details. Our secret shoppers documented a lot of information throughout their calls, including things they talked about, why they felt ways that they did, and some of these specific testimonials jumped out at me. I won’t read all of them for the sake of time here, but I will read that very last one. “I don’t know how to describe it, but you could tell she talked with a smile on her face.”

I love that because I think that is so true. You can tell when somebody is attentive and sitting up and smiling at the other end of the phone. Non-verbal communication is so easy to pick up whether you’re face-to-face on the phone, whoever it is you’re talking to, it will shine through and I’m so excited that we were able to help bring this out.

So we did the secret shopper. What about the staff survey? We relaunched that as well. We wanted to see if we were able to move the needle in terms of staff perception of the type of customer service that they provide, both internally and externally. A few questions stuck out to me as very interesting for comparative analysis. The question of how often do you provide an excellent service experience? Pre-workshop almost 73% of respondents said always, I always provide an excellent service experience. After the workshop, it seems that we’ve increased self-awareness among staff members because that always bucket dropped to about 52% of respondents. You can see that the almost always box has increased by about 16%.

Being given the vocabulary and a different understanding of what stellar customer service could be, or what more we could do for each other, what more we could do for the community that we serve, has allowed people to understand that there is probably a little bit more I could do. I could do a warm transfer instead of a cold transfer. I could go above and beyond now and again when time permits to track down those answers rather than just transfer it off to someone else. I can look people in the eye. I can listen differently and put my phone down, right?

So we’re seeing some increased self-awareness. I’ll share with you another question. How often do you tailor your communication to the needs of customers, internal and external? Pre-workshop 80% said always, all the time. Post-workshop that bucket drops to 58%. So again, we’re seeing that shift from the always to the almost always as people are learning, yeah there’s probably a little bit more than I could do here.

How often do you become an engaged listener during each customer interaction? Like Matt described, one of the modules was fully dedicated to the different levels of listening, what those are, and how we can employ them. Pre-workshop about 70% said always. Post-workshop, drop to about 50%, 49%.

So it’s fascinating to see these different levels of self-awareness come in after going over different vocabulary, different ways to reach out to people, different ways to serve the customer internally and externally, and let them know that their situation matters, that really here at Children’s Colorado it’s different.

Matt: So for where we’re going from here on out with Children’s Colorado. I have partnered with the patient-family experience team and also the clinical applications team to identify opportunities for improved integration of patient-family experience and service excellence initiatives. And this is going to become an organization-wide push for 2020. So we’re going to break down the silos, generate some common language to support the idea that we are all patient-family experience, clinical and non-clinical, that’s the PFX you see there.

We’re redefining the patient-family experience as habits, not necessarily standards, but habits that we want everyone to be able to understand and practice. We’re building quantifiable strategy plans and observation tools for the managers to hold the team accountable. We’re sending out self-assessments focused on empathy. We’re developing training to break down the barriers in the departments that use Epic kiosks by enforcing techniques to focus on what we call TACOS: which are teamwork, attitude, consistency, open-mindedness, and service, which are going to be are five different ways that we define the customer service experience when you’re dealing with kiosks.

It’s important to understand that we’ve implemented the welcome kiosks, in doing so we haven’t lost any team members. We haven’t replaced any team members. We haven’t downsized at all. This is a very important partner in technology. So we’re keeping everybody on board. We’ve kept everybody on board right now. We are at about an 85% utilization rate and we are moving forward with this training.

So we’re also going to continue to track the results and collect data just as Noelle and the HBI team has, hoping to find steady growth and sustainable results, and we’re going to begin focusing on the scheduling departments by Q4 of next year.

With all that being said what questions might you all have for either Noelle or myself?

Noelle: Please, send us your questions through the chat function or the Q&A function on your screen, and we’ll have a few minutes to answer any questions you have.

How many hospitals are HBI worked with regarding the non-clinical patient experience? Actually, Children’s Colorado was our kickoff. It was not a workshop aspect that we had employed before specific to the customer service aspect that we talked about in these modules. We have worked with several different organizations now, probably 4-6 just this year on other revenue cycle related to patient experience aspects, like point-of-service collections best practices. That’s actually what I’m on-site delivering, a face-to-face workshop for almost 300 staff this week as we are going through those types of workshops to enhance that non-clinical patient experience as well.

What are you doing to keep this at the forefront of employees’ minds on a day-to-day basis to achieve sustainability? Matt, would you like to speak to that? How are we keeping this active in the minds of your staff?

Matt: Yeah, absolutely. And you know, it’s funny because that was a common theme that we got, especially during the train-the-trainer class. How are we going to keep this going? How are we going to move forward with it? How are we going to ensure this isn’t just like a flavor of the week or flavor of the month? The answer is quite simply by constantly reminding them of it. We’re really engaging and empowering our supervisors and managers. We’re giving them the tools to audit their staff to make rounds and observations and we’re making it a really big focus. As I mentioned before we’re partnering with a department called the patient-family experience and for 2020 this is going to be a huge push and it is going to be organization-wide. It’s going to be clinical and non-clinical, it’s going to be everybody. So even for all those folks that said hey, what about the docs? Are they going to get this training? They absolutely are going to get a version of this training, the same training that HBI provided and that we’re continuing to provide on the rev cycle side. It’s a big culture shift within our organization.

So I think sometimes when we kind of takes our reputation for granted, sometimes we tend to get a little bit, I’ll just say a little lackadaisical sometimes when it comes to our efforts. So starting in 2020 we’re going to start pushing those efforts forward again. We’re going to start refocusing what sets us apart from other pediatric organizations. We have several competitors now, it used to be that Children’s Colorado was the obvious choice whenever people needed pediatric help, whenever they needed to send their kids to the hospital, or come to a clinic or specialty. But now we have the Rocky Mountain Pediatric organization. We have Centura. We have a Health One. We’ve got a whole myriad of different options now, but ultimately this is living within the departments.

We obviously have a centralized organization, which is me in the patient-family experience, which is driving this, but it lives and it thrives and it continues to grow and it continues to grow and it continues to work on a very passionate level with the department managers and supervisors. We’re also moving forward with kind of secret shoppers of our own, we’re utilizing what I like to call rock stars. They’re our customer service rock stars, they are people who are very very passionate about what they do. They’ve never lost focus on it, people enjoy interacting with them. They exemplify what we call the balloon boy standards. Our logo is a boy carrying balloons. So we have the balloon boy standards and people who continue to exemplify and exceed those standards are going to be coming along cause we’re meeting with them on a regular basis, once a quarter, once every two quarters, that really hasn’t been determined yet. But we have a lot of different things in place. But ultimately what it comes down to is, how are the departments going to hold their teams accountable?

I also got a question here from Mr. Thomas. This says, what about patient registration times per customer? I just want to make sure that I understand this correctly. So you’re asking about the registration time, the time that it takes to get patients registered? The good news about the kiosks is that patients can do that kind of on their own, with the gentle assistance of the people who are working there at the front desk staff.

We’ve also been very strict about our registration times and what the recommendation is, we’re revisiting that. I am unfortunately not really a part of those decisions or part of that dialogue, but I know we are revisiting those. Because in a lot of different cases, we got some feedback from our staff members saying that hey, we have met these criteria, we have to meet these numbers, there’s no time for customer service when we have to meet these numbers when you have to get so many phone calls in. So there’s a panel of folks in our leadership that are revisiting those, so hopefully, that answered your question.

Noelle: And I see one more question here that says, are you converting the in-person training to an online course for your new hires? We do have that option. We have not yet explored it because we wanted to see how things were going with clinical staff, with the training that the organization was putting together for them, to see what other challenges might exist, but it’s absolutely an option that we would be able to flip all of the information that we put in those modules into e-learning to be uploaded to the LMS. Something to talk about with regards to flipping it into e-learning is that we do lose that ability to have the engaging interactive activities that we do throughout the workshop that really helps participants solidify those learning objectives and interact with it and have those really useful small group discussions.

So I think that starting with the face-to-face and then following up with the online learning to also keep this top of mind, and that would be another way to keep everything in the learning objectives alive as we continue to go on, would definitely be a useful thing. Right now it’s just the face-to-face and Matt has taken on the responsibility of training all the new hires that have been coming in since then.

Matt: We’ve taken all three of these modules the way you talked about earlier, combined them into one approximately 5.5-hour class and it has been met with rave reviews, people have thoroughly enjoyed it. It really gets people talking. They enter the room as complete strangers on their personal devices not interacting with each other at all, and usually by the end of the class, they’re socializing with each other, laughing, joking around, making plans to go and have dinner in extreme situations.

Noelle: And I see one last question here. How long were those face-to-face sessions? Each of those modules were about 90 minutes. Right, Matt? Yeah, 90 minutes.

Matt: Yes.

Noelle: In total, it was closer to 5.5 to 6 hours’ worth of information. So I think that puts us at our last question for the day.

Thank you so much, everybody, for joining us today. Thank you so much, Matt, for going through this with me. You’ve been such an incredible partner. We really enjoyed this engagement over the whole summer and getting to know Children’s Hospital Colorado. We just had such a fun time, and I’m so happy for the impact that we’ve been able to make and look forward to doing more and helping us push out great customer service experience and patient experience to our organizations across the country.

Matt: Likewise. Thank you. Thanks for everything you’ve done.

Noelle: If anybody has any additional questions, go ahead and shoot me an email or give me a call. My contact information is on the screen. And until then we’ll talk to you next time.

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