The word ‘audit’ has never conjured up a positive image. No one wants to be audited — especially nurses, who already face a tremendous burden being the front line of patient care. The last thing they need to worry about is receiving poor ratings from the individuals for whom they’re providing care. What both nurses and patients needed was a way to facilitate productive conversations, and so University of Chicago-Pritzker School of Medicine has done just that. For the past four years, the organization has partnered with Vocera to provide a more accurate care picture for providers and help them access information in more efficient ways. The result? A more open, honest dialogue with patients.
In this interview, Sue Murphy talks about how the organization has transformed rounding and discharge procedures to improve the patient experience, and how they’re leveraging data to continue to tweak those processes. She also discusses the critical role CXOs play in building and maintaining strong relationships across departments, how she utilizes the tactics she learned as a nurse to care for caregivers, and why social media has truly “changed the world for patients.”
- Experience workshops with UChicago’s hArt of Medicine
- Obeserving care providers – “We’re not auditing behavior; we’re shining a light on what they do.”
- Tracking trends & outcomes with Press Ganey’s Tableau
- “It brings me joy to see the growth in people.”
- Role of empathy in care – “It has to be genuine.”
- Patient experience vs patient satisfaction
- “Social media has changed the world for patients”
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What’s really different — and what I love — about this program is we’re not auditing their behavior, but shining a light on what they do well.
I wanted to be a nurse and care for others, and I believe I’m able to care for those who care for patients using some of the tactics I learned as a nurse. It really brings me joy to see the growth in people and see them achieve outcomes.
One person’s empathy is different than another’s. I have never been successful in saying, ‘Everyone, today we’re going to show empathy. Get in there and be empathetic.’ It’s understanding what it looks like when they show empathy, what the patient feels, and the joy it brings.
When you’re implementing telehealth or any new technology, make sure you have patients around the table to help with the decision-making, with the strategy, and where are we going with it. I’ve been much more successful when patients are at the table.
When they have an impact, go back and tell them the impact they’ve had, and they’ll want to do it again. I think sometimes we move on to the next thing, and we never take the time to go back and acknowledge the patients that are doing this.
Gamble: As far as the hArt of Medicine program at UChicago Medicine, how is this structured? Are you sitting down with different groups and looking at what needs to be improved? Does Press Ganey factor into that as well?
Murphy: A little bit. In the beginning when we’ve worked with groups — and I’ll use radiology as an example — we’ve worked with the whole department. And so, prior to even starting with hArt of Medicine, we sat down with leadership members and we looked at what qualitative and quantitative outcomes we want to see with the program, and then we talked about the schedule. We start by bringing people to workshops, and once we’ve decided on the data, we figure out how the logistics are going to work.
We bring people into experiential workshops that talk about things like why you went into healthcare and what makes a difference to you. We have two really important workshops; one is called Engaging your Heart and the other is called Leading Heartfully. Once we’ve finished those workshops and go through some of those elements, we do direct observations of those who are caring for others. If you go through the workshop, we may come and watch you care for your patients.
What’s really different — and what I love — about this program is we’re not auditing their behavior, but shining a light on what they do well. After we observe them, we give them a report, and it’s all positive. It’s not, ‘You should have opened the door’ or ‘you should have sat down.’ It’s all positive; it reiterates the difference they make with patients.
Gamble: And in terms of the information gathered through Press Ganey, can you talk about what’s being done in that regard?
Murphy: With Press Ganey, we use a program called Tableau, which is a way to distribute the data. Every week we refresh it, and it goes to all the leaders. Then we look at comments and scores, and we track the trends and outcomes of what are patients saying. Are there issues with wait times? Are there issues with food, or are there ways to acknowledge that? The hArt of Medicine program teaches the tactics, the coaching, and the mentoring. It’s really about leaders distributing the data of what patients are saying through Press Ganey.
Gamble: Right. And as you touched on earlier, I’m sure it really makes a different when a patient receives a follow-up call, and instead of just ‘How are you feeling?’ there are there are specific questions. That goes a long way toward improving the patient experience.
Gamble: You have a background in nursing; I’m sure that’s been very beneficial in this role. Can you talk about some of the ways in which that nursing experience influences your leadership style?
Murphy: Absolutely. We all have a story. I wanted to be a nurse and care for others, and I believe I’m able to care for those who care for patients using some of the tactics I learned as a nurse. It really brings me joy to see the growth in people and see them achieve outcomes, and to use my experience to help mentor others to care from their heart.
Gamble: It’s interesting. At HIMSS last month, there was a Patient Experience summit where Adrienne Boissy from Cleveland Clinic talked about the role of empathy in patient care. What are your thoughts on the role of empathy, and how leaders help make empathy part of the process?
Murphy: I think it’s really important that it’s part of the process, but I’ve learned that people can’t be just be told to do it. It has to be genuine, and they have to understand what the patient needs. And so I think it’s really important to talk to people and coach them by saying, ‘Put yourself in the patient’s shoes, and turn on your observers and see what patients need.’ One person’s empathy is different than another’s. I have never been successful in saying, ‘Everyone, today we’re going to show empathy. Get in there and be empathetic.’ It’s understanding what it looks like when they do show empathy, what the patient feels when they do this, and the joy it brings when they do that for people. Then it becomes contagious.
I’m a bit of a rebel when it comes to things like empathy workshops. You have to understand the role of the patient and what they’re going through and what the caregiver is going through, and it’s not for me to tell them what to do. They have to find it in their heart.
Gamble: That makes sense. Another area I wanted to get into is patient satisfaction versus patient experience. I’ve seen these two used use interchangeably, and I wanted to get your thoughts on that.
Murphy: To me, patient experience is the score. If you’re having an experience, you’re going to tell me if it was good or bad. It’s a way to score that. Patient engagement, to me, is how am I included in the care plan? Are you engaging me in my care?
If you’re rating the care received like you’d rate going out to dinner or buying a car, that’s experience. Engagement is about how it’s inclusive of the care, how you include that patient or that customer into the care they’re receiving. That’s my feeling.
Gamble: Looking down the road, are there specific initiatives you’re focused on right now, or is it a matter of moving forward with the programs you already have in place?
Murphy: We’re definitely moving forward and continuing to hardwire and really look at the outcomes of the things we’re doing. But looking down the road, there are two things I think need to really be assessed. One is to understand the complexity of patients’ lives and understand what true shared decision-making in their care looks like.
Sometimes we follow regulations with things we have to do in order to get the outcomes we need; for example, the government tells us what we have to do. But in the future, are we really doing these things with the patient’s perception in mind? I think that’s big. I also think we need to really understand what telehealth means and what technology is out there that we can leverage, not just to make it easier for clinicians, but to make it more inclusive for the patient.
Gamble: Right. Looking beyond the reimbursement piece, what are some of the key challenges with telehealth, especially in terms of making sure patients are getting what they need from the experience?
Murphy: There are opportunities and challenges in anything we do. I think the challenges with telehealth and moving technology to the next level is to make sure we’re not just putting it in because it’s a bright, shiny object, but rather, we’re understanding what’s important to them, as well as clinicians. Sometimes we do things because we hear it’s a great thing to do, but do we really understand how it affects everybody? That’s my thought around that.
When you’re implementing telehealth or any new technology, make sure you have patients around the table to help with that decision-making, with the strategy, and where are we going with it. I’ve been much more successful when patients are at the table. We’ve all been patients at some point, but we’re not in the realm when we’re at the table making decisions; bringing on patients to talk about their experience has taught us so much.
Gamble: That’s a great point. Another point from HIMSS that stuck in my head is that focus groups are beneficial, but organizations need to go beyond that point to where patients really are contributing or engaging and having an impact on some of the decisions that are made.
Murphy: Absolutely. And then when they have an impact, go back and tell them the impact they’ve had, and they’ll want to do it again. I think sometimes we move on to the next thing, and we never take the time to go back and acknowledge the patients that are doing this. We need to take them aside and say, ‘Look at what we created with your opinion and your thoughts.’ It’ll make them want to do it again. And so you can’t forget that part.
Gamble: The last thing I wanted to talk about is the evolution we’ve seen in patient engagement. When you look at your career in nursing, as well as your current role, I’m sure it’s been really interesting to see patients take on a bigger role in managing their care. Any thoughts on that evolution, and whether you feel things are going in the right direction?
Murphy: That’s a really good question; I was just talking to someone about this, and this is what I really believe. Things that weren’t there before, like texting and Facebook, have changed the way we communicate with patients, and what we can do. I think social media has changed the world for patients and for healthcare. Things are more easily accessible, whether they’re researching their own health or communicating with care providers.
But the funny part is, whether you’re talking about today or 30 years ago, people just want to be cared for. That hasn’t changed. People just want to feel cared for. And so, yes, technology and innovation have changed a lot of things, but people just want to be cared for. As leaders, we can do that by being genuine; not by teaching people how to do it, but by making sure they find it in their heart to do it the right way.
Gamble: I think that’s a great place to wrap this up. I really enjoyed speaking with you — this has been really interesting.
Murphy: Thank you, Kate. You can tell I love my job. I’m really blessed every day to be able to make a difference for those who care for patients and the patients we serve.
Gamble: That definitely comes through when speaking to you. Thanks again, and I hope we can speak again.
Sue: You’re welcome. Your questions were really thought-out, and I really enjoyed talking with you.
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