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Building Patient Experience Programs in New York, NY: A Case Study

Northwell Health is a large, integrated organization that performed a baseline patient experience assessment in 2014. They concluded that although pockets of excellence existed, inconsistencies in processes, resources and accountability were impacting the patient experience across the organization. To address these fundamental challenges, the Northwell Health Office of Patient and Customer Experience (OPCE) was created. Led by Chief Experience Officer Sven Gierlinger, the office is tasked with standardizing strategy, spreading best practices and advocating for customer-centric standards. Specific areas addressed by the OPCE based on the 2014 assessment included physician and nurse communication, patient and family partnership councils, real-time feedback, first impressions and patient experience data transparency.

To improve the patient experience, Northwell Health also made an effort to improve the employee experience, in parallel with the OPCE program. Northwell Health systematically implemented a cultural transformation that follows the Connectedness, Awareness, Respect and Empathy (C.A.R.E.) framework, with the goal of becoming the health care provider of choice in their geographical area. The culture of C.A.R.E. mission, vision and expectations were communicated to all employees through a cascade of experiential courses, sustained by processes such as weekly huddle messaging and recognition and solidified by policy, competency and performance evaluation measures.

One OPCE process that best exemplifies the goal of connecting with patients is the Immediate Service Recovery (ISR) tool, which allows physicians to obtain and act on real-time patient feedback. This effort is led by Peter Costantino, MD, Chairman of the Department of Otolaryngology at Northwell Health. His team became very engaged in the patient and customer experience program and developed this innovative approach to service recovery. Dr. Costantino and his team recognized that the patient experience survey being used by their office only provided a retrospective understanding of the patient experience, and didn't allow the team to address patient concerns in real time. To overcome this gap, they developed the ISR tool, a short, six-question survey that patients could quickly complete following their visit with the physician. The ISR tool captures patient feedback on the physician interaction and office processes such as ease of scheduling and wait times. Below is the process that was followed with the initial launch of the ISR tool:

  • Medical assistants (MAs) hand-delivered the survey to patients while they were still in the exam room. Once complete, the MA would visually scan the survey responses for any crucial or negative feedback.

  • If there were responses that required attention, the physician was notified and returned to the exam room to address patient concerns in real time.

  • Patients were reminded that they may receive a larger patient experience survey at a later date.

  • Office management collected, reviewed and analyzed ISR responses to identify trends within the practice.

  • Results, trends and concerns were communicated to the physician and their support team.

  • A plan of action was developed and implemented to improve areas of concern.

Over time, Dr. Costantino and his team were able to turn the manual ISR tool workflow into a digital process by using “digital pen” technology. The digital pen is a ballpoint pen with a small camera at the tip. Through a partnership with Waiting Room Solutions (WRS), Northwell Health initiated a focused pilot study at Dr. Costantino's practice using the digital pen with the ISR tool. WRS provides a web-based portal that patients are registered in prior to their visit. This allows the team to print a survey that is compatible with the digital pen. When patients use the pen to complete the ISR survey, a digital image of the completed survey, detail from the individual fields on the survey, and all pen strokes are immediately transferred to the web-based portal. “The beauty of the digital ISR is that our patients can feel comfortable providing us with feedback using a standard pen and paper survey tool, while our administrative team can analyze the responses digitally, eliminating the time-consuming tallying that a manual approach requires,” said David Zeman, MBA, Administrative Director, Otolaryngology-Head & Neck Surgery.

Patients have not reported any reservations about completing the survey in either format. They welcome the opportunity to provide feedback and continue to share their comments regardless of anonymity because they appreciate Northwell Health's efforts to improve their experience.

The new digital process eliminated the cumbersome manual analyses of paper surveys to identify trends and areas of opportunity. Additionally, it has provided a more secure means for collecting information, reducing the risk of patient health information (PHI) disclosure. The greatest feature of the program lies in its simplicity. While iPad or tablet-based survey tools may be useful, the digital pen offers patients a familiar method to provide feedback without introducing confusion that often comes with learning how to use new technologies. The digital pen IRS tool also helps physicians and care teams mitigate and resolve patient concerns immediately. “This is a game changer. The ability to combine real-time feedback with service recovery and digitize data capture for review and analysis with one seamless tool is extremely useful and efficient,” said Dr. Peter Costantino, Chairman and SVP, Otolaryngology-Head & Neck Surgery at Northwell Health.

Incorporating digital pen technology into patient care delivery is still early and its impact is currently being reviewed and monitored. However, the “likelihood to recommend practice” measure for the Otolaryngology service line has seen a 28 percent improvement since they started using the digital pen with the ISR tool. This represents a mean score improvement of 2.9 points. Rank performance was benchmarked against Press Ganey's national database within the Otolaryngology specialty peer group. This significant increase, along with favorable patient feedback, suggests that the digital pen innovation has had a positive impact on the patient experience. Northwell Health is dedicated to providing its community with quality, patient-centered care and continues to seek ways to leverage technology and innovation to support this overarching mission.

Watch a 2-minute video on how Northwell uses a digital pen to improve efficiency and the patient experience.

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