getting to always is what matters to patients...increasingly being defined by non-clinical elements,...

Getting to Always is What Matters to Patients: The Care Experience Journey in the Consumerism Era

Deborah Romer, Vice President, Kaiser Permanente National Service QualityMichelle Munn, Sr. Director, Kaiser Permanente National Service Quality

Copyright © 2015 Kaiser Permanente

Objectives

Who is Kaiser Permanente?

Understand Kaiser Permanente’s approach to the new era of consumerism

Learn key strategies for improving and sustaining “Always” behaviors

Experience Kaiser Permanente’s innovative Coaching for Excellence model to improve reliability and performance

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Kaiser Permanente Markets and Membership(as of 06/30/2014)

Georgia259,450

members

Mid-Atlantic States

516,099members

Colorado618,802

members

Hawaii229,746

members

California 7,341,780 members

Northwest618,802

members

Change in Top Box Since 2009 -Kaiser vs National Average

Source: CMS Hospital Compare

Change in Top Box Since Q1 2009 –Kaiser vs. National Average

Health Care Marketplace

Consumerism & Retail Markets

Opening of Exchanges

Increased Cost-Sharing

Social Media & KP Reputation

Increased Competition/ACOs

STRONG MARKET FORCES

MEMBER

GROWTH

MEMBER

LOYALTY/ADVOCACY

MEMBER

EXPERIENCE

“More than a third [of U.S. consumers] said they would switch providers or health insurers if they were offered their ideal experience. The ideal experience is

increasingly being defined by non-clinical elements, such as convenience, amenities, and customer service. ”

— PricewaterhouseCoopers Health Research Institute Report (2012)

ARE CREATING MORE URGENCY FOR:

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“Designed” to make lives better

Delivering this…

PersonalizedEmpowering

Seamless

Requires this…

Core Values

Engagement• Unit Based Teams

• Evidence-based practices (e.g. rounding)

• Accountability systems• Professional standards• Communication models

Systems built through our members’ lens:

• Access• Phone Service• Digital/Mobile

• Have clarity around our shared purpose

• Are engaged and inspired • Are supported with

training, systems, processes and

technology • Are empowered to do

the right thing for members and each other

And people who…

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Driving Consistency Through a Culture of Excellence

Aligned Leadership

(launching)Seq

uenc

eTa

ctic

s

Aligned Culture

(engaging)

Aligned Behaviors

(standardizing)

Aligned Processes

(sustaining)

Leadership Alignment

Goal Cascading

Accountability

Excellence Teams

Leadership Dev’t

Rounding for Outcomes

Recognition

Experience Standards

Coaching for Excellence

Hiring & On boarding

Communication Skills

Patient Rounding

Pre & Post Calls

Reception Area

Rounding

Validation

Ongoing Reinforcement

Performance Coaching

Technology Enablers

Experience Design

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(Patient & Family Centered Care and Cultural Relevance)

HCAHPS Performance All Domains Compared to National Benchmarks Q4 ‘06

| © 2012 Kaiser Permanente


HCAHPS Improvement Over Time

Key Strategies for improving and sustaining “Always”

People Engagement Data and Analytics Communication and Coaching for Excellence Experience Standards

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Key Strategy:People Engagement

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All employees in the Northwest Region, as well as four medical centers in Southern California received one question about

direct report rounding:

Respondents who perceive their immediate supervisors use “direct report rounding” have greater

favorability across the four indices

48%

52%

59%

80%

86%84% 86%

95%

30%

40%

50%

60%

70%

80%

90%

100%

Work Unit Index Workplace SafetyIndex

WorkforceEffectiveness

Engagement

* 2013 People Pulse – This analysis includes respondents who were asked the “rounding” item

(SCAL Medical Centers [Downey, Orange County, San Diego, West Los Angeles])

Round: No [N=2,422]*

Round: Yes [N=11,160]*

Does your immediate supervisor do “direct report

rounding” with you at least quarterly?

Key Strategy:Data and Analytics

Data Reporting by Unit/Department:

HCAHPS unit level data

Internal evidence to support and monitor key practices:

Nurse Knowledge Exchange (bedside shift report)

Hourly Rounding

Nurse Leader/Charge Nurse Rounding on Patients

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Nurse Knowledge Exchange = Patient and Family Engagement

Key Indicators

Shift change at bedside with introduction of oncoming nurse

Regular updating of the Care Board Reviewed daily plan of care with

patient input Validating patient’s understanding of

their plan of care

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Nurse Knowledge Exchange Impact

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Hourly Rounding Drives Perception of Care and Nurse Communication

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Nurse Manager Rounding = Consistency

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Key Indicator:

A nurse manager or leader visited me daily about my care.

Key Strategy:Skills Labs

Demonstration of “right”

Real environment

Real scenarios

Validate in real time

Video tape

“Yeah, we’re doing that…”

“Now, what does right really look like again?”

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Key Strategy:Communication and Coaching

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Coaching for Excellence: Investment Coaching Model

How can I help you be successful?

“Hi…could I have a minute of your time?”

“Remember the expectation / team agreement

/ standard that…”

“I heard / read / noticed that you …”

“The impact for…when you…is…”

“I wanted to thank you so much for your

attention to … “ OR “How can I help you be

successful?”

“Thank you for taking the time to talk with me

about this.”

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Key Strategy:Experience Standards

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One KP Experience StandardsRevised to reflect the voice of the member, patient, and customer.

Tips / Lessons Learned

Maximizing Use of Data• Transparent and comparative KP data• Actionable data at unit level• Actively used for coaching opportunities

Validating Through Skills Labs• Closes the knowing/doing gap• Reduces variation

Standardizing a Model for Leader Coaching• Clarify and lead with expectations• Enhances coaching in the moment and the “why”• Recognition too!

Branded Experience• Standards

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Thank you

Kaiser Foundation Health PlanNational Service Quality1 Kaiser Plaza 18BOakland, CA 94612

Deborah Romer

Vice President, National Service Quality

[email protected]

Michelle D. Munn

Senior Director, National Service Quality

[email protected]

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mailto:[email protected]

mailto:[email protected]

getting to always is what matters to patients...increasingly being defined by non-clinical elements,...

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