JHAH’s Journey to Service Excellence … The Beginning...JHAH’s Journey to Service Excellence … The Beginning Presented by: Zeina Khouri-Stevens RN, PhD Chief Nursing Officer
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JHAH’s Journey to Service Excellence … The Beginning Presented by: Zeina Khouri-Stevens RN, PhD Chief Nursing Officer (CNO) & Tatiana Mezerhane BSc, LSSGB Manager, Service Excellence Unit
JHAH’s Journey to Service Excellence … The Beginning
Presented by:Zeina Khouri-Stevens RN, PhD
Chief Nursing Officer (CNO) &
Tatiana Mezerhane BSc, LSSGBManager, Service Excellence Unit
JHAH
Contents JHAH: A Joint Venture About Us Cultural Dimensions Patient Satisfaction &
Experience Our Journey Q&A Close
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Presentation Notes
Good afternoon – we are delighted to be here to describe our journey (JHAH’s journey to service excellence) We are in the very beginning of our journey
Johns Hopkins Aramco Healthcare
Strategic alignment of two renowned institutions• Saudi Aramco the national oil company of the
Kingdom of Saudi Arabia provides healthcare to its employees and dependents (360,000) throughout the Kingdom
• Johns Hopkins Medicine (JHM) a premier academic health system bringing healthcare administration, clinical services, education and research; a vast experience in global healthcare delivery
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A little bit about us
Where are we located?• The main hospital is located
in the Eastern Province city of Dhahran, Saudi Arabia with satellite health centers in four additional Eastern Province locations:
• Abqaiq
• al-Hasa
• Ras Tanura
• ‘Udhailiyah
• Additionally, JHAH operates remote area clinics, providing around-the-clock emergency medical support to Saudi Aramco operations.
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JHAH is located in the Eastern Province of Saudi Arabia, providing medical services to Saudi Aramco Employees and their dependents. The main JHAH hospital, located in Dhahran, is a state-of-the-art, 330-bed referral institution that has five intensive care units (cardiac, medical, surgical, pediatric and neonatal) in addition to numerous step-down units. The staff and patients are culturally diverse, we cover 55 different nationalities, 90% of our patients are Saudi citizens and 10% expats.
• Clinical/Quality of care KPIs• Staff Engagement • Patient Satisfaction (2 KPIs – Inpatient and Outpatient)
• “Overall experience at the hospital” with top box defined as 9 and 10 point scale.
• “Overall experience during your visit” with top box defined as 9 and 10 point scale.
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As part of the agreement and one of the strategic goals of this joint venture was to establish a control tool for the new organ ization by developing a KPI dashboard. This dashboard includes 27 critical measures that the organization is constantly focusing on and monitoring, the dashboard includes 2 KPIs for the patient experience (at the hospital and in clinics). This is to emphasize our continuous commitment to patients on quality care, safety, access to care and patient experience.
Is patient satisfaction important to us?
Yes
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Patient Satisfaction is one of our Strategic Priorities and establishing JHAH has launched a new focus on the experience of our care.
Is patient satisfaction important to us?
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Our strategic initiatives are summarized by: We have a ‘captive’ population, our patients are the approximately 360,000 employees and families members – does JHAH care about patient experience?
Cultural Dimensions • Value of Privacy:
• Includes gender separation • Definition of Family:
• Extended family• Family Support
• Emotional Support: • Sensitivity to personal needs• Service expectations
• Diversity of patient population and of staff • Pain Management: Practices & Myths
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Every environment is unique and at the risk of sounding like a cliché – I will discuss the following domain to explain the background and the perspective of out patients These dimensions are on the survey (note to Zeina, the woman in the photo has agreed to its use in JHAH material).
Target Rich Environment In 2016 and 2017 JHAH is launching major organization-wide initiatives:• New IT Infrastructure (Enterprise
Resource Planning) + Epic preparation
• More than a dozen clinical enhancement programs
• New clinical services and modes of practice
• Facilities renovations• Significant change in
employment status
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We cannot look at service excellence in isolation – Within this very diverse and culture rich environment, we continue to focus on the primary mission of improving healthcare for our patients and in the Kingdom and remain target driven:
Patient Satisfaction & Experience
2005
-201
0 • HCAPS based surveys (In-house for clinics)
• Customer Service training 20
11-2
012 • Patient
Satisfaction surveys (In/Out patient)
• Customer Service training
Before December 2015
*Primarily paper-based
Patient Voice ProgramOn the JourneyBefore December 2015
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Several efforts have always been carried out throughout the organization to measure the patient satisfaction, different methodologies were used, surveys were conducted manually via interviews, “paper based” therefore, data was somehow inconsistent and efforts were not aligned in addressing the focus areas to improve the patients’ experience.
Patient Voice ProgramOn the JourneyBefore December 2015
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Our journey started in January 2016 with the establishment of the Service Excellence Unit that has a primary objective to manage the patient satisfaction surveys or we call it: the patient voice program, to align efforts and anchor the function within the organization and to improve the patient experience.
On the Journey..The Beginning
Status Assessment of the JHAH Patient Experience and alignment with JHM
Development of the Service Excellence Unit
Launch of the JHAH patient satisfaction surveys
Service Excellence Committee and Staff awareness
Patient Voice ProgramOn the JourneyBefore December 2015
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1. At the beginning of our journey, a status assessment of JHAH patient experience was conducted, mapping the patients’ journey and alignment with the office of the patient experience at JHM with Dr. Lisa Allen, making sure the tools that we have developed are culturally adequate with the appropriate benchmarks. 2. The unit was developed using best practices standards: -A charter was created to scope the function, including the vision and mission, purpose, challenges, expected benefits, budget, manpower etc. -A communication plan was also developed to identify stakeholders, communication management constraints and risks, methods and technologies and of course a matrix and a process map. -High level processes critical for the unit’s operation were also established to stabilize the function within the organization. 3. In partnership with Healthlinks/Press Ganey, patient satisfaction surveys were launched in phases to cover all services. We started with the Inpatient and outpatients, and added other services such as the ER, AS, HHC, X-ray department and Dental. This enabled us to acquire an internal benchmark and have full visibility on a key indicator for patient satisfaction for all services. With a main focus on acquiring a high response level, we have selected as medium a combination of Phone SMS and phone calls. The key factor for selecting SMS is the exponential growth of smartphones users in Saudi. According to recent research by “Nielson” (a leading global provider of information and insights into what consumers watch and buy) 70% of our population above 16 years use smartphones, so what better way to reach out to our patients. 4. A multi disciplinary service excellence committee was also formed to oversee and review all critical initiatives for correction to ensure project and system alignment.
On the Journey..Transition
Data stabilization, results analysis and identification of areas of focus
Results sharing, access on data portal and training of key personnel
Development of action plans and tracking
Immediate interventions for identified areas of improvement
Patient Voice ProgramOn the JourneyBefore December 2015
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Following the data stabilization and analysis, areas of focus were identified. Program awareness and results sharing was next which included giving access on data portal and training of key personnel which lead to the development of action plans. Immediate interventions were then identified and addressed.
Patient Voice Program
Inpatient Overall Experience of Care Rated as Top Box (9/10 and 10/10)
Interventions:
Addition of private rooms Education of staff regarding Patient Voice
Program Menu enhancement for pediatric patients New food carts to maintain temperature of
food and reduce noise
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Q1 2016 Q2 2016 Q3 2016
Perc
ent
% Top Box Target
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Several key improvement opportunities were identified through the surveys, focus groups and comments received from patients. One of the chronic common concerns raised and rated low by our patients is the accommodations/room comfort. Lack of privacy and noise level were a major source of discomfort and frustration for patients; several projects were executed in the last 2 quarters to address this concern, double rooms are currently being converted to single rooms with no impact on the overall room capacity of the hospital. Temperature and quality of food was another area for improvement, several menu enhancement have been introduced, including new concepts for pediatric patients, new food carts were introduced to maintain food temperature.
Patient Voice ProgramClinic Overall Experience of Care Rated as Top Box (9/10 and 10/10)
Interventions:• Primary Care pharmacy renovation to expand service and
reduce waiting time Caring Experience, Welcome Guides and Coaching
programs to standardize and improve communication of non-clinical front-liners
Additional patient parking
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Q1 2016 Q2 2016 Q3 2016
Perc
ent
% Top Box Target
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Key opportunities for improvement identified at the clinics are: Wait time for prescription, this was addressed by the renovation and launch of our new state of the art pharmacy, where services were expanded and waiting time has been reduced drastically. Courtesy of the registration staff was also one of our major areas of focus, the caring experience program was developed and introduced as a language guide to standardize communication and consistency of patient and family focus. This was followed by the introduction of the welcome guide program to help patient reaching their required destination at the hospital and a “real-time” coaching program to sustain the caring experience program. And of course additional parking..
On the Journey..Moving Forward
Detail oriented analysis
Focused action planning and build on previous stage
Execution of short/medium term interventions
Visibility of correction through publications and motivation programs
Patient Voice ProgramOn the JourneyBefore December 2015
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As we move forward, we are looking at detail oriented analysis, creating a systematic approach to enhance patient and family experience and making it part of the DNA of the organization and making sure corrections at all levels are visible by our patients and staff.
