How 8 health system leaders ensure patients feel heard

For effective patient communication strategies that lead to improvement, hospitals must ensure communication is a two-way effort in which patients feel their input is heard and carefully considered.

Becker's reached out to healthcare leaders to learn more about their patient communication strategies and how they work to ensure they meet that threshold. Their responses, which highlight everything from letters and surveys to social media and advisory councils, are below.

Note: Responses have been lightly edited for clarity and length.

Carl Armato. President and CEO of Novant Health (Winston-Salem, N.C.). Our strategy for everything we do starts with the patient. How can we eliminate their pain points, what do they need and how can we change to meet those needs? It's a balanced approach to quality, patient engagement, team member engagement and operational excellence.

Our patients are regularly surveyed after a visit, and we have a dedicated patient experience team that reviews those surveys and identifies what is going well and where we have opportunities to improve. We also have a robust advisory council composed of nearly 8,000 patients and community members who regularly provide input and feedback on innovations, services and features we offer. Feedback from this council has informed everything from how we develop digital tools to reach patients to how we talk to patients who may be putting off much needed care. Our patients' willingness to share their ideas, opinions and creativity is helping us to achieve our mission of making communities healthier, one person at a time. 

Michael Dowling. President and CEO of Northwell Health (New Hyde Park, N.Y.).

At Northwell Health, New York's largest health system, we have adopted a robust strategy for listening to the "voice" of our patients and incorporating their insights and feedback to improve care delivery. 

In 2021, Northwell surveyed 3.9 million encounters for patient experience, representing services across the continuum of care. As a result of this proactive approach via text, email and mail modalities, we received over 500,000 individual responses. Patients receive a letter from the facility's executive leader that explains how feedback is important, valued and used to elevate care. Survey result data is processed and analyzed to identify areas of strength and opportunity in which interactive dashboards are populated in real time and available for all team members to access. This past year, Northwell in partnership with Press Ganey launched the consumer analytics platform powered by Binary Fountain. The platform leverages healthcare-specific natural language processing technology to deliver powerful qualitative insights into the patient experience. It identifies specific categorical insights and associated sentiments critical for performance trending, benchmarking and process improvement efforts. 

Northwell also receives countless letters, emails and notes from patients and families. Leaders at hospitals and medical practices follow up with patients, acknowledging their feedback. We use their words as inspiration and reflection in our continuous endeavor to improve. Meeting patients where they are, we recognize the importance of having a high-touch and humanistic digital presence. Our team is also constantly engaging with patients on major social media channels. 

We employ numerous efforts while patients are in our care to elicit feedback for either validation of a positive experience and/or for service recovery opportunities. For example, in our hospitals, we have adopted purposeful proactive rounding, bedside interdisciplinary rounds and nurse leader rounding. These proactive, evidence-based approaches are designed to proactively engage with patients and families to best address their expressed and unexpressed needs.

Northwell Health often convenes focus groups and other deep-dive interviews around specific topics of interest. These interviews range from telephonic to going as far as meeting with patients in their homes talking to them in guided interviews about their healthcare journey and their thoughts about loyalty and wellness. 

The feedback we receive becomes the core driving force behind our ongoing patient experience efforts. 

Collaborative forums where dedicated patients and families sit alongside healthcare leaders, providers, and professionals to help guide patient-centered decision-making. We currently have a patient and family partnership council representing the health system and 19 site/service line based PFPCs where patients have been instrumental in both local and system-based programs and initiatives. 

Scott Ellner, DO. CEO of Billings (Mont.) Clinic. The goal of the patient experience effort at Billings Clinic is to ensure that everyone who walks through our doors feels informed, heard and cared for. Understanding patient perspectives and expectations helps us stay patient centered. This foundational work focuses on gathering feedback from our patients and families and bringing that back to our operational teams to keep improving. Patient experience spans the continuum of care, from the first phone call to the final bill and includes our physical settings, processes and interactions. We must listen every step of the way. 

Billings Clinic has a dedicated patient experience team that focuses on consistent, frequent team member and patient/family rounding.  This gives us more opportunity to gather feedback from our patients and their guests and provides leaders support and coaching to help them find success in rounding while shadowing care team members, following patients through a visit and gathering patient perspectives and feedback in real time. We also employ a patient survey that helps us track defined and standardized organizational goals around physician and nurse communication. These surveys help to provide teams real-time and quarterly patient feedback data on the most important aspects of patient care and coordination, which they can then apply to their day-to-day duties and patient interactions. This data goes out to all departments within our organization, clinical and nonclinical, and quarterly reports are sent transparently to our providers with a focus on communication quality. Patient feedback data is also posted on teams' huddle boards and in break rooms, and leaders have access to an online portal with transparent patient feedback data. 

Patient feedback isn't always about improvement, and we frequently share patient comments with leaders to highlight successes with their teams while reinforcing positive comments with individuals directly. The patient comments are also shared each morning on our organizational safety operations briefing. As an organization, Billings Clinic is always looking for innovative ways to capture and share patient voices with our teams. This includes our patient family advisory council and a robust service recovery system that helps us to identify needs and quickly correct them with the patient while finding a long-term solution if needed.  In another example, when the COVID-19 pandemic began in 2020 we made personal phone calls to all of our patients to listen, inform, provide resources and comfort them.

Rick Evans. Chief Experience Officer for NewYork-Presbyterian (New York City). Healthcare must be fundamentally oriented toward the people we serve and if we are to do that well, we must also solicit feedback.  Even more importantly, we need to act on feedback.  At NewYork-Presbyterian, we have multiple channels for feedback including surveys with ratings and narrative comments, letters, phone calls and patient and family advisory structures. NewYork-Presbyterian is fortunate to have several councils that we rely on for advice, guidance and for co-design of new programs and services. Through our patient and family advisory councils, we've learned that when we ask for feedback, we must follow up after we have acted on that feedback to share how we used it to improve our service. Closing the feedback loop is not only respectful, but also sets the stage for more trusting and substantial dialogue in the future. Our PFACs have also taught us that if we want patients and families to provide meaningful feedback, we must involve them from the beginning rather than just running a finished product by them at the end of the process. I have yet to see a single thing that we have ever asked our PFACs about, or co-designed, that was not made significantly better by the process.

William Jackson Jr., MD. President and CEO of Erlanger Health System (Chattanooga, Tenn.). We invite our patients to engage with us through various means, including direct conversations, DAISY awards, social media and our website, and praise and criticism both have a place in our feedback cycle. Like many organizations, we have a patient experience officer who focuses on education and methodology, as well as taking feedback and turning it into actionable plans. However, we firmly believe that every associate has a critical role in enhancing patient experience at the point of service and making them feel valued and respected. 

If we notice that a certain service or person is consistently praised, then we look to see what the unique root of that praise is, and how we can implement that same experience across the health system where it makes sense. We have implemented DAISY and Spotlight awards throughout the health system to gather, share and praise those caregivers who go the extra mile routinely for our patients. These awards can only be submitted by peers, patients and families, so it gives us a very essential view of the care we provide and sometimes even our shortcomings. Similarly, complaints are logged in a formal tracking system and thoroughly investigated, looking for root causes and potential commonality with other opportunities. An example of applying the patient feedback we receive can be seen in our women's services department at Erlanger East Hospital. This team, which recently received a coveted regional "Best of the Best" rating for the 14th year in a row, reviewed their Press Ganey feedback and made substantive changes to their processes and standards. Additionally, Children's Hospital at Erlanger utilizes a diverse parent advisory group that guides our care of children, giving voice to their unique needs.

Another important and increasingly prominent way we engage with our patients is through social media. We have a dedicated social media team that regularly responds to our patients' questions, comments and concerns. These trained professionals work to engage with patients and the community in meaningful and intentional ways to help alleviate stress, inspire confidence and bolster our reputation as the approachable authority on health and wellness. 

Leslie Jurecko, MD. Chief Safety, Quality and Experience Officer for Cleveland Clinic. We have an established program called Healthcare Partners that ensures patient voices are heard. This allows us to solicit patient input directly into how we design our care. Patients in the program share firsthand experiences and their unique insights to help improve the patient experience and care and help innovate for future care and facilities. In fact, patient feedback played a role in designing care and services at our multidisciplinary cancer center that opened in 2017.  

Not only do we invite and solicit patient feedback, but unsolicited feedback is used to make us better, too, and we let patients know. For instance, all formal patient complaints and compliments receive a personalized written response. And the feedback is used to inform our actions, such as patient complaints were trended to guide our visitation policies changes throughout the pandemic so we could respond and adapt to the things patients told us were most impactful.  

In addition to implementing patient feedback in all forms, we value transparency and were one of the first major health systems to publish patient reviews of physicians on our website.

Kevin Manemann. Chief Executive for Providence Southern California (San Pedro). From primary care to complex procedures, we aggressively encourage patient feedback during visits, post-discharge calls, randomized follow-up Press Ganey surveys and through questions sent to our patient portal.

All caregivers, providers and volunteers who hear negative feedback are encouraged to manage it up to a department leader, or to patient relations or risk management. The same is true for complaints received during post-discharge follow-up calls to all inpatients. An interview takes place, and we document the conversation electronically, so all complaints or grievances are reviewed and resolved.

Good feedback is shared with our caregivers to encourage and reinforce quality care and positive behavior.

Patients are consumers and have choices. We strive to be open and responsive to ensure a great patient experience because it's the right thing to do for those who place their care in our hands. Frankly, if we don't commit to this level of accountability, we risk losing their business and that of anyone they may influence among family and friends and through social media, online reviews and other means.

Roberta Schwartz. Executive Vice President for Houston Methodist. Nurses, physicians, staff — all of us strive to make patients feel safe and confident in their care, whether it's an outpatient surgery, a telemedicine check-in or a major surgery that requires hospitalization for several days. After all, we are here because our patients are here, and we are charged with providing unparalleled safety, quality, service and innovation. Before patients' appointments begin, we ask them to fill out postcards with their expectations; we specifically ask them what would make their visit better and then we follow up to meet those needs. Our nurses and staff check in with patients throughout their stay. We send them surveys when their visits are done. Our patients' feedback — whether it be through written requests, surveys or the spoken word — is essential to making us better every day. 

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