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“No rounding logs”: How Vidant Health is bringing humanity back to healthcare

Julie Kennedy Oehlert, DNP, is the Chief Experience Officer at Vidant Health in eastern North Carolina. When it comes to innovation in healthcare, she does not mince words.

“Healthcare can’t get out of its own way,” she says. “There are too many incentives to keep everything exactly the same.”

For her, the rise of retail clinics and the surge in high-tech healthcare disruptors are signals from the marketplace—signals that health-system leaders should not ignore.

“It’s a call for change,” Julie says. “These innovations are patients saying that healthcare organizations aren’t giving them what they want.”

According to Vidant—and to NRC Health’s own research—what patients want is to see more compassion in their care. They want quality with an empathetic touch. Put another way, they want to see humanity embodied in their care experiences.

Here are the human innovations that Julie believes organizations need to prioritize.

Not all care can be quantified

“I understand the intent of Consumer Assessment of Healthcare Providers and Systems (CAHPS) data, and I think it’s been a force for good,” she says, “but more and more we’re finding that it doesn’t tell us what we really need to know.”

According to NRC Health’s Market Insights survey, while CAHPS is an important data source, its surveys can alienate some patients. Fifty-five percent of patients, for instance, would prefer to give hospital feedback via email. This is more than five times the number of patients who prefer postal mail (10 percent) and phone calls (11 percent).

Disregarding patient preferences for feedback modality lowers response rates and can make feedback less useful. “It turns an act of ‘we want to hear from you’ into a long list of questions that a patient ticks off,” Julie explains. “The quality of the relationship with the patient is not evident in the questions or answers.”

By enforcing a quantitative state of mind, overly formalized feedback operations stifle the empathic connections that patients want from their caregivers. Vidant is working to simplify feedback so that it is clear, immediate, and centered around three simple questions:

  • “Did you feel we care about you?”
  • “Do you feel that Vidant culture is relationship-focused?”
  • “Do you feel your care team treated you as a valued member of the team?”

Transparency is a two-way street

Julie also wants to see organizations do a better job of bringing patients into the loop regarding their own care.

“When you think about how information moves in healthcare, and how little of it makes its way to the patient, that’s a sign that organizations aren’t valuing these patient touchpoints enough,” she says.

It’s important to remember that, for the average healthcare consumer, a hospital stay can be a bewildering experience. And the bewilderment is particularly acute in one arena: billing.

“It takes me 60 seconds to buy something on Amazon,” Julie says. “Why does it take me five days to figure out how to pay a healthcare bill? That absolutely needs to change.”

Results from NRC Health’s Market Insights survey confirm Julie’s judgment: confusing bills are the second-most-commonly cited patient complaint. (Wait times, of course, are number one.) Just 26 percent of patients report that they have an easy time understanding their bill.

Accordingly, clarifying costs isn’t just the latest CMS mandate. It’s also a gesture of respect for patients’ concerns.

“In healthcare, there is this notion that it is such a complicated service, and our patients could not begin to understand,” Julie says. “But patients are smart. It is insulting not to provide the transparency in pricing they are asking for, if and when we are able to do so.”

Staff needs humanity, too

Julie believes that her final recommendation is her simplest and most important. If organizations are to have any hope of improving the patient experience, she says, they must take care of their healthcare team members.

“For me as Chief Experience Officer, everything I do is designed with team-member well-being in mind,” she says.

Caring for team members not only improves retention and helps combat burnout, it also leaves them with more emotional energy to spare for patients.

“We predicate everything on this idea at Vidant Health,” she says. “A focus on team members translates to a better patient experience.”

As an example, she shares an innovation on what Vidant feels is an outdated practice: rounding. Leadership at the organization eliminated all formal documentation of nurse-leader rounding. The organization now uses no rounding logs, and no formal scripting. They train leaders using improvisation and a focus on relationship-building, and then simply ask the patients if they met a nurse leader during their stay.

“In the end, the vast majority of our units showed patient-reported nurse-leader rounding rates of greater than 90 percent,” Julie said. “Several of them showed 100 percent! Our grievances also dropped as consistent levels of nurse-leader rounding helped address patient issues in real time.”

More opportunities for humanity

Humanity comes first at Vidant, and the organization is proud of improvements in both team experiences and patient experiences.

This is just a small sampling of the ideas Julie shared with NRC Health in our 2019 Healthcare Consumer Trends Report. In that report, Julie—along with other experience leaders—looked back on some of 2018’s most important industry concerns, and suggested innovative ways for health systems to meet emergent challenges, including:

– The single most important factor driving healthcare consumer decisions

– The operational measure that best predicts care quality and patient satisfaction

– The three largest sources of patient dissatisfaction

– And more!

Healthcare consumers had a lot to say in 2018. Take the time to listen, and use their voices to prepare for the year ahead. Click here for the full report.