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“Owning the experience:” Using Real-time to rally clinicians at Riley Hospital For Children

Tracy Miller is the Director of Patient & Family Experience at Riley Hospital for Children, part of the Indiana University Health system. She’s uniquely qualified for the position.

Putting aside the expertise she has culled from a distinguished career in consumer marketing, she also brings a crucial perspective to her role — first-hand experience of having a child in Riley’s care.

In 2005, Tracy’s daughter was diagnosed with a brain tumor. Not only did Riley’s excellent caregivers bring her to a full recovery, they also made every effort to form a partnership with Tracy, giving her an uncommon agency over her experience with her daughter.

To this day, Tracy is still overcome with gratitude whenever she talks about it.

“I would do anything to pay back these people who helped us,” she says.

Tracy believes that every patient — and their families — should have experiences like hers. And with the help of NRC Health, she’s working to help Riley’s staff consistently deliver them.

The consumerist / clinical divide

No small part of this work, Tracy says, is helping clinical staff embrace the modern demands of consumerism in healthcare.

Soaring costs of care and hyper-convenient digital services have conditioned consumers to expect unprecedented convenience from their healthcare providers. For Tracy, with her background in consumer products, this is an intuitive evolution in the marketplace. But for clinicians, whose notions of service are rooted in their medical training, some of the tenants of consumerism can be challenging to accept.

“It’s a hard message in healthcare, that patients are consumers, too,” Tracy says. “Clinicians are naturally inclined to see things from a quality of care perspective. While that’s extremely important, how patients feel about their care experiences is important too.”

How to talk with clinicians? With data in hand.

Tracy therefore sees it as her role to help clinical staff cultivate a customer experience mindset.

“They’re the ones doing the real work of care, here,” she’s careful to point out. “I just want to help them do it in a way that meets families where they are.”

Clinicians are committed, life-long learners. They’re eager to acquire new skills, so long as they believe those skills will genuinely serve their patients.

To motivate them to pursue patient-centered care, then, clinicians need to have a coherent vision of where this center lies. Only a thorough and accurate accounting of patients’ needs and desires will be compelling enough to inspire change.

That’s why reliable patient feedback data is so important, and why Riley turned to Real-time, from NRC Health.

Real-time is a patient survey solution that reaches 100% of patients within 48 hours of their episodes of care. It augments traditional paper surveys with more modern modalities, like email, texting, and interactive voice response (IVR) calls.

Further, Real-time helps health systems streamline their feedback operations.  Eschewing length and formalized paper surveys, Real-time uses short, customized surveys that directly target the measures that matter most to leaders.

The tactics

 With the advent of Real-time at Riley, the organization saw an immediate improvement in response rates to feedback surveys. Tracy knew that the larger n-numbers would be invaluable in winning buy-in from clinicians. She set out to strategically integrate Real-time’s data into Riley’s clinical operations.

Hands-on training

 First, Tracy made it her personal mission to help every department leader understand the importance of Real-time’s data.

“I met with each one of them, one-on-one, in front of their computer, for forty-five minutes to an hour,” she says.

That’s no small investment of time. But familiarizing department heads with the operations of the Real-time platform — its data feeds, dashboards, subscription to reports,  and customized alerts — helped them to fashion Real-time into Riley’s mold. This made Real-time’s insights easy to accept.

Processing feedback

The integration could not, however, stop at the department heads. Tracy knew that how patient feedback was relayed to front-line clinicians would make or break Real-time’s success. She took a nuts-and-bolts approach to ensure staff would be receptive.

“How to talk about these findings is really important,” Tracy says. “I coached team leaders to print Real-time reports, in color, and hang them on their huddle boards, and start the discussion from there.”

These succinct presentations captured, at a glance, where units were succeeding and where they were not. Staff no longer had to guess at where there could be room for improvement.

Rewarding excellence

Finally, Tracy believes that it’s impossible to over-state the value of recognizing high-performers.

“That’s the most powerful aspect of all this — calling out, by name, the team members and departments who do their jobs really well,” Tracy says. “When they get recognized for their efforts, you start to see positive change happen across the organization.”

She taught department managers to post displays of excellent nurses and physicians; to jot down personal thank-you notes to anyone who did particularly well; to show a sense of pride in what the department has achieved.

“The effect on staff motivation is magical,” Tracy says. “It gets staff invested in the scores, proud of what they’re doing. It’s where the results really come from.”

The outcomes

And at Riley, those results were remarkable.

Three major departments — the ED, radiology, and the retail pharmacy — all saw remarkable gains in overall experience measures. Organization-wide, Riley’s overall Net Promoter Score improved by 2.11 points in 2018.

The retail pharmacy’s success was particularly striking. Measures of the pharmacy’s Net Promoter Score (NPS) improved by a full 17 points in 2018.

For these achievements, Tracy gives full credit to Riley’s leaders and teams.

“It’s the easiest thing in the world to make excuses when you get negative feedback. These leaders and team members didn’t do that. They owned what they heard from patients, and started dialogues on what they could do better. That sense of ownership, focusing on what they could improve on, is how they succeeded,” Tracy says.

A culture of partnership

More than improvements in experience, Tracy has observed important changes in Riley’s culture.

Now, when leaders meet, Real-time feedback is a fundamental part of the organization’s strategic goal-setting; every team meeting begins with reprising the organization’s promise to patients and families; and across the organization, clinicians, managers, and team members are taking patient feedback to heart, as they seek to improve how they serve.

Most cheering to Tracy is that she recognizes what she sees from Riley’s clinicians today — the way they foster partnerships with their patients is just like what she experienced first-hand with her daughter.

“It doesn’t happen incidentally. There are a lot of challenges our providers face today and they go into pediatric medicine with a heart to serve.  My coaching is to help them be as engaged as possible with what matters most to Riley patients and families,” Tracy says.

In Real-time, Tracy has a way to help illuminate what those challenges are, and point the way toward possible solutions.

“It’s the clinicians who deliver all this care,” Tracy says. “But if they have reliable feedback data on hand, they can be all the more effective when they deliver it.”