Rounds and Rounds We Go
Release Date:
It’s common today that, as consumers, we receive a survey after all kinds of experiences – shopping, travel, home repair – you name it. You fill out a survey with the hope that it might change the next outcome to be better. But what about the here and now? As experience management improves consumers are demanding action during the experience. Now think of yourself not only as a consumer, but as a patient and the timeliness of feedback and action becomes that much more important. Host Pat Gibbons welcomes Laura Anning, Chief of Patient Experience for Washington Hospital Healthcare System, and Liz Wallshield, Senior Technology Consultant at Walker, for a discussion on using patient rounding as a way to quickly action on feedback.
Laura Anning
Washington Hospital Healthcare System
Connect with Laura
Liz Wallshield
Walker
Connect with Liz
In this episode:
- Chapter 1: Introduction to Improved Feedback Mechanisms (00:01 – 00:56)
- Chapter 2: Enhancing Patient Experience through Immediate Feedback (00:56 – 02:54)
- Chapter 3: The Process and Impact of Rounding (02:54 – 07:57)
- Chapter 4: Technological Integration in Feedback Collection (07:57 – 11:43)
- Chapter 5: Implementation Challenges and Benefits (11:43 – 16:25)
- Chapter 6: Expanding and Enhancing Feedback Mechanisms (16:25 – 22:56)
- Chapter 7: Take-home Value (22:56 – 25:30)
Highlights
What is patient rounding?
Laura: “…when I talk about rounding, I like to use the term visiting because basically a round is when you go into a room and it could be a physician or another caregiver or a nurse leader, and you basically sit down and visit with the patient and, and ask for feedback and listen to what they have to say… It’s not meant to necessarily be a survey necessarily, but more of a conversation to learn more about their experience. What I love to ask the questions, you know, what’s going well, what can we do better? And then ask some other more pointed questions. But essentially it’s a visit.”
Streamlining alerts for better employee experience
Liz: “So on my techie side, I’m very excited because at Washington uses a platform that looks like we’ll need to do a little bit of enablement on their platform side, but they already have an alerting platform that Qualtrics can integrate with using a web service call, which if your eye is glazed, as soon as I say a web service call, that’s okay. Basically, what we can do is just have Qualtrics call this other software and say, hey, put an alert in front of this specific person so that they don’t have to go seek it out in their emails, because the folks that we’re alerting are not sitting behind a computer waiting to receive an email all day.”
Transcript
Pat:00:00:01
As consumers, we get countless requests for feedback after our experience is complete. Can we do better than that?
Laura:00:00:09
We’ll have the ability for leaders to see the dashboard, and they can go in at any point in real time, see what our patients are telling us. And that’s one of the great things that I love about this, is that it’s all right there. We don’t have to wait a month or 2 or 3 months to get survey results back, but we get it right then and there.
Pat:00:00:30
Let’s look at gathering feedback for immediate action on this episode of The CX Leader Podcast.
Announcer:00:00:44
The CX Leader Podcast is produced by Walker, an experience management firm that helps our clients accelerate their XM success. You can find out more at walkerinfo.com.
Pat:00:00:56
Hello everyone. I’m Pat Gibbons, host of this episode of The CX Leader Podcast. It’s a great time to be a CX leader, and we explore the topics and themes to help leaders like you develop great programs and deliver amazing experiences for your customers. You know, it’s common today that as consumers, we receive a survey after all kinds of experiences. Shopping, travel, home repair, you name it. You fill out a survey with the hope that it might change the next outcome to be better, whether that’s for you or someone else. But what about the here and now? As CX improves, consumers are demanding action during the experience. Now, with all of that, think of yourself not only as a consumer but as a patient, and the timeliness of feedback and action becomes much more important. Well, we’re going to dig into that today because my guests today have terrific background in patient experience, and their advice can be helpful to CX leaders and other industries, too. Laura Anning is the chief of patient experience for Washington Hospital Health Care System in Fremont, California, and she’s joined by my colleague Liz Wallshield, senior technology consultant here at Walker. Laura. Liz, welcome to The CX Leader Podcast.
Laura:00:02:18
Thank you for having me.
Liz:00:02:20
Thanks for having us.
Pat:00:02:21
You bet. Well, I’m glad to. You know, I’ve said before, you know, if I look back over the years and our company’s experience and customer experience, you know, I would have never thought we’d get so ingrained in patient experience. But I’m so glad we did. It’s so purposeful and, you know, so meaningful to a lot of different people. So yeah, let’s let’s get into it. Laura, let’s start with you. Maybe you can tell us just a little bit about your background and the hospital system and how you got involved in patient experience.
Laura:00:02:54
Yeah. So I’ve been with Washington Hospital and health care system for one year and three months. Um, before this I lived in Phoenix, Arizona, and was working in patient experience for, um, about ten years or so. So I’ve been in the, in the industry for a while, but my whole entire career has been in, in healthcare. And the minute I started working in the hospital, I knew that that’s where that’s my happy place, um, being able to help people. And so, um, my degree is in exercise physiology and had been in many different careers since. But this is really my my true passion.
Pat:00:03:29
Yeah. Wonderful. Wonderful. And, Liz, I know you work with clients in a number of industries, but you’ve kind of developed quite a specialization within healthcare, correct?
Liz:00:03:39
Yeah. So like a lot of people, uh, a lot of my daily work was interrupted during the COVID pandemic. Um, and at that time, we kind of retooled the main technology platform we use with most of our clients, which is Qualtrics to provide epidemiology and scheduling and all kinds of resources for health departments, uh, mostly at the state and local level. And, you know, obviously everyone at some point is a patient. So I had an understanding that your experiences in healthcare are really important, but I started to get into more of the technology of how we deliver some of those solutions to patients. And so, um, I kind of wiggled my way into actual patient experience more directly with patients rather than that one step removed with the help, um, health departments. Uh, so, yeah, that’s kind of my my winding path to get over here.
Pat:00:04:36
Yeah. Yeah. Again, it does prompt kind of a passion, you know, for what we do. And it’s been wonderful to see. So today we’re we’re going to talk a little bit about a topic that really could apply to a lot of industries. But it’s really important in health care is, you know, not just kind of waiting till after the experience and looking back to evaluate it, but doing things kind of in the moment. And, and one of those areas in the area we’ll kind of focus on today is something called rounding. And maybe we should start. Laura, maybe you can tell us a little bit about what is rounding and why is that such an important part of the patient experience?
Laura:00:05:13
Yeah. And when I talk about rounding, I like to use the term visiting because basically around is when you go into a room and it could be a physician or another caregiver or a nurse leader, and you basically sit down and visit with the patient and, and ask for feedback and listen to what they have to say. So, um, essentially that’s that’s what it is. It’s not meant to necessarily be a survey necessarily, but more of a conversation to learn more about their experience. What I love to ask the questions, you know, what’s going well, what can we do better? And then ask some other more pointed questions. But essentially it’s a it’s a visit. And that opportunity to make a connection with the person in the bed. And then also, um, who else is in the room and their family members, which is also another really important person to be reaching out to and connecting with. Um, when a patient’s in the hospital or wherever they may be, because you can do rounding, inpatient rounding can be done. We’re doing it in our outpatient ambulatory surgery areas. Rounding can be done in clinics. It can be done in really any area in health care.
Pat:00:06:24
Yeah. So in in when we talk about experiences and touch points, it’s obviously one of the key touch points. And and it kind of led to you having kind of a strategy or a solution around it. Correct. How did that kind of evolve?
Laura:00:06:41
Yeah. So, um, my former organization, we also did, um, rounding. And at that time it was a manual process. So whenever we were rounding, we were collecting information and data, but it was all done paper. So everything would kind of come to me. I would consolidate it. And and we learned so much. But it was it was a tedious process. So we know that rounding is an evidence based best practice for, um, for safety and for patient experience. So we want to do it, but we also want to be really efficient and gather as much information as we can and then, um, take action. So really our strategy was how do we we make this a priority in our organization? And then how do we make sure that we have high quality rounding? We’re getting valuable information, and that it also isn’t something that’s taking hours and hours and hours to do, but is efficient as an efficient process.
Pat:00:07:40
Yeah. So then it kind of evolved to like many things, is having a technology solution that kind of becomes a key part of that. Liz, maybe you can kind of comment on how that developed and what, uh, what your team put together, you know, to make it all work.
Liz:00:07:57
Yeah. So my challenge was kind of to take this best practice that was already happening in, in the hospital and create a system where we could gather that feedback in a way that is a little bit more uniform, which makes it a lot easier for us to spot patterns and even easier for us to do something simple like know who we’ve spoken to today and who we might go seek to have a conversation with because they haven’t been spoken to yet. So we wanted to make sure that, you know, usually I’m building a survey, this is almost more of just like a summary form of a conversation rather than a really formal, you know, how likely are you to recommend us on a scale of 0 to 10, um…
Pat:00:08:45
Right.
Liz:00:08:46
…conversation.
Pat:00:08:46
Yeah.
Liz:00:08:47
Um, and, and to make that as, as to minimize the amount of disruption that, that would cause nursing leaders as they’re performing these visits and also give them some tools to just do that a little bit more efficiently. Um, and also to be able to visualize those results in real time.
Pat:00:09:08
So by collecting them in some sort of let’s say scalable way, it allows you to have a system that would address immediate concerns. But also you could look at the big picture and look for trends and such that were bigger solutions that needed to be developed. And am I getting that right?
Liz:00:09:31
Yeah. So we definitely have a system for alerting, which I’m sure we’ll get into a little bit more. And it’s current state, it’s available inside of our technology platform and via email, where we let folks know of a couple of possible scenarios. One is just that there is something in the room that needs to be addressed, like linens need to be changed, trash needs to be taken out. Something that is very comfort but also safety focused. And then the other kind of alert, which is also more urgent, um, would be a, um, an alert to the care team when a patient or their family member indicates that they’re not sure what happens after discharge, they’re not feeling ready for discharge. Those are the kinds of things. And Laura, you can correct me if I’m wrong would have been kind of a you run around and you find the person to fix this problem type of task that now we can automate a little bit. But a lot of the feedback that you get from a patient that isn’t super urgent, when you collect enough of it to start to identify themes, you can still take action on that. So the folks who don’t have anything super urgent, someone needs to jump on right now, but they tell you something about the process of getting care, or what it was like to be an inpatient in your hospital that they didn’t like, or they would like to see done better, or that they felt what really, really well, what you got a bunch of that data in the aggregate, you can start to, um, find additional insights that it would be really hard to put together when you’ve got, you know, 30 different people having conversations with 400 patients a day.
Pat:00:11:08
Right. So and Laura so I’m kind of thinking of the difference between kind of the old way that you talked about, which was, you know uh kind of offline and individual, which on one hand is very personal. Um, that’s the whole nature of it. But in this you, you can do it without losing the personalization. In fact, you’re being able to I assume some patients would cite a preference or something that they’ve noticed that then goes into a system that everyone can be aware of.
Laura:00:11:41
Yeah.
Pat:00:11:41
Does that make sense?
Laura:00:11:43
Absolutely. And what’s great is that we’ll have the ability for leaders to go be able to see the dashboard. And they can go in at any point in real time, see what our patients are telling us. And that’s one of the great things that I love about this is that it’s all right there. We don’t have to wait a month or 2 or 3 months to get survey results back, but we get it right then and there. And in fact, today when I was, um, rounding, we had an opportunity for a patient who didn’t have the best experience in the emergency room. And so I was able to alert one of the leaders in the and from the emergency room, and they came right up and talked to the patient and did service recovery within 15 minutes. And that leaves a really strong, lasting impression that we care about you. And we heard you and we apologize. And so that’s what I love, is that you can take action, um, and do service recovery on the spot practically and fix things immediately.
Pat:00:12:46
Right. Yeah, communication can be fast, seamless and effective and personalized. You know it. Yeah. Makes sense.
Pat:00:13:06
So obviously this is a change in your organization. Any changes is always kind of tough to implement. What were some of the things that you had to do to kind of get people on board with a new system? And, uh, you know, as far as training and education on how this new system would work and what were some of the challenges involved?
Laura:00:13:27
Yeah. I’ve been I feel really fortunate because everyone was so excited about this coming and really jumped on board. Um, I think, um, so I’m happy about that. That doesn’t surprise me. Having worked at this organization. Um, this is just how how they operate here. Um, I thought the training, um, was was fun. We did do the training with. We’re starting with the nurse leader rounding on patients. And so when we did the training about a month ago, I actually had a, a patient bed brought to the training room. And I played the role of the patient. And we had one of the nurse leaders play the role of the rounder. And we actually demonstrated how the technology worked. And what was the difference between a not so good round, which I often like to use the term a drive by. And then we had them do some coaching from a good round to a great round, because we want to have every single round be beneficial. I don’t we really don’t want it just to be a check the box or driving by, “hi, bye.” We want them to actually sit down, make a connection. And so uh, we also tried to have some fun with it and do some, some role play activity. And um, so yeah, the rounding has been good. I think just the biggest challenge is when you get in there and you use it, you, you think to yourself, well, I wish it was this way. So then we go in and fix it. And then I wish this question could be tweaked a little bit. And then you go in and fix it and, and, and actually it’s been good. But I think that’s been my biggest learning is that it’s not going to be perfect right out of the gate like I thought it’s going to be. And it wasn’t I mean…
Pat:00:15:10
Yeah,
Laura:00:15:10
…it’s just and we’re still tweaking…
Pat:00:15:12
Sure.
Laura:00:15:12
…it like to this day every we’re constantly making changes. But that’s what’s also great about it, is that we have the ability to actually go in and make those changes ourselves as well for the, you know, for the little changes. So, um, I think that’s been one of the the biggest “a-ha’s” for me is that I expected perfection right out of them. And, and it’s just he’s going to continue to evolve and it’s going to look different in the different service lines. So rounding in in the surgery areas is going to look different than inpatient. And I’m sure clinic rounding will look a little bit different. But…
Pat:00:15:47
Yeah.
Liz:00:15:47
Every product is perfect until you put it into the hands of the end user.
Pat:00:15:51
Right?
Laura:00:15:52
Yes.
Pat:00:15:53
Well. Liz…
Liz:00:15:53
And then… And then…
Pat:00:15:54
Yeah.
Liz:00:15:54
…you. Yeah, you find out that it never it never quite works exactly the way that you had imagined it when you were building this, this beautiful, perfect…
Pat:00:16:02
Right?
Liz:00:16:02
…thing. Right?
Pat:00:16:03
Right. Yeah. So I, I’m interested in how you kind of set up the user experience because obviously, you know, to maintain a personal conversation. But still I assume they’re working on a tablet of some sort and they’re making selections, but still trying to carry on a personal conversation. Um, yeah. Liz, what was your perspective and kind of developing that?
Liz:00:16:25
Um, my thoughts were the open ended feedback was going to be important, but it was also going to take the nurse’s attention away from the patient. So we needed that placed early on, and we needed it to just be one time. We also wanted as many things as possible, all on one page, so that we’re not just kind of here’s an answer check move. Here’s an answer check move, which feels a little more robotic. Um, and then some of the entries in the survey, I really like that we just kind of put a checklist, basically, which you don’t have to finish when you’re directly in the room. Um, you can continue to make eye contact, have that conversation. Uh, this just to minimize the number of clicks, allow you to have a more free flowing conversation. And some of the data that we’re capturing doesn’t really require you to pose. You don’t need to say, what patient is your room dirty? That would be silly to ask you. Just use your eyes and you look and you notice.
Pat:00:17:21
Right? So obviously it sounds like the project has been a success. People have bought in. It’s probably a better experience for the staff, for the patient, for the families involved. Where does it head from here? I know, Liz, you mentioned alerts and some other things that might be, uh, incorporated in the program as well.
Liz:00:17:44
So on my techie side, I’m very excited because, um, at Washington uses a platform that looks like, um, we’ll need to do a little bit of enablement on their platform side, but they already have an alerting platform that Qualtrics can integrate with, um, using a web service call, which if your eye is glazed, as soon as I say a web service call, that’s okay. Basically, uh, what we can do is just have Qualtrics call this other software and say, hey, put an alert in front of this specific person so that they don’t have to go seek it out in their emails, because the folks that we’re alerting are not sitting behind a computer, um, waiting to receive an email all day. They’re just not going to do that. Um, but they do already have this alerting system they’re using for other things. So we can just slot this right in there. And that should make the response time a bit better in the amount of kind of mental burden on the folks who are responsible for responding to these alerts a little bit less, because they’re not having to manage more than one system.
Pat:00:18:47
Yeah. And you know, Laura, to those that might be listening and saying, well, this is very interesting, but I’m not in patient experience. I work for a different you know, I’m in CX but I’m in a different industry. Do you see ways that this kind of a system could be applied for other types of businesses or organizations?
Laura:00:19:05
Yeah. I think any organization that is trying to get feedback can use this platform 100%. Um, because it’s it’s so easy and the fact you can access it using a QR code. Um, it makes it very simple. Um, so I think really any, any organization can do that. Um, I know, um, in Washington, um, once we learned and understood the capabilities, um, we’re also using it for our hand hygiene audits. Um, which is saving, again, so much time because now the whole hand hygiene audits instead of using paper is done, you know, on their phone, and, um, they’re doing 250 hand hygiene audits a day. That’s all with, you know, mystery shoppers and people watching. So, um, all of that now has been automated. And I asked, how many hours did that save? And they said 24 hours a week…
Pat:00:20:03
Wow.
Laura:00:20:04
…which is a lot.
Pat:00:20:05
Yeah.
Laura:00:20:06
That’s a lot of time. So anything that we use a survey for or we’re using Survey Monkey now we can we can use Qualtrics. So even in the or they’re they’re we’re looking at using it for safety audits. Um basically anything that was was manual. It can now be automated.
Pat:00:20:26
Yeah.
Laura:00:20:26
So um, yeah. So we’re we found out pretty quickly that we didn’t need it, just need this tool just for rounding. But it’s been, uh, been a benefit in a lot of different areas.
Pat:00:20:36
Yeah, well, I think you’ve answered what I’d planned for my next question. And that was kind of the return on, you know, because there is a business side to any change that you make in an organization. But it sounds like the the return, even from a business standpoint, has been significant. Correct?
Laura:00:20:53
Yep, it’s been a big time saver, um, for sure. And we’ve just been able to get, you know, so much more information. Um, we’ve even, you know, did some surveys with some different, um, employee groups to, to better understand, like the culture and their departments and, um, just have learned a lot. And I love this quote by Lyndon B Johnson. Um, and it is if you’re not listening, you’re not learning. And I feel like that’s what this has given us, that ability to do is just listen. And once we listen and we take the right actions, that’s going to be a game changer. But we sometimes don’t know what we don’t know. So, um, I’m just excited and and living in this, um, community here in Fremont, we have a lot of diversity, and that’s one of my upcoming projects that I’m really looking forward to is really understanding, what does it look like for different cultures? What are their different needs? Because I don’t I don’t really know. So I’m looking forward to really understanding the patient’s needs and essentially like the customer needs from all these different cultures that that we have in this community so that we’re better meeting their needs. So I’ve got a lot of plans. Oh my gosh, I, I, I, um, I feel like, um, this could be a full time job, um, just using this, but, um, I think it’s, it’s definitely going to help us. And it already has.
Pat:00:22:25
Yeah.
Laura:00:22:25
So I’m excited about the possibilities for the future.
Pat:00:22:28
That’s wonderful to hear your enthusiasm and just the potential of not only you know what it means to your organization, but what it means to your patients. So, okay, well, we’ve come to that point where we asked our guests for what we call take home value. You know, one tip, one idea, one concept that ideally, our listeners can put to use right away. So Liz, let me start with you. What would be your take home value from today?
Liz:00:22:56
So I work a lot with folks who have a brand new shiny platform. Uh, like Laura did, who have a lot of passion and a broad and beautiful vision. And the one thing that I find myself repeating the most is we just got to launch one thing. It doesn’t have to be 100% perfect. It has to be good enough to make a good impression so that we can capitalize on the momentum. And you just have to trust that if you launch the first thing, then the second thing, and then phase two of the first thing and the 80th thing will all follow once we’ve started building that momentum.
Pat:00:23:33
That is good practical advice. Laura, how about you? What’s your take home value today?
Laura:00:23:38
Yeah, and I love yours, by the way, Liz. Um, so mine is really is simple. And actually, I used it today. I was, um, shadowing a hospitalist. And at the end, oftentimes this is how they end their round. They’ll, they’ll say, um, do you have any questions? And most of the time the patients say, no. And I asked him, I said, could you try something for me? I said, could you try asking what questions do you have for me? And just try that on and see what how that feels. So going from a close ended to an open ended. And so he did it with the the next patient. He said, so what questions do you have for me. And it was interesting. The patient smiled and he said, you know what, I don’t have any questions, but thank you for asking. And it just was it was just again, it’s just a small tweak in language from do you have any questions? Please say no to what questions do you have for me? Um, and so that’s that’s I easy one…
Pat:00:24:37
And…
Laura:00:24:37
…simple.
Liz:00:24:38
I love that so much. So as as the person who’s usually the patient in that scenario, when my doctors say, what questions do you have for me? I feel like this is an expected part of the appointment. I’m not taking their time. I’m not keeping them away from someone who is sicker. They’re not frustrated with me because I always worry about that. Um, but they actually just expected me to have questions. And this is all, like, normal. It always makes me feel like maybe you should try to think of a question really quick, rather than waiting until I get home and Googling it, which is dangerous.
Laura:00:25:12
Yeah, exactly.
Pat:00:25:14
No. Well. Well said. And thank you both for being a guest and for your take home value today. And I know that I believe both of you are on LinkedIn. If people want to continue the conversation or they have questions for you, is it okay if they reach out to you?
Laura:00:25:28
Absolutely.
Liz:00:25:29
Sure thing. Yeah.
Pat:00:25:30
Wonderful. Laura Anning is chief of patient experience for Washington Hospital Healthcare System, and Liz Wallshield is a senior technology consultant here at Walker. And if you want to talk about anything you heard on this podcast or how Walker can help your business customer experience, feel free to email us at podcast@walkerinfo.com. Remember to give The CX Leader Podcast a rating through your podcast service and give us a review. Your feedback will help us improve the show and deliver the best possible value to you, our listeners. Check out our website cxleaderpodcast.com to follow the show to find all our previous 300 plus episodes, podcast series and a link to our blog which we update regularly. The CX Leader Podcast is a production of Walker, we’re an experience management firm that helps companies accelerate their XM success. And you can read more about us at walkerinfo.com. Thank you for listening and remember, it’s a great time to be a CX leader and we’ll see you next time.
Tags: Pat Gibbons patient experience Laura Anning Washington Hospital Healthcare System rounding Liz Wallshield