The Hospital Sant de Déu

Joan Vinyets Rejón

Healthcare Innovation Catalyst

Patient experience is recognised as an important component of high-quality care. There is a broad consensus that it is a key strategic element in facilitating a culture of continuous improvement in healthcare. Understanding how patients experience the care we provide and their needs, preferences, and wishes enables us to identify crucial issues (pain points, inefficiencies, gaps in processes, communication, etc.) in care models and facilitates their improvement—better quality, safer, and more efficient services. Research in the United States has linked a high-quality patient experience with lower overall costs. Further research also reveals how patient-centred care often incurs lower costs due to shorter lengths of stay. In addition to improved efficiency and quality, it has also been demonstrated that incorporating patient experience facilitates the engagement of teams of professionals to make improvements or test new ideas in an agile way. It helps organisations to promote a climate of continuous improvement and a culture of innovation. 

For many years, Sant Joan de Déu Hospital has been committed to a care model that incorporates the patient experience as a core element in its strategy of continuous improvement and innovation. This is not just a question of improving information, medical appointments, or care areas, but also implies considering the role and impact that the culture of the whole organisation has on the patient's experience throughout the entire care process. The healthcare we provide must add value, from their own perspective, according to how they go through the proposed experience. We aim to ensure that they receive the right care at the right time and in the right way. 

In our experience, a solution is not sustainable if it does not imply a substantial shift in organisational culture. It must encompass the development of patient-centric strategies by deploying a culture based on patient experience that maximises benefits for patients and the organisation. It requires strategically implementing the patient experience as a springboard to foster cultural change in the organisation—a commitment in terms of management, resources and leadership model. Achieving successful strategic implementation means going beyond developing patient experience projects on an ad hoc basis. First, it requires constant attention from the organisation's leadership to emphasise the importance of this commitment at all levels and that it permeates throughout the organisation. In addition, several essential elements must be considered to drive this strategic approach to improve patient experience and facilitate cultural change. 

How can hospitals improve patient experience and foster a culture of change?

While we recognise that there is no single path, in our experience, the following elements facilitate better outcomes across the organisation, making the patient experience a strategic priority:

"We encourage our industry leaders to embrace the paradigm shift of patient experience as a strategic element to foster a culture of innovation and continuous improvement throughout the organisation."

● Management leadership committed to the patient experience focuses on the sustainability of a successful implementation, which depends on leadership that is effectively distributed throughout the organisation and actively supported by management and the entire board. This support must empower all teams to promote a culture of continuous improvement, creativity and innovation without fear of risk. On the leadership side, this needs to be demonstrated by incorporating the patient voice into strategic discussions and ensuring that it is reflected in the organisation's mission and vision, and across its dashboards and scorecards.

● Active and demonstrative communication helps in disseminating and promoting the importance of the patient experience, communicating at all levels, disseminating and reinforcing patient-centred values and procedures to all people in the organisation and teams (care and non-care professionals). In particular, leadership must constantly communicate the importance of patient engagement and make it visible, demonstrating the impact this engagement can have on the quality of care, patient satisfaction and efficiency.

● Training and supporting teams are required to develop special training programmes in empathy skills and new agile and creative methods (human-centred design, design thinking, LEAN) for quality improvement and innovation. Facilitating and constantly accompanying teams with examples, tools, and permanent mentoring initiatives is crucial for their practical application. Professionals must be encouraged to conduct small improvement projects and test new ideas quickly, and successful ideas, learning and results are then shared throughout the organisation. 

● A network of internal role models helps establish small working groups in all service areas and a network of role models to act as ambassadors of the patient experience. It also facilitates small ways to reinforce the importance of the patient's role by offering staff development opportunities. These models empower the role of the champion and accompanying them to promote dynamics and initiatives to improve the patient experience and, at the same time, drive change at the operational level by breaking down organisational silos.

● A structure for patient involvement and empowerment ensures the active involvement of patients and families/carers in the continuous improvement and innovation of the care model. Promoting opportunities to develop collaborative working relationships with patients so they can see first-hand how involvement can positively influence their work. Patients and families should also play a role at the management level by incorporating them in meetings with leadership teams.

● A measurement and feedback system setting up a structure and appropriate tools (surveys, comments, reports, dashboards) and activities (focus groups, shadowing, counselling) in order to perform measured evaluation and ongoing reporting on patient experiences, assess progress, and identify new opportunities for continuous improvement. This system facilitates sharing feedback, patient satisfaction and NPS scores with each service area and/or department.

● Promoting a strategy of feedback and recognition, both for patients and families and for the professionals who have collaborated in the improvements, to consolidate the impact that their participation has had on the projects, as well as giving explicit value to the time they have dedicated to them.

It is important to developing a consistent, integrated programme of activities rather than small, sporadic projects. Finally, sufficient resources must be allocated to help improve care and ensure this model of excellence in the patient experience. The model cannot rely on a single person but must incorporate a driving team and structure that extends to the managerial level. To achieve transformation, the team must go beyond supporting patient, family and professional engagement activities, by embedding the patient experience in the organisation's strategic objectives (e.g., quality, safety, processes, accreditations, etc.). We encourage our industry leaders to embrace the paradigm shift of patient experience as a strategic element to foster a culture of innovation and continuous improvement throughout the organisation.