Including Patients: Co-Designing the Patient Experience Session Code A16/B16 These presenters have nothing to disclose. Including Patients: Co-Designing the Patient Experience 26th Annual National Forum on Quality Improvement in Health Care December 9, 2014

Session Objectives Objective 1: Identify how assumptions could be shaping your improvement work and impeding understanding of what really matters to your customers Objective 2: Describe the basic approaches of experience-based design and ways to involve patient and families in improvement activities Objective 3: Identify strengths and gaps in your organization that suggest practical steps you can take post-conference 2

2013-2017 Strategic Service Plan We create an extraordinary patient experience. INTEGRATION OF QUALITY & SERVICE Patient experience integrated into organizational strategies. PARTNERSHIP WITH PATIENTS & FAMILIES Active participation in process improvement to transform care delivery. Engage, develop & activate people Select for service, develop skills and enhance accountability with our people.

The Patient-Family Partner Program Virginia Mason team members represent the patient voice RPIW created a patient recruitment strategy PFP recruitment and development First Innovation Co-Design Event  Kaizen Event created standards for preparing teams 108 PFP and growing stronger! Innovation Event EBD formally began with development, testing of the emotion word list and implementation Gaining the “voice of the patient” through surveys and random interviewing

Virginia Mason Production System Toyota Production System philosophies and practices have given us an effective management approach focused on achieving: Customer first Highest quality Obsession with safety Highest staff engagement A successful economic enterprise

Exciting Addition to Our Toolkit Technical tools of VMPS are great Measure time, flow, defects, etc. Tended to flow processes from our perspective But what about the emotional experiences of our customers? How do negative experiences impact flow and quality? What does their process flow look like? How can we incorporate their stories and emotions?

Experience-Based Design Is… A philosophy and set of methods focused on an understanding of the experiences and emotions of those who are involved in receiving and delivering healthcare services, striving to understand what people naturally do and feel. What really matters to our customers?

The Value of Emotion Words

Experience Questionnaires Basic EBD Methods Observations Interviews Experience Questionnaires Focus Groups Fly on the wall; subtle presence Big ears, big eyes, small mouth Collect stories, guide through an experience Open-ended questions Visual depiction of a process Customers select emotions at each touch point Small group Guide through a common experience Open-ended questions

EBD Helps Bust Assumptions We observe and learn directly from customers about their experiences and what they need

Shifts in Thinking Under Way From To One patient on the team Half patients, half staff Designing for patients and families Designing with patients and families Listening to voice of one or few Listening to voice of many Convenient sampling Broader sampling Conventional surveys More qualitative data EBD data for events only Creating a habit of listening to fuel kaizen plans

Where We’re Heading Don’t listen very much to our users, we do the designing Design and improve, then ask our users what they think Listen to our users, then go off and do the designing Listen to our users, design together Professor Paul Bate, UCL 2007

Pancreatic Cancer Experience Co-Design Example

Data Collection Collected data March through August 2013 Customers identified were patients, families and Virginia Mason staff 6 Observations 58 Interviews 117 Questionnaires 1 Focus Group

Co-Design Workshops 50% patients and families and 50% staff Series of three workshops: September 13, 2013 (8 hours) October 30, 2013 (3 hours) December 3, 2013 (3 hours) Present data and prioritize opportunities for improvement

Patient/Family Results

Staff Results

What staff are saying…..

Themes from the Data

If there was one thing you could fix about the pancreatic cancer experience today, what would it be?

Idea Generation

Prioritization Idea Generation Group Discussion Negotiating Priorities

Work Groups Soul Mates Care Giving Matters! Team Connect Understand and document patient values and goals Care Giving Matters! Provide better resources and support for care givers Team Connect Improve support services and care coordination

How does it feel to be involved in co-design?

Know Me

Path of the Patient

Patients and Family Partners Insightful about what we do well and areas where changes may be needed Help us develop priorities and make improvements based on patient- and family-identified needs Push us out of our mental valleys and come up with new ideas and solutions

Discussion How do you understand what matters most to your customers? How are you involving patients and families in designing their experience? What is one thing you’re going to go back and do differently?

Contact Information Susan B. Haufe, MHA Administrative Director Patient Relations and Service (206) 223-7627 susan.haufe@virginiamason.org