1. 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

2. 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

5. 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.

6. 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

7. 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

8. 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?

9. 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?

10. The Value of Emotion Words

11. 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

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

13. 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

14. 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

15. Pancreatic Cancer Experience Co-Design Example

16. 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

17. 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

18. Patient/Family Results

20. Staff Results

21. What staff are saying…..

22. Themes from the Data

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

24. Idea Generation

25. Prioritization
Idea
Generation
Group Discussion
Negotiating Priorities

26. 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

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

28. Know Me

29. Path of the Patient

30. 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

31. 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?

32. Contact Information
Susan B. Haufe, MHA Administrative Director Patient Relations and Service (206)