O f f i c e o f Pa t i e n t E x p e r i e n c e a n d O u t c o m e s S t r a t e g i c F r a m e w o r k
Putting Patients First in Partnership with You!
Declaration of Patient Values As a patient, what I value about my experience is... …receiving the best quality care in a safe and well co-ordinated manner, across the continuum of my care. …being informed about my care, in terms and language that I can understand. …being introduced to each member of my health-care team, including their roles. …being an active participant in my care, having my views heard, and making decisions in collaboration with my family and health-care providers. …being treated with dignity and respect and receiving equitable and compassionate treatment regardless of my race, religion, ethnicity, age, sex, gender identity, sexual orientation or disability. …having timely and easy access to services that I need. …feeling safe and protected in a clean, comfortable, hazard-free environment. …having my privacy and confidentiality protected and knowing that my information will not be shared without my permission, or discussed in public places. …being cared for in a hospital that is responsive to community feedback and takes steps to continuously improve on service delivery. …being made aware of research opportunities and having the choice to participate.
As a patient, I will... ...share the responsibility for my care and wellbeing and provide accurate information. ...ask questions when I am unsure or need clarification. ...be respectful and courteous to all physicians, staff, students and volunteers. ...respect the rights, property, privacy and diversity of all, including other patients and their families.
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Mandate of the Office of Patient Experience and Outcomes The Mount Sinai Hospital has a long-standing commitment to excellence in patient care, teaching and research. Our strategic plan was created to Put Patients First, and by doing so, we will emerge a stronger organization, better positioned and prepared to face the opportunities and challenges of our health-care system today and in the future. To help achieve our strategic plan, Mount Sinai has created the Office of Patient Experience and Outcomes. In today’s world, resilient organizations distinguish themselves through continuous evaluation and a relentless drive to improve. The Office of Patient Experience and Outcomes, in partnership with our clinical Centres of Excellence and reporting to the Chief Clinical Officer, will help Mount Sinai lead Canadian hospitals with a renewed focus on patient and family-centred care. The Office mandate is to: • improve the experience for all our patients and their families that results in the best outcomes; • engage a wide cross section of stakeholders — our employees, volunteers, board of directors and the greater community; • design, implement and evaluate quality improvement best practices; • enhance our use of information for decision making and promote a culture of safety performance and transparency. By putting patients and families first in partnership with you, we are best positioned to deliver a high quality, consistent and caring patient experience that results in the best possible outcomes. We’re here for you.
Joseph Mapa President and CEO
Dr. Tom Stewart Chief Cinical Officer
Tracy Kitch Chief Nursing Officer
Office of Patient Experience and Outcomes: Putting Patients First in Partnership with You
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Patient and Family-Centred Care 8 Dimensions of Patient and Family-Centred Care
“Understanding and respecting patients’ values, preferences and expressed needs is the foundation of patient-centred care.” — H a r v e y P i c k e r , p i o n e e r i n pa t i e n t - c e n t r e d c a r e
Patient and family-centred care is an approach to the planning, delivery and evaluation of health care. It is grounded in mutually beneficial partnerships among patients, families and health-care providers.1 It is a collection of best practices that treats the patient and family in a holistic manner and helps to direct the efforts of all health-care professionals in the delivery of a patient experience that meets expectations and results in the best outcomes. At Mount Sinai Hospital, patients and their families are at the core of everything we do. There is a genuine partnership between our health-care professionals and our patients and families. We are committed to measuring and understanding our patients’ unique perspectives on the care they receive. We utilize industry-standard survey tools to measure our performance, report our results and strive for improvement in eight key dimensions.2 1
www.ipfcc.org
2
www.hcahpsonline.org
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Dimension
Description
Patient Preferences
Creating a culture of respect for patient autonomy, values and preferences
Emotional Support
Helping to alleviate fear and anxiety over a patient’s illness, treatment and prognosis
Physical Comfort
Providing an environment that is comfortable and calming throughout the patient’s experience
Information and Education
Providing information and education relevant to treatment and care and sharing that information in a respectful and effective manner
Continuity and Transition
Preparing the patient and their family for the entire journey and ensuring continuity of care during transitions
Co-ordination of Care
Collaboration and effective communication among all members of the care team to help ensure co-ordination of care
Access to Care
Ensuring appropriate and timely access to the required services
Family and Friends
Actively engaging family and friends, as defined and instructed by the patient
http://www.nrcpicker.com/member-services/eight-dimensions-of-pcc/
Office of Patient Experience and Outcomes: Putting Patients First in Partnership with You
A Culture that Dares to Compare At Mount Sinai we have organized the care we deliver into five Centres of Excellence (CoE): • Frances Bloomberg Centre for Women’s and Infants’ Health • Daryl A. Katz Centre for Urgent and Critical Care • Christopher Sharp Centre for Surgical Oncology • Centre for Musculoskeletal Disease • Zane Cohen Centre for Digestive Diseases The Office of Patient Experience and Outcomes is closely aligned with our Centres of Excellence and their important work in identifying areas of quality improvement, developing key performance indicators, assisting with measurement and facilitating performance improvement.
The Office also works with our diagnostic centres, clinical departments, nursing and allied health professionals, and the greater community to better align and deploy resources to strategic and operational priorities. The Office provides oversight of patient safety and risk management initiatives including critical incident investigations and the development of Sinai’s Quality Improvement Plan, which is mandated by Ontario’s Excellent Care For All Act.3
The Balanced Scorecard Each of Mount Sinai’s Centres of Excellence has developed a balanced scorecard of Key Performance Indicators (KPIs), examples include:
We partner with the CoE leadership and clinical care teams and use balanced scorecards to identify best practices and co-ordinate the execution of these practices. Our partnership approach and use of continuous quality improvement methods allow the CoEs to quickly assess where to focus efforts and test interventions that have the greatest potential to achieve the desired results. Information management specialists within the Office help convert data to meaningful information and new knowledge that is used by our clinical teams to provide improved patient care.
Experience and Engagement Patient Satisfaction KPIs
Access and Efficiency Wait Times and Accessibility KPIs
Quality and Safety Government Mandated KPIs
Financial Health Operational Budget KPIs
Development of key performance indicators (KPIs), analysis and interpretation, and benchmarking against peers help all of us answer three fundamental questions:
• How are we doing? • How can we improve? • Did we improve? 3
http://health.gov.on.ca/en/ms/ecfa/pro/legislation/ ecfa_notice.aspx
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Our Call to Action Putting Patients First… At Mount Sinai we involve both patients and families in the design, delivery and improvement of the care experience. Behind this commitment are teams of passionate professionals delivering: • The Best Medicine: care that is safe, high quality and in accordance with our Declaration of Patient Values.4 • The Best Care: care with empathy, where all members of the Mount Sinai community ask, “How can I help you?” • The Best Research: care that is evidence-based, recognizing that science informs today’s work and tomorrow’s discoveries.
In Partnership… Our success depends on our ability to actively seek out meaningful engagement and work with individuals, teams and the greater community. We aim to foster collaborative relationships and help develop high performing teams with the skills and tools needed to meet patient and family expectations and achieve the best possible outcomes.
With You! To be successful we need you. Mount Sinai was founded on the principles of inclusiveness and compassion that recognize and value each person’s unique skills. Valuing and respecting each other’s differences is one of our core values and greatest strengths. Your knowledge and feedback are critical, and allow us to serve our patients more effectively and distinguish Mount Sinai Hospital as a leading teaching hospital and care centre.
“Providing the best experience requires a team-based approach to care. Our approach at Mount Sinai utilizes the expertise and skills of the patient’s providers and ensures we partner with our patients and their families.” — D r . S a m i r S i n h a , d i r e c to r o f g e r i at r i c m e d i c i n e , m o u n t s i n a i ho s p i t a l
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http://www.mountsinai.ca/patients/declaration-of-patient-values
Office of Patient Experience and Outcomes: Putting Patients First in Partnership with You
“Put patients and families on the Improvement Team… not only an important force in driving the achievement of measured results, it is also the leverage point with the greatest potential to drive long-term transformation of the entire care system.” — Seven Leadership Leverage Points for O r g a n i z a t i o n - L e v e l I m p r o v e m e n t i n H e a lt h C a r e 5
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Reinertsen JL, Bisognano M, Pugh MD. Seven Leadership Leverage Points for Organization-Level Improvement in Health Care (Second Edition). Cambridge, Massachusetts: Institute for Healthcare Improvement; 2008.
Developing and Incorporating Best Practices Mount Sinai has a long history of partnering with patients, families, care teams and the community in the development of initiatives that improve the patient experience and result in the best outcomes. Identifying and spreading best practices at Mount Sinai is our priority. Here are a few examples of practices, improvements and innovations from Mount Sinai that are Putting Patients First.
Bedside Experience Tablets Our new Women’s and Infants’ program will include interactive bedside tablets. This technology will enhance entertainment choices, education and the overall patient experience.
Digestive Health Patient Education The Inflammatory Bowel Disease Group in the Zane Cohen Centre at Mount Sinai provides patients and families with a wealth of information and resources that go beyond treatment to how to live well for the future.
Effective Communication Committee Mount Sinai’s Neonatal Intensive Care Team engages former patients to work with care teams and families around their experiences, which brings new perspectives that have already led to new initiatives.
“I tell you, employees walk away from those meetings with changed practices. It’s amazing!” — S a l e n a Moh a m m e d , N u r s i n g U n i t A d m i n i s t r a t o r , NICU
Enrichment Spaces Mount Sinai is leveraging industry best practices to redesign waiting spaces to enhance comfort, learning and enrichment for patients and families.
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Interpreter Program Supports patients and families who communicate in a language other than English. This program utilizes trained volunteers, employees, external agencies, sign language interpreters and telephone interpretation. Language congruence between patients and their care teams is essential in the delivery of an equitable patient and family experience.
Patient Navigators Patient Navigators at Mount Sinai have shown to improve the patient experience, better support families and improve care co-ordination.
“We bring the perspective of previous patients’ experiences along with clinical understanding, to shift knowledge and a sense of control back into the patient’s hands. What is important to our patients and their families determines our priorities.” — n at h a n d u yc k , pa t i e n t n a v i g a t o r
Office of Patient Experience and Outcomes: Putting Patients First in Partnership with You
Patient Advisors
Service Excellence Program In partnership with the renowned Cleveland Clinic we will be the first hospital in Canada to implement its highly successful service excellence programs. 6
Mount Sinai’s inpatient Psychiatry team has enlisted the help of former patients to act as advisors for current patients and their family members; working as part of the team to facilitate communication, identify patients’ concerns and help foster an environment of trust and respect.
Patient Orientation Guide for the Elderly Mount Sinai’s Acute Care for the Elderly (ACE) Unit Team has developed an orientation guide to help patients and families better understand their hospital experience: provide context to their unique health condition, answer questions, introduce care providers, guide family and normalize the patients feelings and worries.
Real-Time Patient Surveying We are evaluating real-time feedback solutions that will allow our care teams to better serve our patients and to develop more engaging relationships with patients, families and each other.
Smartphone Education for New Parents Mount Sinai’s Women’s and Infants’ team has developed a free iPhone application that is a resource to help parents answer questions, make plans and better navigate their expanded family.
Nana Asomaning, G e r i a t r i c E m e r g e n c y, Medicine nurse.
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http://my.clevelandclinic.org/patient_experience/ what_we_do.aspx
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The Patient’s Journey The patient experience is a personal journey; extremely subjective and unique to the individual. It has no clear beginning or end, as it is tied into the continuum of that patient’s overall health care. In order to enhance this experience and the quality of care we deliver, we must breakdown this complex journey; measuring, understanding and carefully designing each touchpoint; considering the feelings and concerns of the patients. At the same we must be mindful that no touchpoint stands on its own, and is impacted by, and has impact upon how patients feel about the rest of their journey. This can be seen in the hypothetical surgical patient experience illustrated below.
At Home:
“Why am I in such pain?”
Primary Care Consultation:
Consultation with Surgeon:
“What is wrong with me?”
“Will I need surgery?”
Pre-Admission:
“What do I need to know beforehand?” Surgical Admission:
“When will I be called in to the OR?”
At Home:
“What’s next in my recovery?” Resting on the Unit:
Surgery:
“Will I be all right?”
“When am I going home?”
Post-Surgery Recovery:
“When can I see my family?”
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Office of Patient Experience and Outcomes: Putting Patients First in Partnership with You
Management Support The Office of Patient Experience and Outcomes brings together, for the first time, experts in health records, data analytics, quality improvement, performance measurement, care design, patient safety, risk management, communications, project management, change management and benefits realization. The Office also includes our customer service representatives in our admitting areas, patient navigators and patient relations. This unique, talented group of individuals, teams and resources allows Mount Sinai to be one of the patient experience and outcomes leaders in Canada. The Office reports to Dr. Tom Stewart, Mount Sinai’s Chief Clinical Officer, and is accountable to the Patient Safety and Quality Committee of the Board. With representation at all levels of decision-making, the Office is able to ensure its mandate is achieved. Patient Experience and Engagement Admitting Experience Design Patient Relations Patient Navigators
Community Partners Chief Clinical Officer Senior Leadership Team
Quality, Safety and Risk Management Patient Safety Quality Improvement Risk Management
Analytics and Outcomes Health Records Performance Measurement
Board of Directors
Our Leadership
Dr. Matthew Morgan Vice-President of Patient Experience and Outcomes Matthew is a specialist in general internal medicine and experienced leader in health informatics, quality improvement and clinician engagement. As Mount Sinai’s first Vice-President of Patient Experience and Outcomes, he provides leadership in the pursuit of clinical excellence as it relates to safety, patient experience and clinical outcomes.
Sandra Dietrich Senior Director, Office of Patient Experience and Outcomes Sandra has 20 years of experience in health-care management. As Mount Sinai’s Senior Director, Office of Patient Experience and Outcomes, Sandra provides leadership through performance measurement, quality and process improvement, planning and the co-ordination of strategic and operational initiatives.
Office of Patient Experience and Outcomes: Putting Patients First in Partnership with You
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600 University Avenue Toronto, Ontario, Canada M5G 1X5 t 416-592-3145 ext. 3252 xo@mtsinai.on.ca www.mountsinai.ca/xo