Latest / Becker’s Healthcare Podcast / Connecting Patient Experience, Employee Engagement, and Quality of Care with Dr. Jennifer Jasmine Arfaa

Transcript

Connecting Patient Experience, Employee Engagement, and Quality of Care with Dr. Jennifer Jasmine Arfaa · Becker’s Healthcare Podcast

• 0:02
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  - Hello, everyone. I'm Rick Evans. I'm the cochair
• 0:40
  - of the Becker's Healthcare Advisory Council of Chief
• 0:43
  - Experience Officers,
• 0:45
  - and welcome to the Becker's podcast.
• 0:47
  - We're having podcast sessions with some great leaders
• 0:51
  - from around the country, some chief experience officers,
• 0:53
  - to learn about what they're doing in their
• 0:55
  - organizations
• 0:56
  - to make the experience better.
• 0:58
  - And it's my pleasure today
• 1:00
  - to be joined by doctor Jennifer Jasmine Arfa.
• 1:03
  - She's the senior vice president and chief experience
• 1:05
  - officer
• 1:06
  - at the West, Westchester Medical Center Health Network
• 1:09
  - in Westchester
• 1:11
  - County, New York.
• 1:12
  - Welcome,
• 1:13
  - Jasmine. How are you?
• 1:15
  - Good morning, Rick. How are you? Thank you
• 1:16
  - so much to you and Becker's Healthcare for
• 1:19
  - highlighting the work that CXOs are doing across
• 1:22
  - the country, and it's a real privilege and
• 1:24
  - honor to be here with you today. Oh,
• 1:26
  - great. Can you just briefly describe the scope
• 1:29
  - of your role at Westchester Medical Center? Yes.
• 1:32
  - I am the inaugural,
• 1:34
  - CXO for the system.
• 1:36
  - We are nine hospitals,
• 1:38
  - with, around 60 outpatient sites,
• 1:41
  - in the, Hudson Valley area, Westchester County areas,
• 1:46
  - in, New York.
• 1:47
  - And I have oversight for patient family experience,
• 1:50
  - patient advocacy,
• 1:52
  - and a few other operational,
• 1:54
  - patient engagement areas across the system.
• 1:57
  - Oh, kudos to your organization
• 2:00
  - for making sure you have this strategic role.
• 2:02
  - And you and I have known each other
• 2:03
  - for a while. They made a great choice.
• 2:05
  - So Yeah. That's that's really awesome.
• 2:08
  - We'll just go through a couple of questions
• 2:09
  - here to help us understand how you're approaching
• 2:12
  - things,
• 2:13
  - at at, WMC Health Network.
• 2:16
  - So
• 2:17
  - how are your patient experience metrics tracking,
• 2:20
  - this year? Where are you seeing success? Maybe
• 2:21
  - some challenges? How are you thinking about that?
• 2:24
  - Yeah. Thank you for that question. So, you
• 2:26
  - know, I really wanted to start out by,
• 2:29
  - thanking doctor David Lubarski, our president and CEO,
• 2:33
  - and also our chief nursing executive, doctor Phyllis
• 2:36
  - Yezzo,
• 2:37
  - for really believing in the mission and vision
• 2:40
  - of patient family experience across the network. And,
• 2:43
  - our organization has really been,
• 2:46
  - unders... Trying to understand, you know, the differences
• 2:49
  - between advocacy, differences between experience,
• 2:52
  - really marrying,
• 2:53
  - employee engagement and quality and safety. And so,
• 2:56
  - as I have reflected on your question,
• 2:59
  - you know, we are seeing,
• 3:01
  - encouraging process... Progress,
• 3:03
  - with
• 3:04
  - things in,
• 3:05
  - with our HCAPS domains looking at communication,
• 3:07
  - responsiveness,
• 3:09
  - healing environment.
• 3:10
  - But we continue to have opportunities just, you
• 3:12
  - know, to be better along with all the
• 3:14
  - other organizations across the country.
• 3:17
  - But we don't want our teams to be
• 3:19
  - focused on numbers alone.
• 3:21
  - And we're reminded, and all of my teams
• 3:23
  - in my previous organizations
• 3:25
  - and
• 3:26
  - here, they know that I have the saying,
• 3:29
  - which I've taken,
• 3:31
  - shamelessly from
• 3:32
  - IHI and other areas.
• 3:34
  - Our our
• 3:36
  - patients and families,
• 3:37
  - they want three things. They want... They say
• 3:40
  - heal me, keep me safe, and be nice
• 3:43
  - to me.
• 3:44
  - Mhmm.
• 3:45
  - And as I have been looking at our
• 3:47
  - comments and looking at our survey results and
• 3:50
  - feedback that we get from the community,
• 3:52
  - you know, there are a couple of examples
• 3:54
  - that come to mind. You know, patient pressing
• 3:56
  - the call bell because they're afraid to get
• 3:57
  - out of bed ask... Is asking us to
• 3:59
  - keep them safe. A mother seeking explanation about
• 4:02
  - her child's care is asking us to help
• 4:04
  - her heal.
• 4:05
  - And someone who's been waiting for hours in
• 4:07
  - the emergency department wants reassurance that they haven't
• 4:10
  - been forgotten about
• 4:12
  - is really asking for kindness.
• 4:14
  - So our our success at WMC Health has
• 4:17
  - come from bringing these stories and examples
• 4:20
  - into performance conversations
• 4:22
  - and service moments using them to improve experiences
• 4:25
  - rather than just simply
• 4:27
  - managing metrics.
• 4:29
  - So as,
• 4:30
  - CXO, one of my top priorities is helping
• 4:32
  - leaders understand that patient family experience isn't something
• 4:36
  - separate from clinical quality, safety, or operations.
• 4:39
  - It's all inter... Interconnected.
• 4:42
  - 100%.
• 4:42
  - I mean, I think, you know, the way
• 4:44
  - I've heard it expressed, and you you said
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  - it as well, it's quality, safety, and experience.
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  - And those things together
• 4:52
  - are what,
• 4:53
  - really constitute excellent health care. Right? And we
• 4:56
  - can't think of one without the other. Absolutely.
• 4:59
  - Yeah. So what's a theme that you keep
• 5:01
  - hearing from patients and families? You touched a
• 5:04
  - little bit on some of the stories you
• 5:05
  - just shared, but what's a theme that you're
• 5:07
  - hearing that maybe never quite makes it onto
• 5:09
  - a metrics dashboard?
• 5:11
  - So I think one of the strongest themes
• 5:14
  - that I hear about and read about,
• 5:17
  - constantly is that our patients and families want
• 5:19
  - to feel seen,
• 5:21
  - heard, and remembered.
• 5:22
  - And we measure communication, responsiveness, cleanliness, and overall
• 5:26
  - ratings, but what is really much harder to
• 5:29
  - measure is that emotional experience of being a
• 5:31
  - patient and or a family member.
• 5:35
  - So we think about an elderly patient who
• 5:37
  - has always been independent and suddenly needs assistance
• 5:41
  - with the most basic personal needs. They're not
• 5:43
  - just dealing with an illness. They may be
• 5:45
  - embarrassed, frightened,
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  - and feeling a loss of dignity. The way
• 5:49
  - we respond in those moments can have an
• 5:51
  - enormous impact on their experience.
• 5:54
  - And just recently,
• 5:55
  - I was working with a a a patient
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  - and family
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  - looking at
• 6:00
  - how they have been
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  - so
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  - anxious in dealing with understanding of the test
• 6:07
  - results or when discharge is happening. It's those
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  - things that you can't quantify
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  - per se in a dashboard, but it's those
• 6:15
  - things that we have to keep back of
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  - our mind constantly.
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  - Mhmm. A 100%. I mean, I like to
• 6:21
  - call those things moments that matter. Right?
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  - And I think sometimes our frontline staff who
• 6:28
  - are under a lot of production pressure Mhmm.
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  - Right, a nurse, a doctor, they're they're feeling
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  - the pressure.
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  - It's easy to turn those moments into tasks
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  - or task lists, and
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  - sometimes that doesn't meet our patient's needs. Right?
• 6:44
  - So thinking through those things is just so
• 6:46
  - important and then helping our frontline teams to
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  - be able to,
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  - to make those moments count.
• 6:52
  - You know, because, again, you probably experienced this
• 6:54
  - where you are. I did in my career.
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  - Not everybody who's a clinician is a great
• 6:58
  - communicator.
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  - It's not a native talent for everybody, and
• 7:01
  - so helping bring that together is so, so
• 7:04
  - important.
• 7:06
  - If I if I can move on,
• 7:08
  - it's
• 7:09
  - not a great season for budgets.
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  - Never.
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  - Yeah. I... That's absolutely true. I I think
• 7:14
  - thirty years in health care for me, and
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  - I think maybe I didn't make budget cuts
• 7:18
  - five of those thirty years.
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  - So that's definitely a challenge.
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  - And they really are tight this year with
• 7:24
  - Medicaid cuts, other things really coming down the
• 7:26
  - pike. How has your team,
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  - adapted,
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  - through all of those, challenges?
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  - Well, like every health care organization in the
• 7:35
  - country, and I challenge you, I challenge everyone
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  - to really tell me one that, you know,
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  - isn't going through this. We're operating in an
• 7:41
  - environment where financial pressures really require us to
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  - be thoughtful,
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  - disciplined in how, when, and where we use
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  - our resources.
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  - And as a CXO overseeing patient family experience
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  - across a very large health system,
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  - I have to balance financial stewardship
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  - with our responsibility to the patients, families, and
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  - the communities that we serve.
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  - But I believe that one of the most
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  - important questions that we can ask when making
• 8:07
  - these types of financial decisions
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  - is how will this decision affect the patient
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  - and family? You know? And then you put
• 8:14
  - yourself in the shoes of that patient and
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  - family.
• 8:18
  - So we may be discussing staffing models,
• 8:20
  - operational efficiencies, technology investments, or reducing expenses. But
• 8:25
  - behind all of those decisions
• 8:27
  - just came from one big meeting yesterday.
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  - No matter how large or small
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  - is a person who is sick, who is
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  - frightened,
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  - or through the lens of that family member
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  - depending on us, Westchester
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  - Medical Center Health Network, to care for that
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  - person that they love. Yeah. Yeah.
• 8:45
  - And it... You know, again, it's a real
• 8:47
  - sign of your organization's commitment that they invested
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  - in you, your position,
• 8:52
  - and in developing a strategy.
• 8:55
  - And I would say that to anyone listening,
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  - you know, where you put your investment says
• 9:00
  - what your priorities are. And, absolutely, there are
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  - budget cuts everywhere.
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  - But, if patient experience is important, someone needs
• 9:08
  - to be working on it, and it needs
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  - to be a domain expert. Expert. Someone like
• 9:12
  - you, Jasmine, who knows
• 9:14
  - how this works, who understands the data, who
• 9:17
  - can help an organization identify the right priorities,
• 9:20
  - that investment is important. And,
• 9:23
  - you know, it results in patient loyalty,
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  - which is good for our bottom line. It's
• 9:27
  - just, you know, the... There has to be
• 9:29
  - some investment even when we're all sort of
• 9:31
  - getting getting tighter and kudos to your organization
• 9:34
  - for doing that.
• 9:35
  - A little bit of inside baseball in terms
• 9:37
  - of patient experience.
• 9:39
  - I I think most of our listeners would
• 9:40
  - be familiar with the HCAHPS survey. That's the
• 9:43
  - inpatient survey required by the government,
• 9:46
  - and publicly reported. There's been an update of
• 9:49
  - that survey, thank god, after a long time,
• 9:52
  - And we're about to see some of those
• 9:54
  - results,
• 9:55
  - nationally. I'm just... What are you waiting to
• 9:57
  - see when those HCAHPS,
• 9:59
  - two point o results come out? What are
• 10:01
  - you curious about?
• 10:03
  - I'm really looking for more meaningful understanding of
• 10:06
  - what our patients and families are experiencing and
• 10:08
  - really where we as a health network need
• 10:11
  - to improve.
• 10:12
  - I have a laser focus as all CXOs
• 10:15
  - do on scores and trends and national benchmarks.
• 10:19
  - They're they're important for accountability and understanding how
• 10:22
  - we're performing,
• 10:23
  - but I don't want our organization
• 10:25
  - to become so focused on that measurement that
• 10:28
  - we lose sight of the patient and family
• 10:30
  - behind it.
• 10:31
  - Clinical outcomes help us understand whether we're healing
• 10:34
  - patients. Quality and safety measures help us understand
• 10:36
  - whether we're keeping them safe.
• 10:38
  - Patient experience measures help us understand whether patients
• 10:42
  - felt informed,
• 10:43
  - respected, included, and cared for throughout their journey.
• 10:46
  - All of these things are deeply connected.
• 10:49
  - But I want our leaders and our frontline
• 10:52
  - leaders to better understand
• 10:54
  - HCAHPS in general, our feedback,
• 10:56
  - what we receive on Google and Yelp.
• 10:59
  - All the pieces of feedback that we get,
• 11:02
  - whether it's through
• 11:04
  - service rounding or interdisciplinary
• 11:06
  - bedside rounding or nurse manager rounding, all those
• 11:09
  - are gifts. And I think the more that
• 11:11
  - we can handle
• 11:13
  - in the moment,
• 11:14
  - the better our HCAHPS
• 11:16
  - scores will become.
• 11:18
  - Yeah. And it's all linked. Right? I mean,
• 11:20
  - patients give us feedback through many, many mechanisms
• 11:22
  - that you mentioned.
• 11:24
  - And, again, it's a chief experience officer with
• 11:26
  - experience like you and others around the country
• 11:28
  - who can look at all that information and
• 11:30
  - create a coherent
• 11:32
  - Mhmm. Picture of what our patients and families
• 11:35
  - are saying, whether that's in a review,
• 11:37
  - comment, a letter, or a survey.
• 11:40
  - And that's just so important to understand and
• 11:42
  - bring... Be able to bring those together. So
• 11:43
  - we're focusing the work on the right things.
• 11:45
  - So thank you.
• 11:47
  - Increasingly,
• 11:49
  - CXOs across the country
• 11:51
  - are
• 11:52
  - thinking less about episodes and inpatient admission,
• 11:56
  - doctor's visit, and more about journeys. The journeys
• 12:00
  - are patients go on as customers.
• 12:03
  - You know, before they're in a doctor's office
• 12:05
  - or in a hospital, they're on a website,
• 12:08
  - or at GPT,
• 12:09
  - some other place trying to get information.
• 12:12
  - So how would,
• 12:13
  - how are you thinking about where patient experience
• 12:16
  - and consumer experience sort of intersect with each
• 12:20
  - other at Westchester? Mhmm.
• 12:23
  - I I I personally don't
• 12:26
  - believe that patients and families see that distinction.
• 12:29
  - I think they see it all as one.
• 12:32
  - But I I I believe that a lot
• 12:34
  - of health care organizations
• 12:36
  - often organize organize themselves that way. So from
• 12:39
  - the patient and family's perspective, I think it's
• 12:41
  - just one continuous journey.
• 12:44
  - I I I feel that we have to
• 12:47
  - be, as an organization,
• 12:48
  - ready at any time for these types of
• 12:52
  - scenarios to come forth, whether it is through,
• 12:55
  - like you said,
• 12:57
  - going on,
• 12:58
  - Google to ask a provider or these different
• 13:02
  - medical,
• 13:03
  - search engines where people go to look at
• 13:06
  - what disease they've just been diagnosed with. Mhmm.
• 13:10
  - I I think... And I say this,
• 13:13
  - everywhere.
• 13:14
  - We can't lose sight of that human connection
• 13:16
  - and that human touch. And
• 13:19
  - whether we look at, you know, patient experience,
• 13:21
  - consumer
• 13:22
  - experience,
• 13:23
  - reputation,
• 13:24
  - all those things, we we just cannot lose
• 13:27
  - sight that there is a human being
• 13:30
  - at the end of every single decision that
• 13:32
  - we make.
• 13:33
  - And organizations have to realize they have to
• 13:36
  - link everything together. It can't be one separate
• 13:39
  - department or it can't be one separate way
• 13:41
  - to look at the the
• 13:43
  - consumerism
• 13:44
  - metrics. Everything
• 13:46
  - has to be relatable.
• 13:47
  - And on the side of looking at data
• 13:50
  - analytics,
• 13:51
  - we
• 13:53
  - we have so much knowledge. We have so
• 13:54
  - much data.
• 13:55
  - We need to marry all those things. So
• 13:57
  - then it gives us a picture perfect
• 14:00
  - idea of really what that patient journey is
• 14:02
  - and what we can do from start to
• 14:04
  - finish, start to continuous
• 14:07
  - to,
• 14:07
  - ensure that every patient and family that comes
• 14:10
  - through our doors has a a very good
• 14:12
  - experience.
• 14:13
  - Yeah. And, you know, I know,
• 14:16
  - in the market you were in, which I
• 14:18
  - have also happened to live in,
• 14:20
  - as even the market that I used to
• 14:22
  - live in the city,
• 14:23
  - you know, patients can't get to us because
• 14:26
  - they're having a bad experience on their website
• 14:28
  - or calling a doctor's office. They'll... They can
• 14:31
  - go elsewhere. There are lots of competitors in
• 14:33
  - Westchester. There are lots of competitors in New
• 14:35
  - York City,
• 14:36
  - and, winning that game requires,
• 14:39
  - thought and strategy.
• 14:41
  - Absolutely.
• 14:42
  - And maybe, as
• 14:45
  - a a finish... Finishing question today,
• 14:47
  - can you just talk about the relationship of
• 14:49
  - patient experience and employee experience?
• 14:53
  - Oh my gosh. My favorite topics.
• 14:55
  - So it's tremendous.
• 14:56
  - And
• 14:58
  - and that's something that I
• 15:00
  - wholeheartedly believe in and promote and showcase it
• 15:03
  - each and every day.
• 15:04
  - You know, you you can't
• 15:06
  - you can't deliver exceptional patient family experience without
• 15:09
  - creating an environment where team members feel supported,
• 15:12
  - respected, and valued.
• 15:14
  - You know, taken... And I wanted to share
• 15:16
  - a couple of things that, I've taken in
• 15:18
  - my,
• 15:20
  - few, months here,
• 15:22
  - from from our different recognition program awards,
• 15:25
  - ceremonies that I've attended and through our patient
• 15:28
  - experience comments and,
• 15:29
  - talking to patients and families as well as
• 15:31
  - staff on the units.
• 15:33
  - You know, it's that nurse who recognizes that
• 15:35
  - a patient is frightened before surgery and takes
• 15:37
  - that extra moment to hold their hand. It's
• 15:40
  - that housekeeper who notices a patient family member
• 15:42
  - crying in the hallway
• 15:44
  - and stops to ask if there's someone that
• 15:46
  - they can call.
• 15:47
  - It's that transporter who recognizes that an elderly
• 15:50
  - patient is nervous and takes the time to
• 15:52
  - explain where they're going.
• 15:54
  - So all these interactions, they they may never
• 15:57
  - appear in a formal dashboard, but they can
• 15:59
  - mean everything to that patient and family. But
• 16:01
  - at the same time, Rick, we have to
• 16:04
  - recognize
• 16:05
  - that what we're asking of our workforce.
• 16:07
  - You know, we think about a nurse who
• 16:09
  - has been caring for complex patients for twelve
• 16:12
  - hours straight on his or her feet dealing
• 16:14
  - with staffing challenges.
• 16:15
  - You know,
• 16:17
  - If if that nurse is exhausted and overwhelmed,
• 16:20
  - it's tone deaf on us, and it's not
• 16:22
  - enough for leadership to say we need you
• 16:24
  - to smile more and improve your patient experience
• 16:26
  - scores. You know? We have to
• 16:28
  - ask what is getting in the way of
• 16:30
  - that nurse providing the care that they wanna
• 16:32
  - provide and what we can do as leaders
• 16:34
  - to help them.
• 16:35
  - So
• 16:37
  - we can ask our team members to make
• 16:40
  - our patients feel seen, heard, and valued if
• 16:42
  - our employees don't feel the same.
• 16:45
  - So ultimately, when we take care of the
• 16:46
  - people who care for our patients,
• 16:48
  - we create the conditions for safer, more compassionate,
• 16:51
  - and reliable care. Yeah. That's great. Thank you.
• 16:54
  - I mean,
• 16:56
  - again, one of the ways I think about
• 16:57
  - it is what you just described, all those
• 17:00
  - all those examples are discretionary effort. Right? It's
• 17:03
  - that extra minute to hear a question. It's
• 17:05
  - that extra second to notice someone in distress
• 17:08
  - Absolutely. Even during a very busy day.
• 17:11
  - That's what... That's really what differentiates.
• 17:13
  - People expect clinical care to be done well.
• 17:16
  - That's... We don't get credit for that on
• 17:19
  - patient experience surveys. It's that discretionary
• 17:21
  - effort
• 17:22
  - that is just so important in in nurturing
• 17:25
  - that to your point. Mhmm. I I don't
• 17:27
  - know about you. I haven't met many employees
• 17:28
  - who don't wanna do that. Exactly. It's just
• 17:32
  - sometimes
• 17:33
  - finding your way to be able to do
• 17:35
  - that is is not easy. Yes. Yes. But
• 17:38
  - I I feel everyone has it in their
• 17:39
  - heart. People wanna do it. People wanna do
• 17:42
  - good. And I think you do it 1%
• 17:44
  - at a time, and then you change the
• 17:46
  - whole culture. You create that culture of kindness,
• 17:48
  - that
• 17:49
  - culture of caring.
• 17:51
  - Well, Jasmine, I really appreciate you spending time
• 17:54
  - with me today on the podcast.
• 17:56
  - Thank you for sharing how you guys think
• 17:58
  - about this,
• 18:00
  - at, WMC Health Network.
• 18:03
  - Hopefully, some of the things you're... You've shared
• 18:05
  - today will help others with their own work.
• 18:07
  - Patient experience belongs to all of us. It's
• 18:09
  - really not proprietary, is it?
• 18:11
  - But, again, thanks for your time.
• 18:13
  - Thank you so much, Rick, and thank you
• 18:15
  - for your leadership and just so excited to
• 18:17
  - see where where we continue to go together.
• 18:22
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  - You need AI you can govern.
• 18:27
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• 18:52
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