Latest / Becker’s Healthcare Podcast / Alpa Vyas, Senior Vice President and Chief Patient Experience and Operational Performance Officer at Stanford Health Care

Transcript

Alpa Vyas, Senior Vice President and Chief Patient Experience and Operational Performance Officer at Stanford Health Care · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where do they go
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  - to pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
• 0:45
  - visit beckershospitalreview.com
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  - and click on the events tab in the
• 0:49
  - upper right.
• 0:51
  - Well, hello, everyone. I'm Rick Evans, cochair of
• 0:54
  - the chief experience officer advisory board here at
• 0:57
  - Becker's HealthCare.
• 0:59
  - I've had the privilege of serving in the
• 1:01
  - Chief Experience Officer role at great hospitals like
• 1:04
  - New York Presbyterian and Mass General Hospital.
• 1:07
  - Chief Experience Officers, or CXOs as we like
• 1:10
  - to call them,
• 1:11
  - across the country play a pivotal role in
• 1:13
  - assuring that their organizations
• 1:15
  - understand the perceptions
• 1:17
  - and the real experience of patients, families, and
• 1:20
  - customers in their health systems.
• 1:22
  - And they assure that their organizations
• 1:24
  - have a defined
• 1:25
  - and robust strategy to continually improve that experience
• 1:29
  - with a goal of maintaining patient loyalty
• 1:32
  - and remaining competitive in their markets.
• 1:35
  - There is deep expertise
• 1:36
  - across the CXO community in American health care
• 1:40
  - and a body of knowledge about how to
• 1:42
  - truly understand and improve and continue
• 1:45
  - improve the patient and consumer experience.
• 1:47
  - Today, I'm joined by one of those innovative
• 1:50
  - and expert CXOs
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  - for a conversation about their work. So I'm
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  - joined today by Alpa Baez, the senior vice
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  - president,
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  - chief experience officer, and operational performance
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  - officer
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  - at Stanford Health Care. Alpa, I've been a
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  - fan of yours for a long time. I'm
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  - thrilled to be with you today. Thanks for
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  - joining us.
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  - Maybe you could begin by just introducing yourself
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  - a little more in your role. Thanks so
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  - much, Rick. And the pleasure is truly mine,
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  - and,
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  - I think the admiration and gratitude to our
• 2:20
  - CXO community,
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  - goes out from myself and to you as
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  - well. So thanks for
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  - having me, and, I'll share a little bit
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  - about,
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  - my role here at Stanford HealthCare. And I
• 2:33
  - know you shared my title, which can be
• 2:34
  - a little bit of a mouthful, but,
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  - it really has been, an amazing experience for,
• 2:40
  - my career. I've been with the organization for
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  - almost seventeen years now.
• 2:44
  - And my background and the the way I
• 2:47
  - came into Stanford HealthCare was actually through our
• 2:49
  - performance
• 2:50
  - improvement team. So I'm a performance improvement person
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  - by heart, but,
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  - over time and,
• 2:57
  - through some really unique experiences through Stanford University
• 3:00
  - and learning more about,
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  - human centered design,
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  - I, moved over to our patient experience team
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  - to really kind of connect
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  - the two elements of,
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  - thinking about improving on behalf of our patients
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  - and families
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  - and bringing, I think,
• 3:17
  - some of that,
• 3:18
  - richness around how do we use feedback from
• 3:21
  - patients to actually make those
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  - improvements. So I've actually been in my role
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  - for a little over ten years now, and
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  - it's been a fantastic,
• 3:30
  - ride. And,
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  - like many of us who live in the
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  - patient experience world, our our roles are a
• 3:35
  - little bit different from organization to organization. And
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  - so, for for my day to day work,
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  - I have a combination of both
• 3:43
  - operations as well as some of the programmatic,
• 3:47
  - elements of patient experience. So I oversee things
• 3:50
  - like our call centers,
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  - language access, our navigation teams,
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  - our nurse advice line, as well as maybe
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  - what's the more traditional patient experience functions like
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  - our,
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  - communications and behavior frameworks,
• 4:06
  - our analytics
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  - work, patient family advisors,
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  - but also kind of expanding into things like
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  - health education,
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  - retail, and,
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  - user research
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  - and design. So,
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  - a real mix of,
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  - combination of operational programmatic,
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  - components, but it really keeps the day,
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  - pretty exciting. And
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  - I would argue that I
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  - have sometimes the best seat in the house
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  - to be the voice of our patients and
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  - families in our,
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  - day to day work, throughout the health system.
• 4:39
  - That's fantastic. I mean, listening to what you're
• 4:42
  - working on, it reflects, as you said, a
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  - lot of variation in the CXO role across
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  - the country.
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  - But, you know, the fact that you've got
• 4:50
  - operations, I mean, I would add it. I
• 4:52
  - I had that in my own experience.
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  - It allows you to understand what it's like
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  - to make the trains run on time. Right?
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  - And so if you've got to do it
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  - yourself when you're trying to get others to
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  - work with you on patient experience, it it
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  - gives you that extra credibility because you know
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  - what it's really like
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  - to deliver,
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  - care on a day to day basis.
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  - Stanford is really lucky to have you.
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  - One of the things I followed with you
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  - and your team and found really interesting, and
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  - quite frankly,
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  - we've emulated it, in places where I've worked,
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  - you and your team have been especially innovative
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  - in finding ways to measure and improve the
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  - patient experience
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  - at your organization, sort of new ways of
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  - thinking about measurement beyond sort of the traditional
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  - HCAHPS that so many people know about. Can
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  - you share some of the ways that you've
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  - done that?
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  - Absolutely.
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  - And I'll give a lot of credit to
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  - the,
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  - service excellence,
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  - team, here at Stanford,
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  - who really took that work on, missy Smith
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  - Bentley, Josh Frost, and so many others, here
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  - at Stanford.
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  - And when I,
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  - took the role about ten years ago now
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  - or over ten years ago now, one of
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  - the first questions
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  - that I asked was, how are we using
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  - the data and the feedback that we're getting
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  - to help make improvements
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  - in the system? And as we started kind
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  - of exploring that question a little bit more,
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  - we started kind of running into, I think,
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  - some of the challenges around more traditional
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  - ways of getting patient feedback. And at the
• 6:20
  - time, over a decade ago,
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  - you know, a lot of the surveys were
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  - still paper based.
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  - The data was delayed.
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  - I I always use the technology.
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  - I can barely remember what I had for
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  - lunch yesterday. Forget what happened operationally or in
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  - the environment six weeks ago, when we sent
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  - out a survey.
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  - And it only captured a part of our
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  - population. And so
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  - I think the hardest part was really being
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  - able to put the insights in the hands
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  - of our frontline leaders,
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  - to help be be able to make those
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  - improvements. And, also, we kept asking the same
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  - questions over and over again. And so I
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  - think one of our kind of theories or
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  - hypothesis is we kind of started asking ourselves
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  - the more
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  - foundational question is, what's really important to patients,
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  - families, and the teams that are caring for
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  - them?
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  - Because the surveys often reflect what leadership might
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  - think is important. But I think really going
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  - to,
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  - the people who are interacting with the system
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  - and working in the system is really important.
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  - So,
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  - and being very lucky to be at a
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  - wonderful organization
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  - like Stanford,
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  - in our backyard, we have pretty much any
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  - type of expert we could think of. And
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  - I remember just kind of googling in our
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  - faculty directory,
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  - survey design expert. And, of course, we had
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  - one.
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  - And so we we started kind of just
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  - the exploratory process
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  - of what it would be like
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  - to actually create tools and methods by which
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  - we could
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  - really create a more real time dynamic,
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  - flexible,
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  - set of questions by which we could
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  - get that more,
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  - actionable feedback. And so it's been a several
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  - year journey, but really moving in that direction
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  - of,
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  - how do we quickly,
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  - get feedback from patients and turn it around
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  - into,
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  - the
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  - opportunities
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  - that our teams can work on.
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  - And I think that's made a real difference.
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  - One in,
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  - I think engaging
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  - our our leadership teams.
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  - Two, we're able to actually understand when interventions
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  - work or not because we have flexibility in
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  - adding questions,
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  - to our surveys, taking them
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  - out, and,
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  - we've shortened our surveys.
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  - So not the kind of 60
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  - or 50 question paper survey, but really shorter,
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  - more dynamic ones that change,
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  - over
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  - time. And while I think surveys are are
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  - really interesting,
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  - and good ways of getting feedback,
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  - we also,
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  - wanted to make sure that we were expanding
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  - our language access.
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  - So surveys and, you know, another six to
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  - eight languages was also super helpful, and we
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  - saw an increase in our response rate. But
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  - my other point around just getting feedback, and
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  - this is where I think the future is
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  - going, is not just about surveys,
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  - but really all the other channels by which
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  - we,
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  - collect and hear,
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  - feedback from our patients. So there's a little
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  - bit about our story and,
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  - just excited to keep going to see how
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  - we can continue to
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  - evolve and
• 9:33
  - innovate. I mean, you guys have been such
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  - leaders
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  - in really making
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  - the methods for getting patient feedback so much
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  - more dynamic
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  - and right sized to your point.
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  - You know, one of the things that killed
• 9:45
  - survey responses, I'm asking I'm answering 50 questions
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  - and I only experienced,
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  - you know, 10 of these, why why do
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  - I have to do this whole thing and
• 9:53
  - you just stop? Yeah. And response rates across
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  - the country have been declining on on some
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  - of those standard surveys year over year and
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  - you guys were really leading that. And as
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  - I said, many organizations are emulating what you
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  - and your team have done.
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  - So how have you you know, you talked
• 10:08
  - about these new ways that you're understanding the
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  - experience.
• 10:12
  - Can you, you know, share any examples of
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  - how you've used that sort of innovative
• 10:17
  - dynamic way to get feedback? Maybe some things
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  - you've learned that you wouldn't have learned otherwise
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  - and how you've used that to make,
• 10:25
  - make a difference for patients. Do you have
• 10:27
  - any, like, specific examples you could share with
• 10:29
  - us?
• 10:30
  - Yeah. Absolutely. And what I think, it really
• 10:33
  - helped us do was to actually focus,
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  - because the the
• 10:38
  - the challenge with kind of looking at patient
• 10:41
  - experience scores is, you know, they can they
• 10:43
  - change,
• 10:44
  - day to day, week to week, etcetera. But
• 10:45
  - how do we help the organization
• 10:47
  - kind of focus on the core?
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  - And,
• 10:50
  - because we were able to extend surveys kind
• 10:53
  - of, beyond our normal reach,
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  - When we looked at kind of the core
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  - themes and we started thinking about our five
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  - year,
• 11:01
  - plan, our annual plan, there really were kind
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  - of three,
• 11:06
  - I would say, core,
• 11:08
  - areas that,
• 11:09
  - were
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  - thematic across.
• 11:12
  - And it's not gonna be a surprise, but
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  - what we kind of learned about each one
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  - of them, I think, is is kind of
• 11:18
  - interesting.
• 11:19
  - One is access.
• 11:21
  - Access, access, access is,
• 11:23
  - I think, a challenge, especially for many academic
• 11:26
  - medical centers.
• 11:29
  - The second is communication.
• 11:31
  - And what we learned about communication is not
• 11:33
  - just kind of giving information. Right? Because I
• 11:37
  - think patients and families are,
• 11:39
  - inundated with information. But it was really trying
• 11:42
  - to understand
• 11:43
  - what information
• 11:45
  - at the right time in the right mode
• 11:47
  - and said or delivered by who.
• 11:50
  - And we're still getting insights on that and
• 11:52
  - really about,
• 11:54
  - how do we understand,
• 11:56
  - different,
• 11:58
  - processes
• 11:59
  - and kind of setting expectations
• 12:01
  - even with patients and families.
• 12:03
  - Certainly, as we're coming into winter surge, we're,
• 12:06
  - thinking about our past feedback that we've received
• 12:09
  - and, you know, how do we help manage
• 12:11
  - when we're in high volume, high capacity,
• 12:15
  - time. So really trying to hone in on
• 12:17
  - more specific details that perhaps wouldn't have shown
• 12:19
  - up,
• 12:20
  - in, more broader,
• 12:23
  - surveys.
• 12:24
  - And then the third element, that we're really
• 12:26
  - focusing on, again, not a surprise to most
• 12:28
  - people, but it's really in the details,
• 12:30
  - is coordination of care.
• 12:33
  - And,
• 12:34
  - it really highlighted to us,
• 12:37
  - and and my team hears me talk about
• 12:39
  - all this, about this all the time.
• 12:41
  - But the coordination
• 12:43
  - and that experience happens,
• 12:46
  - really in the in between spaces of care.
• 12:49
  - And that area,
• 12:51
  - really has to be treated
• 12:53
  - as its own experience. So when people leave
• 12:55
  - the four walls of our institution,
• 12:59
  - that experience,
• 13:00
  - is, I think,
• 13:02
  - if not as relevant, sometimes more relevant as
• 13:05
  - patients progress on their career,
• 13:08
  - excuse me, on their care journey because that's
• 13:11
  - where things can oftentimes kind of fall off
• 13:13
  - the rails. And so,
• 13:15
  - being able to understand a little bit more
• 13:18
  - from our newly designed surveys
• 13:20
  - in those kind of in between spaces, what
• 13:22
  - was really important to patients, helped us kind
• 13:24
  - of drive some of our, interventions,
• 13:28
  - more specifically,
• 13:30
  - for certain patient populations.
• 13:33
  - I I think I recall a conversation we
• 13:35
  - had where you discovered, for example,
• 13:38
  - you know, a big issue was just getting
• 13:40
  - prescriptions
• 13:40
  - refilled or medication questions.
• 13:43
  - Yes. And, again, that's not in any outpatient
• 13:45
  - survey, really.
• 13:47
  - Would you be able to talk a little
• 13:48
  - bit more about that?
• 13:50
  - Yes. And that's actually even outside of our
• 13:52
  - kind of survey,
• 13:54
  - design.
• 13:55
  - One of the things that we're continuing to
• 13:57
  - explore is, as I mentioned before, how do
• 14:00
  - we kinda use all of the even nonsurvey,
• 14:03
  - data to help us understand? So,
• 14:06
  - you know, in in
• 14:08
  - partnership with our, tech platform,
• 14:12
  - with Qualtrics,
• 14:13
  - we were able to do a couple of,
• 14:15
  - quick,
• 14:16
  - proofs of concepts, and we're continuing to kind
• 14:18
  - of evolve and and,
• 14:20
  - design.
• 14:22
  - We basically took some of our unstructured data.
• 14:25
  - So imagine, like, your MyChart messages,
• 14:28
  - your phone calls,
• 14:30
  - etcetera. And we were bay basically able to
• 14:33
  - do some,
• 14:34
  - deeper analytics. And the example,
• 14:37
  - Rick, that you shared in one of our
• 14:38
  - specialties,
• 14:39
  - we noticed that there were a couple of,
• 14:43
  - one, thematically, medications kept coming up.
• 14:46
  - Secondly, when we double clicked into it, there
• 14:49
  - were two issues that we were able to
• 14:51
  - identify.
• 14:51
  - One was,
• 14:53
  - we had many phone calls associated with refills
• 14:57
  - around a particular,
• 14:59
  - medication and medication process.
• 15:01
  - And then the second one was we had
• 15:03
  - patients,
• 15:04
  - calling in or messaging about the side effects
• 15:07
  - that they were experiencing about a particular medication.
• 15:10
  - And this was on the outpatient side. And,
• 15:14
  - to your point, in traditional surveys, we would
• 15:16
  - have never been able to pick that up.
• 15:18
  - But this was a pretty meaningful insight that
• 15:21
  - we were able to share, you know, with
• 15:23
  - our operational and clinical team to say, you
• 15:25
  - know, there there are things that we can
• 15:27
  - do to improve this,
• 15:29
  - and kinda reduce the churn,
• 15:31
  - that patients are experiencing in trying to get
• 15:34
  - their questions answered.
• 15:35
  - I I love this. And this was a
• 15:37
  - was an moment,
• 15:39
  - after you and I spoke about it. You
• 15:41
  - think about I mean, every phone call you
• 15:43
  - ever make to a call center, whether it's
• 15:45
  - the one that you run or the one
• 15:46
  - that I used to run,
• 15:48
  - what's the first thing the patient hears? This
• 15:49
  - will be recorded for quality, you know, assurance.
• 15:52
  - So we're not we're not pulling anything over
• 15:54
  - the the, you know, heads of our patients.
• 15:56
  - We're telling them we may listen. And now
• 15:58
  - we have this technology, and again, you you
• 16:00
  - and your team have lot have led the
• 16:01
  - way on this, where all of that can
• 16:03
  - be looked at and there's just a richness
• 16:06
  - of insight into the patient experience when you
• 16:10
  - take a look at that stuff. And, you
• 16:11
  - know, you mentioned it. There's all this friction
• 16:14
  - that we talk about friction during the experience,
• 16:16
  - but the before and after often become equally,
• 16:19
  - if not more challenging, and that's where we
• 16:21
  - can lose people to your point.
• 16:24
  - It's been really, really helpful to watch what
• 16:26
  - you've done and learn from it, so thank
• 16:28
  - you.
• 16:29
  - Maybe we can, end here as we get
• 16:31
  - toward the end of our time with just
• 16:32
  - a final question.
• 16:34
  - What advice and guidance
• 16:36
  - would you have for other organizations that wanna
• 16:39
  - go deeper
• 16:41
  - in understanding the experience and perspectives of their
• 16:43
  - patients and families based on all of the
• 16:44
  - things you've done? What advice would you give
• 16:46
  - to others? Because there might be people listening
• 16:48
  - out there and saying, well, that's Stanford. I'm
• 16:50
  - not I'm not Stanford. How can I do
• 16:52
  - something like this in my organization? What what
• 16:54
  - would you share with them?
• 16:56
  - No. That's a great question. And I think,
• 16:58
  - to your point, Rick, it doesn't have to
• 17:00
  - be,
• 17:01
  - you know, heavy investment in technology
• 17:04
  - or,
• 17:06
  - resourcing for that matter. I think there's some
• 17:09
  - kind of maybe, like, four or five things
• 17:11
  - that I might suggest for either new leaders
• 17:14
  - in the space or organizations
• 17:16
  - who are,
• 17:18
  - building new programs or just reenergizing,
• 17:21
  - programs.
• 17:22
  - I think the the number one thing that
• 17:23
  - I've learned, again, through my,
• 17:25
  - performance improvement and kind of design days is
• 17:28
  - talk to patients and families.
• 17:30
  - The only requirement there is a little bit
• 17:33
  - of time and maybe
• 17:34
  - a little bit of skill, and we can
• 17:36
  - do that through,
• 17:38
  - work like rounding.
• 17:39
  - As we're checking in with our teams, we
• 17:42
  - can check-in with patients.
• 17:44
  - And I find that asking very open ended
• 17:47
  - questions
• 17:47
  - and not leading the witness
• 17:49
  - actually creates a much richer dialogue.
• 17:52
  - And we, as leaders, then become in the
• 17:54
  - position of listening,
• 17:56
  - which I think is, sometimes the best ways
• 17:59
  - to,
• 18:00
  - get some of these unique kind of kernels
• 18:02
  - or nuggets.
• 18:03
  - So I think really going to the source
• 18:05
  - and talking to patients and families.
• 18:08
  - And then on the flip side, talking to
• 18:09
  - the teams
• 18:10
  - about what are some of their,
• 18:13
  - what are the unique things that they see
• 18:15
  - in the environment? Because I know in all
• 18:17
  - of our organizations, we have amazing people that
• 18:19
  - do really great work every single day.
• 18:22
  - And listening to how they approach patients, how
• 18:26
  - they,
• 18:27
  - think about
• 18:29
  - the experience and what they do every day
• 18:31
  - to kind of,
• 18:33
  - bring that kind of special sauce,
• 18:36
  - to what they do.
• 18:38
  - I think the the other thing is is
• 18:39
  - also to observe.
• 18:41
  - Sometimes if I am,
• 18:43
  - waiting in some of our communal spaces or
• 18:45
  - if I myself am waiting for an appointment,
• 18:49
  - just observing the conversations. What,
• 18:52
  - kind of I'll just call them hacks for
• 18:54
  - better things, do patients use to try to
• 18:57
  - help them navigate,
• 18:59
  - the system? And some of those observations
• 19:01
  - or kind of unique,
• 19:04
  - workarounds that patients are developing
• 19:06
  - are really insights for us as leaders to
• 19:09
  - think about and how can we either leverage,
• 19:12
  - that unique,
• 19:13
  - thing that they've discovered or help kind of
• 19:16
  - solve for it.
• 19:17
  - I think patient and, family advisory councils are
• 19:20
  - also,
• 19:21
  - a really great,
• 19:24
  - resource.
• 19:25
  - I think most organizations
• 19:27
  - have them, so continue to encourage
• 19:29
  - and lean on them. And then,
• 19:31
  - again, just because of my background and the
• 19:33
  - benefit that I've had in learning more about,
• 19:36
  - human centered design, I would say lean on
• 19:39
  - things like, user research.
• 19:42
  - And, again, it really is about just talking
• 19:44
  - to patients and families. And I think
• 19:47
  - in combination with our kind of more traditional
• 19:49
  - survey approaches,
• 19:51
  - these are ways to kind of round out
• 19:53
  - or give additional insights,
• 19:56
  - to the information
• 19:57
  - that we're collecting. But I think all of
• 19:59
  - these things can be done,
• 20:01
  - at an individual level or even at scale.
• 20:04
  - Yeah.
• 20:05
  - Yeah. Thank you for that.
• 20:07
  - And, you know, I I wonder if you'd
• 20:09
  - agree. It seems to me too that even
• 20:11
  - some of
• 20:12
  - the more advanced kind of listening,
• 20:14
  - with every passing,
• 20:16
  - you know, month and year, that does those
• 20:19
  - those services, those,
• 20:21
  - investments are are becoming more and more reasonable
• 20:23
  - for people. You know, the technology is improving,
• 20:25
  - so organizations might even be able to invest
• 20:28
  - in some of the technology that that is
• 20:30
  - needed to even go beyond the things you've
• 20:33
  - shared today.
• 20:35
  - I really appreciate this time, Alpa. You are
• 20:38
  - you and your organization
• 20:40
  - really are leading the way in so many
• 20:42
  - ways, and I hope that if people are
• 20:44
  - listening to this, they're getting some ideas for
• 20:46
  - ways they can go sort of just beyond
• 20:48
  - the basics,
• 20:49
  - of patient experience measurement, be creative,
• 20:53
  - get those insights that'll help us, again, meet
• 20:55
  - our patients and families' needs.
• 20:57
  - So thanks for joining me today and for
• 20:59
  - your expertise.
• 21:00
  - We're hoping that conversations like ours today can
• 21:03
  - not only help all health care organizations
• 21:06
  - do better by the patients that we serve,
• 21:09
  - but we also hope that these conversations will
• 21:11
  - help leaders across
• 21:13
  - industry, like, understand better how patient experience can
• 21:16
  - be measured and improved and why that investment
• 21:18
  - on the part of our organizations is
• 21:20
  - absolutely worthwhile and pays for itself.
• 21:23
  - When you when you put the, effort in,
• 21:25
  - you get the result.
• 21:27
  - So keep an eye, thanks again, Alpa, and
• 21:29
  - keep an eye on Becker's for more conversations
• 21:32
  - with chief experience officers coming up. Thank you,
• 21:35
  - Alpa, and thank you, everyone.
• 21:37
  - Thanks, Rick. Thanks, everyone.