Ohio University NRSE4580 Patient Experience Model of Customer Service Questions

Ohio University NRSE4580 Patient Experience Model of Customer Service Questions ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Ohio University NRSE4580 Patient Experience Model of Customer Service Questions For this discussion, you will use information from your assigned readings, the literature and leaders in your organization to answer the following: Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Describe your organization’s customer service/patient experience model. Include standards, measures, staff training, reward and recognition programs. If you are not currently part of an organization, interview a nursing colleague about their institution for this discussion. Discuss how well the customer service model works. Provide 2 examples illustrating the effectiveness of the model. If it is not effective, provide 2 examples illustrating the ineffectiveness of the model. Provide rationale for your answer. Describe the customer service model/patient experience on your unit or in your department. What is nursing’s role? What is the nurse manager’s involvement? Describe how customer satisfaction is measured on your unit? If customer satisfaction is high, how is it maintained? If it is low, what strategies are in place for improvement? Why is customer satisfaction now tied to reimbursement? Cite references. must contain minimum of two peer reviewed references , in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussion board posts. Textbooks: Diane Huber (2018) Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Chapters 14, 21, 22, 23, 24 gierlinger_et_al_2019_impact_of_a_patient_experience.pdf gierlinger_et_al_2019_impact_of_a_patient_experience.pdf chang_et_al_2016_clinical_nurse_preceptors_perception.pdf Case Study Journal of Patient Experience 1-5 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2374373519831079 journals.sagepub.com/home/jpx Impact of a Patient Experience Leadership Structure on Performance and Engagement Sven Gierlinger, BA1, Agnes Barden, DNP, RN, CPXP2, and Nicole Giammarinaro, MSN, RN, CPXP3 Abstract The patient experience leadership structure at Northwell Health is strategically championed by Culture Leaders, a novel role established to transform the organizational culture from “service excellence” to “patient experience.” This case report describes how the implementation of Culture Leader structure has aided in the improvement of organizational patient experience performance as well as how Culture Leaders remain highly engaged. Responsible for effectuating change by bridging the gap between local and organizational experience strategies, Culture Leader engages key stakeholders within the strategic pillars of culture, care delivery, hospitality, and accountability. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Keywords patient experience, leadership, engagement, accountability, culture leader Introduction Description In every organization, there are individuals who are culture influencers. Formal or informal leaders, they elicit followership and have the ability to make definitive impacts on their colleagues, processes, and organizational culture (1). Leaders effectuate change and their interventions impact outcomes (2). This case report focuses on how Northwell Health systematically implemented a patient experience leadership and accountability structure to drive cultural transformation. The Agency for Healthcare Research and Quality describes patient experience as “the range of interactions that patients have within the health-care system (3).” Patient experience remains a national steadfast priority due to the intrinsic and positive correlation with patient safety and clinical effectiveness(4). Northwell Health is a large, integrated health care organization comprised of 66 000þ caregivers, 23 hospitals, and 650þ medical practice locations, spanning geographically from Westchester to New York City and across Long Island. Due to the inherent growth of the organization by means of mergers and acquisitions, patient experience efforts were historically siloed, fragmented, and inconsistent, with much focus on reactive service recovery. There were pockets of excellence and areas of opportunity to achieve our mission of providing world-class, patient- and family-centered care. Northwell is continually growing and evolving. Consistent challenges include organizational complexity, geographic span, and diverse communities and workforce. In 2014, Northwell’s first Chief Experience Officer joined the organization bringing a unique and refreshed perspective given his hospitality industry experience at the Ritz Carlton Hotel Company. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions The Office of Patient & Customer Experience (OPCE) was soon thereafter created to standardize strategy, disseminate best practice, and advocate for customercentric standards. The OPCE team is comprised of healthcare professionals from various backgrounds coming together to create the overarching patient experience strategy. In 2014, the publically reported patient experience survey, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), the Northwell health 1 2 3 Northwell Health, New York, NY, USA Patient & Customer Experience, Northwell Health, New York, NY, USA Patient & Customer Experience Education & Research, Northwell Health, New York, NY, USA Corresponding Author: Nicole Giammarinaro, Northwell Health, 2000 Marcus Avenue, New Hyde Park, New York, NY 11042, USA. Email: [email protected] Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 Journal of Patient Experience Figure 1. Northwell health patient experience ecosystem. system ranked in the bottom quartile nationally, with individual hospitals ranging from top to bottom decile performance. During OPCE’s initial discovery phase, inconsistencies regarding resources, ownership, scope, and accountability related to patient experience at the local site and service line levels were uncovered. To address this fundamental gap, a novel role, Culture Leader, was created and integrated into the Northwell patient experience ecosystem and strategy (see Figure 1). At Northwell, our promise to patients, families, and customers is grounded in the Culture of C.A.R.E. framework that embodies concepts of Connectedness, Awareness, Respect and Empathy. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Our patient experience ecosystem operationalizes the Culture of C.A.R.E. through holistic programming. Creating Structure and Defining Attributes Aligned with OPCE and reporting directly to their site or service line executive director (ie, CEO), we currently have 63 Culture Leaders responsible for executing local patient and customer experience strategy by engaging key stakeholders around culture, care delivery, hospitality, and accountability. Culture Leaders are multifaceted local experts and change agents who serve on leadership committees, shared work teams, Six Sigma projects, and patient and family partnership councils in addition to leading their respective teams to effectuate local performance improvement and cultural transformation. Implementing and sustaining the Culture Leader structure required vision, leadership, strategy, structure, organizational readiness, and buy-in. Utilizing the tight–loose–tight leadership approach to effectuate attitude, information sharing, and impact, the cornerstone of the relationship between the corporate OPCE and site/service line Culture Leaders is mutual trust (5). The OPCE leadership set clear expectations and strategy (tight), empower Culture Leaders with the ability and freedom to translate those expectations to best be implemented into local culture (loose) but then holds all accountability for performance (tight). This approach gave homage and respect that each entity embraces a unique culture and history while at the same time creating consistency and responsibility. Transforming the organization from “service excellence” to “experience” required an elevated, dedicated leader. Culture Leaders embody a wide variety of skillsets, past experiences, and levels of expertise. Site and service line senior leadership hand-selected their Culture Leader with guidance and support by OPCE leadership. Selection criteria outlined essential attributes of passion for experience, managerial courage, critical thinking, and deep understanding of local Gierlinger et al culture. Culture Leaders come from diverse backgrounds including nursing, allied health, retail, hospitality, theater, administration, and business. Collectively, such varied backgrounds coming together with a shared mental model has resulted in true and honest dialogue. Divergence of complementary perspectives has fostering of a spirit of innovation and challenging the status quo. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Investing in Leadership Development With Culture Leaders identified, OPCE performed a baseline learning and development needs assessment. Results gave insight into the creation of a Culture Leader orientation and individualized development plans. Alongside structured education and development programming, Culture Leaders receive individual mentoring and coaching by the Vice President of Patient & Customer Experience and other OPCE team members. They attend stimulating and engaging monthly best practice sharing forums and actively participate on system-wide improvement shared work teams. Customized sessions throughout the year are provided for particular topics, including strategic planning, emotional intelligence, data and analytics, and performance improvement. To inspire Culture Leaders, OPCE team hosts an annual patient experience conference as well as Culture Leader Summit. Parallel to the implementation of Culture Leader onboarding, OPCE launched the cultural transformative large-scale education program, Culture of C.A.R.E. course. Cascading this 2-hour, experiential curriculum across the organization was the Culture Leader’s priority, and within 18 months, over 61 000 leaders, physicians, employees, and volunteers were educated. Culture Leaders and their team of Facilitators led local-level education after receiving robust training in a facilitation and presentation skills certification program. Culture Leaders were held accountable for deploying at their site/service line, sustainment strategies inclusive of new policy, Culture of C.A.R.E. education for new employees, behavioral competencies, weekly huddle communications cascade, and patient experience assessments. Results At Northwell, our brand is our promise to consumers, our employee promise is our promise to one another and Culture of C.A.R.E. is our promise to patients and families. We have seen positive results within all 3 of our promises since the implementation of the Culture Leader structure. Network of Culture Influencers We have successfully rebranded from North Shore—LIJ Health System to Northwell Health due to a comprehensive internal and external communication and marketing strategy. Culture Leaders supported and educated regarding the 3 Table 1. Northwell Health System Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Performance Improvements; Source: Press Ganey National Database (discharges 1/15/2015—11/30/2018). Ohio University NRSE4580 Patient Experience Model of Customer Service Questions HCAHPS Survey Domain Communication with nurses Communication with doctors Communication regarding medications Care transitions Responsiveness of hospital staff Discharge information Care transitions Rate the hospital 0-10 Hospital environment Change in Percentile Points, (January 1, 2015 to November 30, 2018) þ11 þ11 þ7 þ7 þ7 þ6 þ6 þ6 þ1 rebranding during Culture of C.A.R.E. courses. In addition to the current 63 Culture Leaders, OPCE has educated and certified over 550 Culture of C.A.R.E course faculty who facilitate the courses on an ongoing basis. This large body of patient experience leaders and champions are inspiring and role modeling customer-centric, empathetic care throughout our organization. Patient Experience Performance Between 2015 and 2016, the Culture Leader role was being established and is now an integral part of our organization, partnering with clinical and nonclinical stakeholders. As a result, within the past 4 years (January 1, 2015, to November 30, 2018, year to date), every HCAHPS domain systemwide saw improvement. The most significant HCAHPS domain increases have been within Communication with Doctors and Communication with Nurses, both with an increase of 11 percentile points (see Table 1). In 2017, on the ambulatory and medical practice level, 81 (16%) individual sites achieved the 90th percentile nationally for Press Ganey “Recommend the Practice”. According to publically reported data, Northwell system metrics outperform the New York State average in the following HCAHPS domains: Communication with Doctors, Communication with Nurses, Care Transitions and Rate the Hospital. Culture Leader Engagement Realizing the positive correlation between engagement and experience (6), our organization closely monitors employee engagement as one of the major contributing factors to patient experience performance. In 2018, Culture Leaders participated in the Northwell Health Employee Engagement Survey. The “engagement score” is a score from 1 to 5 regarding our employees’ commitment, satisfaction, and willingness to recommend our place to work (1 ¼ strongly disagree to 5 ¼ strongly agree). Ohio University NRSE4580 Patient Experience Model of Customer Service Questions The Culture Leader overall 4 Journal of Patient Experience Table 2. 2018 Employee Engagement Scores for Culture Leaders only; Source: Press Ganey Employee Engagement Survey Database; n ¼ 48). Survey Item Score Versus Northwell Results Versus National Health-Care Average I like the work I do. Patient safety is a priority in this entity. I feel comfortable raising concerns when I see something that may negatively affect patient care. I would recommend this entity to family and friends who need care. My job makes good use of my skills and abilities. I would recommend this entity as a good place to work. Northwell Health conducts business in an ethical manner. This entity provides high-quality care and service. I would like to be working at this entity three years from now. This entity treats employees with respect. I get the training I need to do a good job. My job responsibilities are clear. Overall, I am a satisfied employee. I get the tools and resources to provide the best care/service. Overall Engagement Score 4.83 4.79 4.72 þ0.32 þ0.34 þ0.44 þ0.36 þ0.41 þ0.49 4.68 4.65 4.63 4.63 4.60 4.58 4.58 4.57 4.54 4.54 4.44 4.60 þ0.32 þ0.42 þ0.38 þ0.42 þ0.29 þ0.25 þ0.48 þ0.40 þ0.19 þ0.35 þ0.42 þ0.32 þ0.42 þ0.52 þ0.61 þ0.51 þ0.34 þ0.42 þ0.64 þ0.58 þ0.33 þ0.52 þ0.50 þ0.48 engagement score was 4.60, þ0.32 versus Northwell average and þ0.48 versus national average; see Table 2. This Tier 1 score places the Culture Leader cohort at the 99th percentile nationally for engagement. Between 2014 and 2018, employee engagement across Northwell Health has improved 40 percentile points. Engagement scores for particular patient experience and service-related questions also saw improvement. Within the past 4 years, the score for question, “The person I report to serves as a good role model for delivering high levels of service,” increased 0.37 points and question, “This entity provides high-quality care and service,” has increased 0.15 points. Lessons Learned Patient experience is an art and science, and thus, our newly defined and empowered Culture Leader group needed to be prepared and supported to execute complex strategies. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Investing time, education, and development in Culture Leaders was essential. As a result, Culture Leaders are revered throughout the organization because they represent the “voice” of our patients and families. Having Culture Leaders in non-patient facing/clinical subsets was also another key driver. There are Culture Leaders from areas of the organization including Finance, Foundation, Information Technology, Procurement, Human Resources, and our innovative Research Institute. Engaging these nonclinical, operational teams around experience helped drive our promises and further engage our people to professional and moral purpose. Conclusions Our organization took a pragmatic approach to defining and establishing a patient experience structure. Culture Leaders are part of the C-Suite, enabling patient experience to have a powerful and persuasive presence during strategic planning, decision-making, and innovative programming. Their commitment, dedication, and passion has had a powerful ripple effect and in turn, they role model, inspire, and lead their teams to excellence. As a result, we have seen significant improvement in patient experience scores and are proud they remain highly engaged in this important work and the organization. Since the Culture Leader role is constantly evolving, we look forward to seeing the future great impacts they will have on our community. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article. References 1. Uhl-Bien M, Riggio RE, Lowe KB, Casten MK. Followership theory: a review and research agenda. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions The Leadership Quarterly. 2014;25:83-104. 2. Avolio BJ, Reichard R, Hannah S, Walumbwad F, Chan A. A meta-analytic review of leadership impact research: experimental and quasi-experimental studies. The Leadership Quarterly. 2009;20:764-84. 3. The Agency for Healthcare Research and Quality. What is patient experience?; 2016. https://www.ahrq.gov/cahps/ about-cahps/patient-experience/index.html. Accessed June 7, 2018. Gierlinger et al 4. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3:e001570. 5. Sagie A, Zaidman N, Amichai-Hamburger Y, Te-eni D, Schwartz D. An empirical assessment of the loose–tight leadership model: quantitative and qualitative analyses. J Organ Behav. 2002;23:303-20. 6. Lowe G. How employee engagement matters for hospital performance. Healthcare Quarterly. 2012;15:29-39. Author Biographies Sven Gierlinger was a previous luxury Hotel Executive, brings a unique perspective to the patient experience dialogue. However, it was his personal patient experience spending three months in 5 hospitals that motivates him to challenge the status quo in healthcare. As Chief Experience Officer for Northwell Health, Mr. Gierlinger is driving culture transformation grounded in quality, engagement and experience. Agnes Barden is the vice president of Patient & Customer Experience at Northwell Health. With over 30 years of clinical and administrative experience, Dr. Barden is a Certified Patient Experience Professional who advocates for compassionate care and patient-centeredness. Nicole Giammarinaro is the director of Education and Research for the Northwell Health Office of Patient and Customer Experience. Ms. Giammarinaro is a Certified Patient Experience Professional who is passionate about creating humanistic educational offerings and research studies. Case Study Journal of Patient Experience 1-5 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2374373519831079 journals.sagepub.com/home/jpx Impact of a Patient Experience Leadership Structure on Performance and Engagement Sven Gierlinger, BA1, Agnes Barden, DNP, RN, CPXP2, and Nicole Giammarinaro, MSN, RN, CPXP3 Abstract The patient experience leadership structure at Northwell Health is strategically championed by Culture Leaders, a novel role established to transform the organizational culture from “service excellence” to “patient experience.” Ohio University NRSE4580 Patient Experience Model of Customer Service Questions This case report describes how the implementation of Culture Leader structure has aided in the improvement of organizational patient experience performance as well as how Culture Leaders remain highly engaged. Responsible for effectuating change by bridging the gap between local and organizational experience strategies, Culture Leader engages key stakeholders within the strategic pillars of culture, care delivery, hospitality, and accountability. Keywords patient experience, leadership, engagement, accountability, culture leader Introduction Description In every organization, there are individuals who are culture influencers. Formal or informal leaders, they elicit followership and have the ability to make definitive impacts on their colleagues, processes, and organizational culture (1). Leaders effectuate change and their interventions impact outcomes (2). This case report focuses on how Northwell Health systematically implemented a patient experience leadership and accountability structure to drive cultural transformation. The Agency for Healthcare Research and Quality describes patient experience as “the range of interactions that patients have within the health-care system (3).” Patient experience remains a national steadfast priority due to the intrinsic and positive correlation with patient safety and clinical effectiveness(4). Northwell Health is a large, integrated health care organization comprised of 66 000þ … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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Ohio University NRSE4580 Patient Experience Model of Customer Service Questions

Ohio University NRSE4580 Patient Experience Model of Customer Service Questions ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Ohio University NRSE4580 Patient Experience Model of Customer Service Questions For this discussion, you will use information from your assigned readings, the literature and leaders in your organization to answer the following: Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Describe your organization’s customer service/patient experience model. Include standards, measures, staff training, reward and recognition programs. If you are not currently part of an organization, interview a nursing colleague about their institution for this discussion. Discuss how well the customer service model works. Provide 2 examples illustrating the effectiveness of the model. If it is not effective, provide 2 examples illustrating the ineffectiveness of the model. Provide rationale for your answer. Describe the customer service model/patient experience on your unit or in your department. What is nursing’s role? What is the nurse manager’s involvement? Describe how customer satisfaction is measured on your unit? If customer satisfaction is high, how is it maintained? If it is low, what strategies are in place for improvement? Why is customer satisfaction now tied to reimbursement? Cite references. must contain minimum of two peer reviewed references , in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussion board posts. Textbooks: Diane Huber (2018) Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Chapters 14, 21, 22, 23, 24 gierlinger_et_al_2019_impact_of_a_patient_experience.pdf gierlinger_et_al_2019_impact_of_a_patient_experience.pdf chang_et_al_2016_clinical_nurse_preceptors_perception.pdf Case Study Journal of Patient Experience 1-5 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2374373519831079 journals.sagepub.com/home/jpx Impact of a Patient Experience Leadership Structure on Performance and Engagement Sven Gierlinger, BA1, Agnes Barden, DNP, RN, CPXP2, and Nicole Giammarinaro, MSN, RN, CPXP3 Abstract The patient experience leadership structure at Northwell Health is strategically championed by Culture Leaders, a novel role established to transform the organizational culture from “service excellence” to “patient experience.” This case report describes how the implementation of Culture Leader structure has aided in the improvement of organizational patient experience performance as well as how Culture Leaders remain highly engaged. Responsible for effectuating change by bridging the gap between local and organizational experience strategies, Culture Leader engages key stakeholders within the strategic pillars of culture, care delivery, hospitality, and accountability. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Keywords patient experience, leadership, engagement, accountability, culture leader Introduction Description In every organization, there are individuals who are culture influencers. Formal or informal leaders, they elicit followership and have the ability to make definitive impacts on their colleagues, processes, and organizational culture (1). Leaders effectuate change and their interventions impact outcomes (2). This case report focuses on how Northwell Health systematically implemented a patient experience leadership and accountability structure to drive cultural transformation. The Agency for Healthcare Research and Quality describes patient experience as “the range of interactions that patients have within the health-care system (3).” Patient experience remains a national steadfast priority due to the intrinsic and positive correlation with patient safety and clinical effectiveness(4). Northwell Health is a large, integrated health care organization comprised of 66 000þ caregivers, 23 hospitals, and 650þ medical practice locations, spanning geographically from Westchester to New York City and across Long Island. Due to the inherent growth of the organization by means of mergers and acquisitions, patient experience efforts were historically siloed, fragmented, and inconsistent, with much focus on reactive service recovery. There were pockets of excellence and areas of opportunity to achieve our mission of providing world-class, patient- and family-centered care. Northwell is continually growing and evolving. Consistent challenges include organizational complexity, geographic span, and diverse communities and workforce. In 2014, Northwell’s first Chief Experience Officer joined the organization bringing a unique and refreshed perspective given his hospitality industry experience at the Ritz Carlton Hotel Company. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions The Office of Patient & Customer Experience (OPCE) was soon thereafter created to standardize strategy, disseminate best practice, and advocate for customercentric standards. The OPCE team is comprised of healthcare professionals from various backgrounds coming together to create the overarching patient experience strategy. In 2014, the publically reported patient experience survey, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), the Northwell health 1 2 3 Northwell Health, New York, NY, USA Patient & Customer Experience, Northwell Health, New York, NY, USA Patient & Customer Experience Education & Research, Northwell Health, New York, NY, USA Corresponding Author: Nicole Giammarinaro, Northwell Health, 2000 Marcus Avenue, New Hyde Park, New York, NY 11042, USA. Email: [email protected] Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 Journal of Patient Experience Figure 1. Northwell health patient experience ecosystem. system ranked in the bottom quartile nationally, with individual hospitals ranging from top to bottom decile performance. During OPCE’s initial discovery phase, inconsistencies regarding resources, ownership, scope, and accountability related to patient experience at the local site and service line levels were uncovered. To address this fundamental gap, a novel role, Culture Leader, was created and integrated into the Northwell patient experience ecosystem and strategy (see Figure 1). At Northwell, our promise to patients, families, and customers is grounded in the Culture of C.A.R.E. framework that embodies concepts of Connectedness, Awareness, Respect and Empathy. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Our patient experience ecosystem operationalizes the Culture of C.A.R.E. through holistic programming. Creating Structure and Defining Attributes Aligned with OPCE and reporting directly to their site or service line executive director (ie, CEO), we currently have 63 Culture Leaders responsible for executing local patient and customer experience strategy by engaging key stakeholders around culture, care delivery, hospitality, and accountability. Culture Leaders are multifaceted local experts and change agents who serve on leadership committees, shared work teams, Six Sigma projects, and patient and family partnership councils in addition to leading their respective teams to effectuate local performance improvement and cultural transformation. Implementing and sustaining the Culture Leader structure required vision, leadership, strategy, structure, organizational readiness, and buy-in. Utilizing the tight–loose–tight leadership approach to effectuate attitude, information sharing, and impact, the cornerstone of the relationship between the corporate OPCE and site/service line Culture Leaders is mutual trust (5). The OPCE leadership set clear expectations and strategy (tight), empower Culture Leaders with the ability and freedom to translate those expectations to best be implemented into local culture (loose) but then holds all accountability for performance (tight). This approach gave homage and respect that each entity embraces a unique culture and history while at the same time creating consistency and responsibility. Transforming the organization from “service excellence” to “experience” required an elevated, dedicated leader. Culture Leaders embody a wide variety of skillsets, past experiences, and levels of expertise. Site and service line senior leadership hand-selected their Culture Leader with guidance and support by OPCE leadership. Selection criteria outlined essential attributes of passion for experience, managerial courage, critical thinking, and deep understanding of local Gierlinger et al culture. Culture Leaders come from diverse backgrounds including nursing, allied health, retail, hospitality, theater, administration, and business. Collectively, such varied backgrounds coming together with a shared mental model has resulted in true and honest dialogue. Divergence of complementary perspectives has fostering of a spirit of innovation and challenging the status quo. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Investing in Leadership Development With Culture Leaders identified, OPCE performed a baseline learning and development needs assessment. Results gave insight into the creation of a Culture Leader orientation and individualized development plans. Alongside structured education and development programming, Culture Leaders receive individual mentoring and coaching by the Vice President of Patient & Customer Experience and other OPCE team members. They attend stimulating and engaging monthly best practice sharing forums and actively participate on system-wide improvement shared work teams. Customized sessions throughout the year are provided for particular topics, including strategic planning, emotional intelligence, data and analytics, and performance improvement. To inspire Culture Leaders, OPCE team hosts an annual patient experience conference as well as Culture Leader Summit. Parallel to the implementation of Culture Leader onboarding, OPCE launched the cultural transformative large-scale education program, Culture of C.A.R.E. course. Cascading this 2-hour, experiential curriculum across the organization was the Culture Leader’s priority, and within 18 months, over 61 000 leaders, physicians, employees, and volunteers were educated. Culture Leaders and their team of Facilitators led local-level education after receiving robust training in a facilitation and presentation skills certification program. Culture Leaders were held accountable for deploying at their site/service line, sustainment strategies inclusive of new policy, Culture of C.A.R.E. education for new employees, behavioral competencies, weekly huddle communications cascade, and patient experience assessments. Results At Northwell, our brand is our promise to consumers, our employee promise is our promise to one another and Culture of C.A.R.E. is our promise to patients and families. We have seen positive results within all 3 of our promises since the implementation of the Culture Leader structure. Network of Culture Influencers We have successfully rebranded from North Shore—LIJ Health System to Northwell Health due to a comprehensive internal and external communication and marketing strategy. Culture Leaders supported and educated regarding the 3 Table 1. Northwell Health System Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Performance Improvements; Source: Press Ganey National Database (discharges 1/15/2015—11/30/2018). Ohio University NRSE4580 Patient Experience Model of Customer Service Questions HCAHPS Survey Domain Communication with nurses Communication with doctors Communication regarding medications Care transitions Responsiveness of hospital staff Discharge information Care transitions Rate the hospital 0-10 Hospital environment Change in Percentile Points, (January 1, 2015 to November 30, 2018) þ11 þ11 þ7 þ7 þ7 þ6 þ6 þ6 þ1 rebranding during Culture of C.A.R.E. courses. In addition to the current 63 Culture Leaders, OPCE has educated and certified over 550 Culture of C.A.R.E course faculty who facilitate the courses on an ongoing basis. This large body of patient experience leaders and champions are inspiring and role modeling customer-centric, empathetic care throughout our organization. Patient Experience Performance Between 2015 and 2016, the Culture Leader role was being established and is now an integral part of our organization, partnering with clinical and nonclinical stakeholders. As a result, within the past 4 years (January 1, 2015, to November 30, 2018, year to date), every HCAHPS domain systemwide saw improvement. The most significant HCAHPS domain increases have been within Communication with Doctors and Communication with Nurses, both with an increase of 11 percentile points (see Table 1). In 2017, on the ambulatory and medical practice level, 81 (16%) individual sites achieved the 90th percentile nationally for Press Ganey “Recommend the Practice”. According to publically reported data, Northwell system metrics outperform the New York State average in the following HCAHPS domains: Communication with Doctors, Communication with Nurses, Care Transitions and Rate the Hospital. Culture Leader Engagement Realizing the positive correlation between engagement and experience (6), our organization closely monitors employee engagement as one of the major contributing factors to patient experience performance. In 2018, Culture Leaders participated in the Northwell Health Employee Engagement Survey. The “engagement score” is a score from 1 to 5 regarding our employees’ commitment, satisfaction, and willingness to recommend our place to work (1 ¼ strongly disagree to 5 ¼ strongly agree). Ohio University NRSE4580 Patient Experience Model of Customer Service Questions The Culture Leader overall 4 Journal of Patient Experience Table 2. 2018 Employee Engagement Scores for Culture Leaders only; Source: Press Ganey Employee Engagement Survey Database; n ¼ 48). Survey Item Score Versus Northwell Results Versus National Health-Care Average I like the work I do. Patient safety is a priority in this entity. I feel comfortable raising concerns when I see something that may negatively affect patient care. I would recommend this entity to family and friends who need care. My job makes good use of my skills and abilities. I would recommend this entity as a good place to work. Northwell Health conducts business in an ethical manner. This entity provides high-quality care and service. I would like to be working at this entity three years from now. This entity treats employees with respect. I get the training I need to do a good job. My job responsibilities are clear. Overall, I am a satisfied employee. I get the tools and resources to provide the best care/service. Overall Engagement Score 4.83 4.79 4.72 þ0.32 þ0.34 þ0.44 þ0.36 þ0.41 þ0.49 4.68 4.65 4.63 4.63 4.60 4.58 4.58 4.57 4.54 4.54 4.44 4.60 þ0.32 þ0.42 þ0.38 þ0.42 þ0.29 þ0.25 þ0.48 þ0.40 þ0.19 þ0.35 þ0.42 þ0.32 þ0.42 þ0.52 þ0.61 þ0.51 þ0.34 þ0.42 þ0.64 þ0.58 þ0.33 þ0.52 þ0.50 þ0.48 engagement score was 4.60, þ0.32 versus Northwell average and þ0.48 versus national average; see Table 2. This Tier 1 score places the Culture Leader cohort at the 99th percentile nationally for engagement. Between 2014 and 2018, employee engagement across Northwell Health has improved 40 percentile points. Engagement scores for particular patient experience and service-related questions also saw improvement. Within the past 4 years, the score for question, “The person I report to serves as a good role model for delivering high levels of service,” increased 0.37 points and question, “This entity provides high-quality care and service,” has increased 0.15 points. Lessons Learned Patient experience is an art and science, and thus, our newly defined and empowered Culture Leader group needed to be prepared and supported to execute complex strategies. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions Investing time, education, and development in Culture Leaders was essential. As a result, Culture Leaders are revered throughout the organization because they represent the “voice” of our patients and families. Having Culture Leaders in non-patient facing/clinical subsets was also another key driver. There are Culture Leaders from areas of the organization including Finance, Foundation, Information Technology, Procurement, Human Resources, and our innovative Research Institute. Engaging these nonclinical, operational teams around experience helped drive our promises and further engage our people to professional and moral purpose. Conclusions Our organization took a pragmatic approach to defining and establishing a patient experience structure. Culture Leaders are part of the C-Suite, enabling patient experience to have a powerful and persuasive presence during strategic planning, decision-making, and innovative programming. Their commitment, dedication, and passion has had a powerful ripple effect and in turn, they role model, inspire, and lead their teams to excellence. As a result, we have seen significant improvement in patient experience scores and are proud they remain highly engaged in this important work and the organization. Since the Culture Leader role is constantly evolving, we look forward to seeing the future great impacts they will have on our community. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article. References 1. Uhl-Bien M, Riggio RE, Lowe KB, Casten MK. Followership theory: a review and research agenda. Ohio University NRSE4580 Patient Experience Model of Customer Service Questions The Leadership Quarterly. 2014;25:83-104. 2. Avolio BJ, Reichard R, Hannah S, Walumbwad F, Chan A. A meta-analytic review of leadership impact research: experimental and quasi-experimental studies. The Leadership Quarterly. 2009;20:764-84. 3. The Agency for Healthcare Research and Quality. What is patient experience?; 2016. https://www.ahrq.gov/cahps/ about-cahps/patient-experience/index.html. Accessed June 7, 2018. Gierlinger et al 4. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3:e001570. 5. Sagie A, Zaidman N, Amichai-Hamburger Y, Te-eni D, Schwartz D. An empirical assessment of the loose–tight leadership model: quantitative and qualitative analyses. J Organ Behav. 2002;23:303-20. 6. Lowe G. How employee engagement matters for hospital performance. Healthcare Quarterly. 2012;15:29-39. Author Biographies Sven Gierlinger was a previous luxury Hotel Executive, brings a unique perspective to the patient experience dialogue. However, it was his personal patient experience spending three months in 5 hospitals that motivates him to challenge the status quo in healthcare. As Chief Experience Officer for Northwell Health, Mr. Gierlinger is driving culture transformation grounded in quality, engagement and experience. Agnes Barden is the vice president of Patient & Customer Experience at Northwell Health. With over 30 years of clinical and administrative experience, Dr. Barden is a Certified Patient Experience Professional who advocates for compassionate care and patient-centeredness. Nicole Giammarinaro is the director of Education and Research for the Northwell Health Office of Patient and Customer Experience. Ms. Giammarinaro is a Certified Patient Experience Professional who is passionate about creating humanistic educational offerings and research studies. Case Study Journal of Patient Experience 1-5 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2374373519831079 journals.sagepub.com/home/jpx Impact of a Patient Experience Leadership Structure on Performance and Engagement Sven Gierlinger, BA1, Agnes Barden, DNP, RN, CPXP2, and Nicole Giammarinaro, MSN, RN, CPXP3 Abstract The patient experience leadership structure at Northwell Health is strategically championed by Culture Leaders, a novel role established to transform the organizational culture from “service excellence” to “patient experience.” Ohio University NRSE4580 Patient Experience Model of Customer Service Questions This case report describes how the implementation of Culture Leader structure has aided in the improvement of organizational patient experience performance as well as how Culture Leaders remain highly engaged. Responsible for effectuating change by bridging the gap between local and organizational experience strategies, Culture Leader engages key stakeholders within the strategic pillars of culture, care delivery, hospitality, and accountability. Keywords patient experience, leadership, engagement, accountability, culture leader Introduction Description In every organization, there are individuals who are culture influencers. Formal or informal leaders, they elicit followership and have the ability to make definitive impacts on their colleagues, processes, and organizational culture (1). Leaders effectuate change and their interventions impact outcomes (2). This case report focuses on how Northwell Health systematically implemented a patient experience leadership and accountability structure to drive cultural transformation. The Agency for Healthcare Research and Quality describes patient experience as “the range of interactions that patients have within the health-care system (3).” Patient experience remains a national steadfast priority due to the intrinsic and positive correlation with patient safety and clinical effectiveness(4). Northwell Health is a large, integrated health care organization comprised of 66 000þ … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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