Improving the Patient Experience at Nebraska Medicine
By Carla Snyder, Program Coordinator, Office of Health Professions Education and Jeremy Carr, Patient Experience Advisor Lead, Nebraska Medicine
An important strategic corporate goal for Nebraska Medicine was to improve patient experience survey scores for ambulatory care clinic visits. One strategy for attaining this goal was to make patients feel known. A best practice for doing so was using a personal greeting when summoning a patient from a clinic’s reception area to an exam room. Previously (and in keeping with typical health-care organizational cultures), staff members loudly announced patients’ names to a waiting room full of people, making them feel like they were not known.
Nebraska Medicine’s Patient Experience Team created a short, instructor-led training program to improve a patient’s first impressions of the care team when the patient presents for an office visit. To best utilize available time and accomplish training as expediently as possible, the training was delivered to clinic staff within regularly scheduled clinic staff meetings.
The ultimate goal of the training was to increase the percentage of “Very Good” responses to the question, “Clinic Likelihood to Recommend.”
Program Details
In researching the key drivers that most frequently result in a “Very Good” response to the “Clinic Likelihood to Recommend” question, it was discovered that the “Staff Worked Together to Care for You” question has the largest impact on this metric. This question, in turn, could be strongly influenced by patients’ first impressions formed from their reception in the clinic through waiting in the exam room for their medical provider.
Through using a tool called the skeptic’s lens, the Patient Experience Team recognized that using a personal greeting to help patients feel known was an opportunity to convey the staff’s friendliness and courtesy. This behavior also positively impacts patients’ perception of the staff working together to care for them.
The training had the following objectives:
- Raise staff awareness of their ability to create more enjoyable patient experiences, thereby increasing their engagement and enjoyment of their job for their own health.
- Explain how the use of a personal greeting conveys positive intent and helps patients feel known.
- Outline the procedure for front desk staff to sufficiently document the patient’s appearance within the Electronic Health Record (EHR) for rooming staff to identify the patient.
- Instruct rooming staff how to extend a personal greeting to a patient (i.e., greet patients by name and escort them to the exam room).
The initial training program was piloted in a smaller department that contained only 10 staff members and utilized patient photos taken during a clinic visit or during an inpatient stay as the method for identifying a patient. The patient photos became a significant barrier as they were frequently insufficient for staff to quickly and accurately identify a patient. Clinic staff brainstormed other ways to ensure accurate identification of patients for rooming staff who may not know the patient and are not physically present when the patient checks in with the medical receptionist at the front desk.
It was decided that the front desk staff would document a consistent, concise description of the patient in a particular field in the EHR. This information displays in the EHR and also prints out on the document the nurse or medical assistant uses when he or she goes into the reception area to retrieve patients and escort them to the exam room. Further refinement of this EHR documentation process found that using a physical clinic layout with numbered zones helped staff identify where patients were sitting in the reception area.
Dashboards for the clinic’s results of the patient experience survey questions about “Friendliness/Courtesy of Nurse/ Assistant” and “Courtesy of Registration Staff” are shared with the staff each month. The Patient Experience team also shared best practices from the pilot clinic with other clinics, encouraging them to begin implementing this behavior in their own area.
Based on early success with this project, personal greetings have become the expectation for rooming staff in all clinical departments, and the organization is working to hold staff accountable to perform this behavior. The manager and/or the Patient Experience staff routinely perform observations to verify that staff are utilizing this tool. If a staff member isn’t using the tool, a coaching session is held to determine if there are barriers that prevent him or her from using the tool or if there is a lack of understanding of his or her accountability for using the personal greeting.
Results
Organization-wide patient survey results for the metric, “Courtesy of Registration Staff,” moved from 77.6 percent in August 2018 (pre-training) to 79.9 percent in June 2019 (the end of our fiscal year). The metric, “Friendliness/Courtesy of Nurse/Assistant,” moved from 79.3 percent in August 2018 to 80.6 percent in June 2019.
The leadership team set a corporate strategic goal for fiscal year 2019 to move “Very Good” responses to “Clinic Likelihood to Recommend” from 81.9 percent to 82.8 percent. Nebraska Medicine attained a final year-end score of 83 percent.
How Panda Restaurant Group, Inc., Invests in Its People
By Jennifer Sun, Ph.D., Curriculum Development and Design Specialist, and Dominique Peña, System Administrator, Panda Restaurant Group, Inc.
Panda Restaurant Group, Inc.—the parent company of Panda Inn, Panda Express, and Hibachi-San—is dedicated to becoming a world leader in people development. We are the largest family owned and operated restaurant company in America with more than 40,000 associates. Our mission is to deliver exceptional Asian dining experiences by building an organization where people are inspired to better their lives.
In 2009, Panda Restaurant Group, Inc., consisted of 1,300 stores; 1,200 managers; and 57 annual new store openings. Today, we support more than 2,200 stores; 1,800 managers; and roughly 100 annual new stores. Our rapid expansion maintains a need for consistency and quality leadership.
Our company’s culture shapes the evolving leadership curriculum and inspires unique approaches to develop great operations. “Great Operations” is one of the key components of our company’s five core values that support our mission to inspire better lives. The ultimate goal is to support sustained business growth from 2,200 stores to 10,000 stores with solid, long-term leadership that will grow with our business.
In addition to being in the food business, we are in the people business. We are committed to caring for our Panda family, so they, in turn, can care for our guests. We invest in our people and continuously seek ways to elevate our competency-based curriculum and operation training, as well as inspire excellence and growth among our associates.
Great Operations (GO) Curriculum
The Great Operations (GO) Curriculum is the largest leadership program offered through University of Panda (UOP). It supports a shared vision, provides a consistent language, and establishes an operational baseline for performance standards. It was strategically designed to develop competencies through a blended approach of modalities that are immersive and interactive, such as instructor-led trainings, videos, e-learning, and on-the-job training (OJT) for all leadership roles. We supplement career roadmaps with tools, opportunities, and support that pave the way for associates to take ownership and be accountable for their learning.
Initially, the curriculum was designed to address our rapid growth with an emphasis on technical skills. Today, the curriculum is more holistic in providing a centralized and decentralized approach that addresses culture, mindset, and skill gaps. This program aligns with the business need for innovative solutions and solid leadership that support our commitment to people development.
The GO Curriculum inspires, energizes, and elevates participants to become sustainably productive leaders. We set up our associates for long-term success in their roles by requiring completion of in-store prerequisites that emphasize fundamental, operational, and leadership competencies. For example, this includes completion of field-based OJT and e-learning modules. When associates are well trained, they are equipped with the knowledge, skills, and abilities to deliver exceptional service to our guests.
The GO Curriculum delivers learning to each leadership role at introductory, foundational, and advanced levels. The main components then are categorized into a variety of relevant classes that focus on Mindset (view), Skillset (competence), and Toolset (system and processes). This “whole person” approach allows Panda leaders to apply the learning in all aspects of their lives.
Outcomes
The GO Curriculum has had a lasting impact on the business and laid the foundation for expansion. More than 10,000 associates in leadership roles have graduated from the program since its inception. Our leaders contributed to Panda’s growth from 1,300 stores in 2009 to 2,200 stores in 2019.
General Managers in Training (GMIT) who successfully complete their prerequisites are eligible to enroll in the first course series of the GO Curriculum. GMITs who meet the introductory class competencies then are given the opportunity to move forward in the process for GM promotion. Nearly 500 GMITs were promoted to GM in 2018.
Associates who continue in the course series are given the opportunity to elevate their store’s performance with a specific focus on team development and sales. We conduct a 28-day Challenge as one of our follow-ups where senior manager feedback and key performance indicators validate the participant’s ability to apply concepts and tools introduced on the job. The friendly competition motivates participants by recognizing the top performers with the highest impact on store sales.
Connecting with Co-Founders
Panda Restaurant Group, Inc., is fully invested in our people. Our companywide “No best, only better” mentality inspires opportunities for continuous elevation.
Panda is unique in that our co-founders, Andrew Cherng and Dr. Peggy Cherng, are actively involved in the evolution of our training programs, especially our GO Curriculum. Key stakeholders meet regularly to ensure the program continuously aligns with Panda’s strategic business goals and our co-founders’ vision for the program. Some of the classes within the GO Curriculum include “Moments” where our co-founders can personally share their insights, coach participants, and actively listen to associates. These candid interactions generate open dialogue and create genuine connections in the class. This level of engagement allows for true partnership with our co-founders and empowers associates with a stronger sense of belonging and gratitude for what it truly means to be part of the Panda family. Associates leave the class inspired to be leaders who create possibilities in their personal and professional lives.
