How patient experience data prompted patient engagement improvements

Ensuring an optimal patient experience might be a personal and professional passion for Shanna McCann, a senior experience coach at Children’s Minnesota Pediatric Hospital, but she knows making those improvements relies on cold, hard data.

Indeed, it was a scrupulous review of patient experience metrics that led McCann and her team of “kid experts” at the free-standing health system to zero in on a crucial aspect of healthcare delivery: patient education.

“When we saw an opportunity within the infectious disease clinic on the metric ‘got enough information,’ we knew that had an opportunity to improve,” McCann told PatientEngagementHIT on a phone call.

Getting enough information, whether it be about a new diagnosis or a change in care management plan, is essential to the overall patient experience of care. Patient education supercharges patient engagement, as patients who know about their diagnoses and care management are better able to take part in the journey to well-being.

Data has linked patient education materials to better chronic disease management, while lower patient health literacy levels have been tied to poor outcomes like hospital admission and mortality rates.

But delivering a high level of patient education can be challenging. Data has shown that patients are excited to look at patient education materials, but few healthcare organizations have those educational resources.

And infectious disease settings like the one McCann and her team were working with have their own unique obstacles.

“These are sometimes long appointments. They are an hour long with one physician,” McCann explained. “They're taking an extensive history but also sharing education along the way. Naturally, not everybody learns through verbal intake; some folks need to write it down, and some people need to see a visual. That is a challenge.”

When pediatric patients and their guardians must absorb a significant amount of information during a lengthy appointment, it’s hard to retain everything, McCann added. In fact, studies have shown that patients forget up to 50 percent of what they learn during a medical appointment.

And none of that is to mention the ongoing nature of infectious disease diagnoses, McCann stated.

“In some cases, during those first couple of appointments, we don't have a definitive diagnosis,” she said. “There is that sense of uncertainty when a family leaves that we know what we're going to do immediately, but we still don't have the answer.”

That lengthy diagnosis process can make patient education feel disjointed, and it heightens the need for providers to explicitly lay out expectations for patients and their families.

So it was no surprise when McCann and her team reviewed their patient experience metrics at Children’s Minnesota’s infectious disease clinic, which they gather using software from NRC Health, and found some missteps with the “got enough information” metric.

“We first asked, how do we know enough is enough? We started observing families and observing our process with the medical director and team, and they realized that we didn't have a standard patient education for the top three diagnoses that they see in the clinic,” McCann noted.

Developing those patient education tools was top of the to-do list, and those eventually became available to patients using Children’s Minnesota’s institutional handout system, including as a part of clinic discharge paperwork and within the EHR. All said, the organization increased its infectious disease patient education materials by 75 percent.

Increasing the emphasis on patient education was also a significant change management project, as it asked healthcare providers, who already confront high administrative burden, to rethink their patient engagement strategies at the point of care, McCann said. That made Children’s Minnesota’s training sessions on patient education challenging.

The first step to overcoming potential power hierarchies between patient experience teams and provider teams is centering the patient and the data.

“First of all, when we come together as a clinician group and an outsider from patient experience, we can really center and agree that we're here to put kids first, and we use our data as our true north,” McCann stressed. “This is one way that we gain buy-in from the provider team is we're looking at our data.”

“But when we come together, there is a little bit of tension and I like to approach that with curiosity,” she acknowledged.

Again, McCann relies on the patient experience data.

Of course, the patient experience team comes to any meeting with the provider team with a few resources about how the organization can make improvements. But to spark the discussion, McCann likes to ask the provider team how they engage or educate patients.

“And we knew looking at our data who our top performers were who were always getting full marks from patients and families,” McCann recalled. “And we knew that if they didn't speak up, we would ask them what they were going to do. So we had a little game plan, and I had some materials around teach-back that I was prepared to present if we were asked by the provider team for suggestions.”

But those top-performing clinicians did speak up, and the training session blossomed into a full discussion about how clinicians can rethink their patient engagement strategies.

“You kind of get stuck in your patterns,” McCann pointed out. “It was a great reset to hear from their peers more than from me, how the teach-back method can be really impactful in helping families understand, comprehend, and digest all of that information.”

By using more standardized patient education materials, plus stressing the importance of patient education strategies like patient teach-back, Children’s Minnesota was able to move the needle on its patient experience measures.

That notably shook out to a 2.9 percent increase in overall patient experience scores, correlated to a boost in parents and families receiving enough information about their children’s health and treatment.