- This is the second of a three-part series centered on the steps required to make a patient engagement initiative successful. The first article, Three Steps to Jumpstart Effective Patient Engagement Initiatives, focused on jumpstarting an initiative. The final article will focus on the positive outcomes for which you can aim.
Once a comprehensive patient engagement initiative is agreed upon, the next step is to focus on an effective implementation plan.
Many tech-based implementation phases have an explicit beginning and end. The project team executes a project plan, installs some new software, and — voilà — problem solved. But patient engagement initiatives require an ongoing commitment.
As noted in the first installment of this three-part series, an effective patient engagement strategy depends on fundamental changes in organizational behavior and continual process improvements. As an organization’s needs evolve, the solution must be optimized as new staff and patients come on board, technology changes, the regulatory environment evolves, and so forth.
A patient engagement strategy must align with the overall organizational/business strategy. An organization’s staff, their skills, and the messages that surround a patient engagement system will contribute to its success. Change must occur across an organization to achieve the desired engagement outcomes.
Launching a patient engagement program is a bit like adopting a pet. The owner reaps many benefits, but it changes daily life. A comprehensive patient engagement system requires a commitment to new ways of communicating on a day-to-day basis.
Step 1: Setting the Stage for Success
Like so many things in life, success will depend on the effort and planning invested. While one might think implementation is largely about an effective project plan, the success of an initiative actually depends on persuading the many people who will be affected by this initiative of its value. Without a belief in the organizational change to be implemented, the best project plan is going nowhere.
Build a cross-functional team: Some organizations opt to create a new position to manage this initiative, which is not really necessary. In fact, since the organization is implementing a strategy that will affect the entire system (which may involve hospitals, clinics, individual medical practices, and so forth), it’s more effective to build a team that includes front-line staff and leaders who have experience in working with and navigating the organization.
Appoint a champion: This individual must have strong experience in leading, managing, and motivating teams. The champion should be passionate about the concepts, skilled at articulating the mission, and good at connecting with people. This person must sell this initiative team by team and get each one fired up about a new way of working. The reality is all of an organization’s competitors are doing the same.
Assign a project planning or operations professional: Consider teaming the champion with a project management specialist. This individual can keep everyone on track once the project plans are developed.
Internal and external communications: Selling a new vision for patient engagement requires a marketing and communications campaign to an array of constituents. A list of three-to-five key messages will form the foundation for all initial outreach. They must underscore not just the how, but the why, of the approach. Stress the benefits to patients and to staffers.
Executive announcement: Consider launching with an announcement from a top executive, setting the tone that this represents an organization-wide change. Depending on the size of the organization, this might require an all-hands meeting, a video, or an email, so that everyone gets the same message.
Keep communicating: Keeping everyone up-to-date takes time, but it is critical to success. This requires that everyone affected, including patients, be informed of pending changes. It also involves setting expectations, so that staffers and patients can anticipate next steps.
Step 2: Project Planning and Implementation
Patient engagement implementation works best with a decentralized approach. While the overall strategy is likely centralized, outcomes and objectives in each subgroup or practice area are different. Allow flexibility for each department, floor, clinic, or hospital to define its own successes. This improves implementation outcomes and promotes participation. It’s simply more interesting to work on an initiative that you feel meets your daily needs.
Segment the organization into logical sub-groups: For each sub-group, establish a cross-functional team of stakeholders. Build a group with a positive, can-do attitude. Camaraderie is key.
Meet with each team: Offer five to ten measurable goals or outcomes the team can accomplish with the new patient engagement technologies. Let team members brainstorm to address the business problems they want to solve for their clinic, hospital, or practice. Ask the team to prioritize their objectives and discuss how the organization’s new tools can address them.
Develop sub-group-specific project plans: The business problems of a hospital will differ from those of a clinic. Their plans will therefore vary, but some elements will be consistent. While this may initially add complexity to the implementation, tailored project plans will yield a sense of ownership on the part of the teams. As a result, they will help sell the vision internally, which will result in higher utilizations.
Test concepts with patients: After all, patient activation and participation are central to your patient engagement strategy. Don’t assume that you know how patients will respond to various outreach and engagement strategies. What works for a patient with a high degree of health literacy may not work for a healthy young person who has had little exposure to the healthcare system. Some organizations feel it’s a mistake to have patients meet directly with the project teams, preferring to gather input via focus groups and summarizing it for the team. But the staff will benefit by hearing from patients directly. In turn, patients will be more engaged in the process, offering more candid, valuable feedback.
Deal with doubters: When implementation begins, the naysayers will speak up. Be prepared with facts and creativity. For example, at one organization a physician was a bit skeptical about engaging patients via technology, but she wanted to help educate her diabetic patients with out-of-range A1C levels (i.e., a measure of blood sugar levels). As part of a project to recertify for her internal medical boards, she instructed her patients to watch a video about managing their diabetes on their phones before leaving the hospital parking lot. While it was a small sample size, her project revealed that 98 percent of patients watched the video as instructed. Within six months, 86 percent of those patients had in-range A1C values.
Leverage vendor experts: While some aspects of a project plan will be unique to the organization, it’s safe to assume that the vendor has seen many of the issues you encounter during implementations time and again. The vendor should be a business partner who can help accomplish your business goals. Let the vendor team guide the implementation process and the initial steps of staff training. Take full advantage of the vendor’s experience. They’re invested in your success; a happy customer makes a happy reference.
The testing phase: As part of the project plan, the team will need to consider the testing phase. Will you go live in an entire community or sub-group? A subset of that group? How will you measure success for each group? Be prepared for the worst. Invariably, the problems that you’ve worried about most will go flawlessly. Other issues will jump out instead.
For example, in one implementation, the team underestimated patients’ concerns about the possibility of a phone or email scam. After a patient received an automated follow-up call from the new system, he contacted the health system’s legal team to report it. The implementation team had failed to keep the legal staff in the communications loop, which led to some uncomfortable phone calls. This situation is a reminder that communications strategies need to include everyone in the organization, and that patients need to be alerted to the types of communications they’re going to receive.
Step 3: Optimizing Utilization
Once the teams have completed the initial rollout of their new patient engagement solutions, everyone breathes a collective sigh of relief. But the work has just begun. The organization has embarked on a new path. It will take time to fine-tune processes and to get the whole organization rowing in the same direction.
Recruit the vendor to help with utilization optimization: How can processes and tactics be fine-tuned to make sure the organization is getting maximum value out of the product?
Reinforce the long-term gains: Continually report to executive leadership, staffers, and patients on the benefits of using technology to engage. Actual stories from patients combined with solid outcome data is the best. Share successes internally and externally.
Handling staff turnover: The process of staff engagement and education is ongoing. As staffers change roles or leave the organization, how will staff education be managed beyond the initial implementation phase?
Engaging new patients: As new people come in the door of your hospital, clinic, or office, what is the plan for getting their attention? A recent survey indicated that individuals who were encouraged by their clinician to use online medical records were nearly two times more likely to access their record compared to those who were not encouraged. One practice found it effective to have a staffer take five minutes with new patients on their first visit to get them signed into their portal. It removed one communication barrier for many patients.
Reach out to existing patients: If patients aren’t using the portal or watching videos, can someone on the staff call or email to find out why? A staffer might ask, “I see that you got a call from an automated system with these questions, but you didn’t respond. Would you find an email more effective?”
Appeal to different patients and their circle of care: Patients’ needs are different. Some require expectation management while others require solid coaching and encouragement. The needs of a 30-something primary care patient who gets a physical once per year are different than those of a patient with a chronic condition. Family members caring for an elderly parent have different needs than existing patients facing surgery for the first time, whose questions and concerns may be driven by fear. Over time, patient engagement strategies must be tailored and expanded to better serve the various patient constituencies.
An ongoing commitment to success: To keep patients and staff engaged, the organization must continually iterate, adapt to changing technologies, solicit feedback, and employ creativity.
Pam Holt, RN, BSN, MOL, is operational consultant for patient engagement with Clinical Effectiveness at Wolters Kluwer, Health. In her role, Pam helps deliver measurable business outcomes through patient engagement strategies. Prior to joining Wolters Kluwer, Pam served as the System Director for Patient Education at Mercy Health System, based in Chesterfield, Missouri.
Wolters Kluwer Health is a leading global provider of trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers, students and the next generation of healthcare providers. With a focus on clinical effectiveness, research and learning, safety and surveillance, and interoperability and data intelligence, our proven solutions drive effective decision-making and consistent outcomes across the continuum of care. To reduce the variability that prevents effective care, healthcare professionals around the world use our trusted solutions, such as UpToDate®, Lexicomp®, Medi-Span®, and Emmi® patient engagement programs.
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