To deliver a great patient experience, you need to deliver excellence consistently.  Every single encounter with your patient makes a difference. To set the scene, I would like to use the words of the great rock musician Bruce  Springsteen: ‘Getting an audience is hard. Sustaining an audience is harder. It demands a consistency of thought or purpose and of action over a long period of time.’ This quote obviously relates to producing music and performing, but his emphasis on ‘consistency of thought or purpose and of action over a long period of time’ is equally true for your focus on your patients.

There is plenty of evidence that a long-term sustained focus on any area leads to improvement and that is what you are aiming to achieve in your own practice, clinic or hospital. In your work with patient experience, you started by defining your patient experience strategy, setting out your vision, which forms your guiding map of what you want your practice to be and setting your objectives to achieve in order to have this vision. In last month’s article, we focused on measuring patient experience, discussing the various methods of doing so, including surveys and focus groups, and the importance of capturing and presenting the data in a format that can be easily understood and used.

Identify what patients are telling you.
The next step in the process is to reflect on the findings from the measurement activities to fully understand what your patients are telling you. Identify the highlights and low- lights. You will celebrate the high- lights with your team, as these show the respects in which you are delivering a very positive experience for your patients. The lowlights are where you will need to focus more attention, as these are the identified areas for improvement. Even if all your results are good, I would encourage you to focus on the lowlights. The results may not seem to be disappointing, but there is always room for improvement and focusing on consistent improvement is what you are aiming to achieve. I would suggest choosing three lowlights and create an improvement plan for each of these. The time-scales can vary, but a quarterly plan with monthly review points would allow enough time to deliver and measure improvement, while the monthly reviews will ensure you and your team retain a focus on following up the actions and improving patient experience. The monthly reviews will come around very quickly.

Take ownership.
Agree who will take ownership of the improvement plans and who will develop them and manage their progress. I would suggest the overall owner is a senior individual within the team to ensure the right level of focus is given and that actions can be delegated with authority. But you may want to choose a team member to create the actual improvement plans and own the management of the process.

How will your improvement plans be developed?
Every individual who interacts with your patients, from your marketing manager through to the receptionist at the hospital where you operate, is a member of your own patient experience team. But it may not be possible to involve every individual in the development of the improvement plans, although, ideally, you want to involve as many as possible. Involving people at the creation stage is more likely to result in their buy into the process. The best method might be to set up a 30-minute team video call, but, prior to the meeting, circulate the results of your survey, high- light the three lowlights you are going to focus on and ask everyone to come to the meeting prepared to suggest ways to improve. During the meeting, everyone should be encouraged to contribute their thoughts and ideas, and this is more likely to occur in an open culture where individuals know that their input is valued and will be considered seriously. In an open culture, you will receive lots of suggestions and you will need to consolidate on a few actions which you all agree will deliver the best results. For those who are unable to take part in these early discussions, ensure you invest time in communicating your plans with them and giving them the opportunity to contribute. Your improvement plans are basically action plans describing what actions will be taken, by whom and by when. They should be short, very clear and easy to review. Many of you will be familiar with the SMART methodology: Specific, Measurable, Actionable, Realistic, Timescales and this would be a good tool to use. Your success will be measured when you next review your patients using the measurement strategies you implemented previously. If you are running ongoing surveys, you will be able to review the results monthly. If you are running one-off surveys from time to time, your implementation plan should include an action to run a new survey to measure improvement in the key focus areas, ideally quarterly.

Barriers to improvement
There is much research to show that middle managers can be a barrier to the improvement of patient experience, and the reason for this relates to their objectives not being aligned. The leaders and senior members of organisations are committed to improvement and intrinsically believe that it is vital. The front- line staff are engaging with patients every day and they want to deliver the best experience possible. But often middle managers are tasked with making the business more efficient and more profitable and this does not lead to a focus on improving patient experience. To engage middle managers fully, their objectives and key performance indicators need to include goals for improvement in patient experience.

Embedding an improvement culture
If you follow this plan, you will be reviewing the progress of your actions in your improvement plans monthly and measuring for improvement on a regular basis, ideally quarterly. Every three months, you can review your highlights and lowlights and change the focus of the improvement plans, if appropriate. Once each year, you can invest time with your team reviewing your patient experience strategy. Is your vision still relevant? Are your objectives and your measurement criteria still correct or do they need refining?

Patient expectations do evolve over time
The experience of living through 2020 has taught us many things, but one important lesson is that change is inevitable and can be drastic. The growth in telemedicine has been phenomenal and is a good example of how delivery of the patient experience can alter, and very quickly. Not so long ago, our patients would regularly pay their invoices in person by cheque and we would do a weekly bank visit to pay them in, and then BACS transfers became more popular. Nowadays, it is common for patients to receive a text message containing a link to a payment page where they pay by credit card. I believe that online appointment booking will become increasingly popular over coming months and we will make greater use of video in a broader range of applications. While we cannot predict everything that will happen as we adapt to new ways of working, we can ensure we deliver a positive patient experience. This process described here, of continual review, will ensure that the focus on improving patient experience is embedded in your team culture and happy patients will equate to the ongoing success of your practice.