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Stanford Health Care sees Qualtrics experience data as key to improving patient outcomes

Derek du Preez Profile picture for user ddpreez May 3, 2024
Summary:
Moving beyond just survey data, Stanford Health Care is thinking about how it can collect and understand patient data, using Qualtrics, to improve the experience (and outcomes) for patients with varying needs.

healthcare, people, technology and medicine concept - close up of doctor in white coat with stethoscope and tablet pc computer over blue background with charts © Syda Productions - Shutterstock
(© Syda Productions - Shutterstock)

Based in Palo Alto, Stanford Health Care (SHC) operates two major hospitals in the northern California region, is made up of a network of community physicians, and takes care of approximately 20,000 patients annually. SHC recognizes that healthcare is changing drastically, with advancements in technology and medicine, coupled with increased demands on the system itself, meaning that service delivery is transitioning towards more data-driven, personalized care. 

As a result, SHC is trying to think differently about how the experience of patients - and their physicians - can lead to improved health outcomes. Too often healthcare systems reduce ‘experience’ metrics to simple operational measures, such as ‘number of beds occupied’ or ‘time spent waiting in the emergency room’. In reality, whilst these metrics do make a difference to patients, they may not be as important as an empathetic conversation with a care provider, or availability of a physician that understands your unique community needs. 

Interestingly, Stanford Health Care has four pillars that make up its core corporate strategy, one of which is patient experience (alongside quality and safety, employee and physician engagement/wellness, and financial strength). And this focus on experience is thought about internally as a requirement to improve patient healthcare outcomes. Speaking this week with Alpa Vyas, SVP of Chief Patient Experience and Operational Performance Officer at SHC, she said: 

If patients trust the system, they trust their care team. If they're more inclined to follow the path, you reduce their readmissions, you reduce the rehospitalizations. Right? These are those types of measures that we can tie experience to, making sure that we close the loop for patients so they don't end up delaying care. 

SHC has been using Qualtrics’ Experience Management platform (XM) since 2021, where its aim was to move beyond collecting simple survey data. Vyas explained that a key priority for the organization’s experience strategy has been culture change. This was important in changing the minds of everyone at SHC of the significance of experience management. She said: 

Really, what we started with was the cultural change, which was focusing on communication and behavioral frameworks, establishing that for teams. Not everybody understood what experience really even meant in the context of healthcare. 

If you think about a decade ago, when most people thought about how you measure anything like experience [in healthcare], it still was all a little bit new. This is a little ironic, because we're in the people business.

SHC has adapted its language from ‘satisfaction’ to ‘patient experience’, even broadening that out to be inclusive of a patient’s family, loved ones, or caregivers. Equally, the organization is thinking about the direct relationship between physician or employee wellness and engagement, the employee experience, with the experience of the patient and their health outcomes. Vyas explained: 

We see it in our data, both anecdotally and the information that we're looking at, that those two things are very much linked.

For me, if we're successful in creating a meaningful experience for physicians, it will show up in the quality or the outcomes that patients can achieve. That would typically mean that they trust us more. They are more inclined to communicate and tell us where things perhaps aren't going right. And that then in turn, would result in greater adherence to a care plan. 

This is particularly important to SHC, which is fully aware that certain minority groups, or people from communities that aren’t white, straight, or male, can receive subpar healthcare delivery because of a variety of different factors. Vyas said: 

I've been thinking about this a lot, especially in the context of health equity, and the notion of really understanding the social drivers of health. And if a patient doesn't have trust in their care team, or in the health system, they may not be inclined to share information about food insecurity, income, or transportation. 

That notion of experience can help drive outcomes. I think that we have to use that to our advantage, because there's all sorts of reasons for patients who are sick, scared, trying to navigate the complexities of healthcare…there's all sorts of potholes and ways that patients can get directed off of their path. 

So, if we use experiential data to actually help inform not only operational or system improvements, but that personalized data will eventually, I think, translate into what we could do clinically for a patient. 

Real-time understanding

Prior to Qualtrics, SHC was collecting survey data, particularly around interaction points with the healthcare system (highlighting process issues), but this information was being collected in traditional ways - often taking weeks or months. This isn’t conducive to implementing change at moments in time that matter to patients who may have exited the healthcare system by that point. Vyas said: 

It was really hard for teams to go, hold on, what was happening that day in the clinic or in the hospital to say, is this random variation? Or could we tie it to something that was actually happening in the clinic? Or an intervention that they were trying to improve? 

This has since changed with the introduction of the Qualtrics XM platform, which also has more inclusive language options. She added:

Right from the get go, getting more of that real time information has been super helpful to our teams. The other thing that we got. that we were able to implement more, and we're just really now digging into the data, is that our surveys were only available in English and Spanish. 

But now we have flexibility of offering up to six to eight additional languages. Being able to get feedback from patients that, perhaps in the past, wouldn't have filled out a survey, has been fairly meaningful. 

Furthermore, SHC has been able to broaden the questions that it can ask, using Qualtrics. Vyas and her team have worked with physicians and the broader faculties to co-develop surveys, particularly around he physician interaction. This has helped physicians better engage with the significance of experience data and has brought them along in the process. Vyas said: 

As a physician who's taking care of patients, what is meaningful for you in terms of feedback from patients? Instead of the standard stuff, like ‘did the physician look you in the eye?’. Working with our physicians to actually create more meaningful questions means that when we present data, it gives them more of an ability to act on it and actually use it from an improvement standpoint.

Vyas said that she has spent a lot of time trying to dispel the myths surrounding data, pushing teams to think about ‘measurement modernization’ as an approach. A big part of this has, as noted above, meant moving beyond survey data, towards operational data, as well as semantic and unstructured data that is floating around SHC at all times. For example, conversations taking place in the call center, or conversations that are stored that take place between patients and physicians. 

Whilst it’s going to be hard for some areas of care to ever achieve a totally positive experience, just because of the nature of the experience (e.g. chronic pain patients are in chronic pain, which is not a very pleasant experience!). However, Vyas still believes that there is room for improvement. She said: 

Are their scores 100%? No, but they're better. And so I think, patient populations like that, where you might not be able to see yourself ever hitting that high mark, just given the conditions that they're dealing with, what I found out is that if you do give people the tools and the resources, they'll be able to make the incremental improvement. 

And for other healthcare organizations that are thinking about experience improvement, Vyas noted that it’s key to think about that culture change, as well as prioritizing data collection that may not have been prioritized in the past. She said: 

It's multi-pronged. Firstly: culture, culture, culture, culture. Lay the foundation and the groundwork. That really just sets the tone. And then I think in terms of leveraging data and analytics, I would say don't be constrained by the traditional ways that we have done our work. 

Use data benchmarking comparisons, gingerly. Don't chase the metric. Stay focused, I think, on the things that are important to the team and to the patients. And don't collect feedback just to collect feedback. Make it actionable, because if we keep asking questions, and don't do anything about it, that's not good. 

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