Leigh I. G. Iverson, MD (May 2017)

Leigh I. G. Iverson, MD, ACS Fellow 5 stars
"Excellence in healthcare requires collaboration between the provider side and the patient as well as his or her family. Excellence 24/7's P
atient Outreach provides an effective method of obtaining and effectively utilizing access to the collaborative process."

Best Practices Library

Patient Procedures | Special Needs | Special Conditions | Special Accommodations | Prior Experiences | Document Completion | Quick Response Code | Organizational Culture | Team Member Recognition | Ongoing Patient Communication/Engagement | Contact Surface with Patient | Permanent Patient Record | Feedback from Client Staff | Surveys of Physicians and Nurses | Unsubscribe | Certificate of Excellence | Social Media | Transfer of Patient Request | Radiation Oncology Patients | Staff Responses | Contact All Patients | Weekly Meetings | Business Cards for Team Members | Translation | Employee Involvement | Excellence 24/7 Client Forum | Daily Briefings

Pre- Appointment

Library of Patient Procedures: To better prepare the patient for the upcoming procedure Excellence 24/7 recommends including in the pre-appointment solicitation the opportunity for the patient to view the appropriate procedure explanation. Many of our client facilities have their own library of patient procedures available to which we redirect patients upon submission. In the event the client does not have such a library there are many available through the various nationally accredited medical organizations. Client results confirm that the inclusion of this step increases the frequency of patient arriving better prepared for the procedure. And further results confirm that the inclusion of this step reduces the number of instances where the procedure cannot be conducted to the patient not being properly prepared.

Special Need Requirements: Client facilities often have available to patients a number of programs to assist patients with special needs. But when the facility is not aware of the potential patient special need until arrival for the procedure, often times the ability to provide the service is limited. Excellence 24/7 recommends addressing this issue in the pre-appointment solicitation by providing the patient a listing of special needs accommodations which are available and encouraging the patient to select those they will require thus providing the medical facility with advance notice. Or alternatively one client is utilizing the following:

Question: Does the patient or caregiver require any special accommodations? (I.e., Translator, Child Life, Communication Device, Adaptive Equipment, Etc.)

Response Options: Yes / No

If “Yes” selected, then:

Please explain:

Special Conditions: The pre-appointment outreach is an excellent opportunity for the healthcare provider to learn of any conditions the patient may have that need to be considered during treatment. One client address this are as follows:

Question: How does the patient handle health care experiences?

Response Options: Well / With difficulty

If “With difficulty” selected, then:

Please explain:

Prior Experiences with the Healthcare Provider: To further strengthen patient engagement: A question relating to prior experiences that the patient may have had with the facility is often of value in the pre-appointment solicitation. A question similar to: “Reflecting on your last appointment at XYZ Medical Facility, is there something that we could have done better?”

Document Completion: To minimize registration time and similar, and to reduce the hard copy documents the facility is required to maintain, Excellence 24/7 recommends including in pre-appointment solicitation links to basic registration forms, patient histories and similar. If these are available on line at the client facility links to these documents will be included. If they are not available on line at the facility Excellence 24/7 can prepare such which will automatically be delivered to the facility upon completion by the patient.

During Appointment

Patient QR Code Submissions: QR codes can be very compelling and futuristic; but in the healthcare environment, the challenge is to make them more engaging and less sterile.

Medical facilities typically have mandatory postings in patient areas that can be very distracting and offer minimal application to the general population. As such, when QR codes are displayed in a format that mimics these postings they will likely be overlooked and disregarded.

Although increasing every day; in today’s world, the most common applications for QR codes are to gain information; directions, ingredients or schedules, to name just a few. When the QR code is displayed in a manner that stimulates interest or curiosity, an individual would be much more likely to notice it and be provoked to scan the code.

Healthcare can be overwhelming and intimidating, regardless of how routine the nature of the visit. The QR code provides a real-time connection for assistance and an opportunity for service recovery. Regardless of whether a patient is lost in the facility, becoming anxious in a dressing room or waiting in a cold exam room the QR code provides an immediate way to communicate.

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Post Appointment

Organizational Culture: One of the many benefits often resulting from implementation of the Excellence 24/7 Patient Outreach Process is a shift to a very patient centric organizational culture. There are generally a variety of factors that influence this shift but one significant factor is immediate recognition of outstanding performance by the staff. In many cases the patient outreach process utilized by clients prior to working with Excellence 24/7 report result months after the service is provided. Excellence 24/7 reports results immediately upon patient submission, often times the day of service. The inclusion of a section within the post-appointment solicitation encouraging patients to identify staff members that provided excellent service enables clients to recognize the display of the desired behaviors immediately. This recognition significantly increases the probability of these desired behaviors being repeated. “What gets rewarded, gets repeated.”

Team Member Recognition: Team member recognition is paramount for both employee satisfaction and retention. “You Rock” – every time a Team Member is mentioned by a patient for providing exceptional service a Manager gives them a rock inscribed with “You Rock”, subsequent rocks would say “Keep on Rocking” or “Rock On”. Internal incentive awards for recognition and immediate praise while the patient encounter is still fresh in their mind is a great motivator and a visible reward carries to an opportunity for some healthy competition amongst the staff.

Community Hospital of the Monterey Peninsula - Montage Heath You Rock Rock On!

Ongoing Patient Communication/Engagement: The Excellence 24/7 Patient Outreach Process also provides an excellent vehicle to an ongoing communication with the patient indefinitely post appointment. Providing the patient with an easy to use tool to reach out to the healthcare provider with any question or concerns that may arise. A method of contact that in many cases is far more patient friendly than a phone call to the healthcare provider.


Expand Contact Surface with Patient: The patient outreach process is intended to encourage patient interaction at three different points, pre, during and post appointment. But the Children’s Hospital of Pittsburgh of UPMC has considered adding a 4th point of potential interaction.

A pocket Quincy for the patient/parent to take home. (Quincy is the mascot for the Radiology department at the Children’s Hospital of Pittsburgh of UPMC.) The pocket Quincy will do more than solicit post appointment feedback, it is envisioned to solicit post appointment questions and or allow the patient to raise any issues following the appointment. Generally, intended to provide a rather light manner for the patient/parent to stay in touch with CHP. The QR code will deliver instant alerts to a location which ideally is monitored 24/7. Ideally will be printed on a small business card size piece of rather thick stock so it will have some shelf life, maybe even laminated to maximize longevity.

Children's Hospital of Pittsburgh Message from Quincy the Dog

Transfer of Knowledge to Permanent Patient Record:
it is common for a variety of patient specific information to be shared at all three of the scheduled patient interactions within the Excellence 24/7 Patient Outreach Process, with the majority of this information gleaned in the pre-appointment submission. Upon consultation with our client organizations we have learned that much of the information that is being shared is not currently a part of the permanent patient record. It is our recommendation that the appropriate member(s) of the client staff be assigned to review all patient submissions in order to determine what information should be incorporated within the patient record and that the client initiates a process to ensure same is occurring on an ongoing basis.

Feedback from Client Staff: We pride ourselves in the fact that we enjoy a close relationship with client staff at all levels. And that these relationships foster a free exchange of information regarding our work together. That said, we still conduct periodic surveys (every six months unless something other is preferred by the client) of front line staff soliciting suggestions for process improvement and attempting to quantify the value that we provide. These surveys, coupled with regular client interactions, assist us in our efforts to be ever improving the services we provide.

Periodic Surveys of Physicians and Nurses: The primary interactions that we have within the client organization are with other than the doctors and nurses directly involved with patient care. In some cases, clients have suggested and found value in quantifying the impact of the Excellence 24/7 Patient Outreach Process on the work of these professionals.

E-Mail Unsubscribe Requests: It is extremely desirable, and in some cases legally required, to provide e-mail recipients with the opportunity to Unsubscribe. Though we generally see a very low unsubscribe rate, well less than 1%, we do want to minimize the impact the unsubscribe requests have on future e-mail efforts conducted by us on behalf of the client or which may be conducted by the client themselves. Thus, we have found it advantageous to word the unsubscribe request notice to ask if patients would like to be removed from future e-mails for a specific appointment. Unsubscribe requests are shared with client if they so desire but the process of removing patients from future e-mails for a specific appointment is handled by Excellence 24/7.

Monthly Certificate of Excellence: The majority of the feedback that is solicited via the Excellence 24/7 Patient Outreach Process is of narrative in nature. However, we do like to include some questions that are very objective and measurable. We utilize the data collected in these questions, in conjunction with analysis of patient narratives and in collaboration with client staff leadership, to identify an area within the client organization which we recognize with a hard copy Monthly Certificate of Excellence.

Facebook/Yelp and Other Social Media Opportunities: On the “Thank You” page of the various patient interactions we recommend including links to Facebook, Yelp, Instagram or the social media sites where the client has a presence. We have found that this inclusion does generate a significant increase in social media awareness for the client.

Seamless Transfer of Patient Request: Departments that participate in the Excellence 24/7 Patient Outreach Process often times receive patient input/feedback relating to other departments within the medical facility. Patients that have something they wish to express or questions for which they desire answers will use the communication tools provided by Excellence 24/7 even if these are directed to a department other than the department generating the interaction. Client organizations need to be prepared for this and develop processes which allow for the seamless transfer of patient information within the organization.

Customized Tool for Radiation Oncology Patients: Based upon the nature of the ongoing treatments for Radiation Oncology Patients Excellence 24/7 has developed a customized tool that allows and encourages unlimited ongoing interactions. It is hoped that in some small way this may ease the burden these patients are facing.

Appropriate Narratives Included in all Staff Responses: It can easily become practice for staff members to report that an item is “Fully Resolved” without the inclusion of a narrative response detailing actions taken to reach resolution. Excellence 24/7 strongly recommends against this and will highlight same to client as they are observed. Maintaining a record of the actions taken can only be of benefit in the future.

General Practice to Contact all Patients that Provide a Submission: Excellence 24/7 recommends that, as a general practice, clients contact all patients that provide a submission. Many patient responses may not specifically require a response from the medical facility. But if for no other reason than to build engagement with the patient, it is encouraged that all patients receive an acknowledgement, either by e-mail or by phone, from a client representative. These unexpected acknowledgements by the facility can often create “WOW” moments in the eyes of the patient helping develop future loyalty.

Weekly Meetings Client/E247: Establishing a schedule for regular discussions between Client and Excellence 24/7 has proven effective. Not lengthy discussions but simply “touching base” on a regular schedule provides a format for an ongoing exchange of thoughts and enables E24/7 to respond promptly to any client requests. Business Cards for Team Members: The development of business cards which are made available to all client team members has proven effective in increasing the QR Code patient submissions. Additionally, the providing of business cards throughout the staff population enables patients to identify “Star Performers” enabling leadership to provide immediate recognition.

Business Cards for Team Members: The development of business cards which are made available to all client team members has proven effective in increasing the QR Code patient submissions. Additionally, the providing of business cards throughout the staff population enables patients to identify “Star Performers” enabling leadership to provide immediate recognition.

Daily Briefings: Many of our clients conduct daily briefings with their staff as the day begins. Reviewing the individual patient pre-appointment submissions, specifically the special needs, special accommodations and any questions submitted for that day’s patients at these meetings enables the organization to be better prepared to meet and exceed the expectations of individual patients. An equally valuable exercise at these daily interactions includes the sharing of feedback from the prior days patients and specifically recognizing the Star Performers as identified by patients.

Quincy Feedback Card Quincy Feedback Card - My Name Is

Translation: The Excellence 24/7 documents can be delivered to patients in any language as desired by client. Client is responsible for developing the translation which will be used by E24/7. All narratives submitted by patients will be delivered to client exactly as submitted, thus if translation to English is required this is the responsibility of the client.

Employee Involvement: For all clients Excellence 24/7 provides as a no cost inclusion a QR Code that is designed to be placed throughout employee area in order to solicit input of all types from the staff. Suggestions for improvement, concerns, grievances, whatever the staff may wish to share can be shared via the “Your Opinion Matters” QR Code.

Excellence 24/7 Client Forum: On a quarterly basis Excellence 24/7 hosts our online client forum. The forums are generally held on the second Wednesday of the quarter starting at 2:00 p.m. Eastern Time and last approximately 90 minutes. To develop the agenda for each forum Excellence 24/7 reaches out to clients to ascertain what topics they would like to see included and as well to ascertain if they have topics they would like to present to other attendees. As this process is completed, an agenda for the forum is finalized and shared with all clients. And of course, time is allocated at the end of each forum for open discussion. We encourage live participation by clients to maximize the exchange of ideas and knowledge. But additionally, all forums are recorded and made available shortly after the conclusion so that clients who were not able to participate can view the discussion and share with other in their organization. The Excellence 24/7 Client Forum is but another way that we work to improve the healthcare experience, one patient at a time.

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