LeadingAge Magazine · July-August 2017 • Volume 07 • Number 04

Get Ready for the ‘Experience Era’

July 18, 2017 | by Dianne Molvig

The “patient experience” concept has become popular in the acute-care sector, and now some long-term services and supports providers are adopting it as well.

Tammy Marshall’s job title at The New Jewish Home, New York, NY, is one you rarely see in the world of long-term services and supports. She may be the only person in the LeadingAge membership who has the words “chief experience officer” on her business card.

Her responsibility is to ensure that the “patient experience” concept (or “client experience,” as The New Jewish Home prefers to call it) is brought to life throughout the organization.

That means an individual’s wishes, rather than institutional convenience, are at the center of every care decision, whether the person is a resident on any of The New Jewish Home’s 3 campuses or is a home-care, day care or night care client. Whatever the setting, the resident or client is in control.

“We are in an ‘experience era’ in health care,” Marshall says. “It’s about engaging people on a human level, rather than a transaction level.”

A Perfect Fit

The patient (or resident or client) experience concept has its roots in the patients’ rights movement that sprang up decades ago, notes Jason Wolf, president of The Beryl Institute, the Dallas-based membership organization that describes itself as a “global community of practice dedicated to improving the patient experience through collaboration and shared knowledge.”

The New Jewish Home
A rehab client loosens up at The New Jewish Home. The
“experience” approach puts the individual’s wishes, rather
than institutional convenience, at the center of every
care decision. Photo courtesy of The New Jewish Home.

Patient experience became a more formalized concept in the last decade or so, Wolf adds, when institutions such as Sharp Health Care in San Diego and the Cleveland Clinic, among others, added an “experience officer” or some such position to their management teams.

Wolf emphasizes that patient experience is about much more than patient satisfaction, although the two often get confused. The Beryl Institute defines patient experience as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”

Recent surveys by The Beryl Institute show that 56 percent of health care entities—including hospitals, physician practices and long-term care facilities—say they have some sort of effort under way to incorporate the patient experience idea in their organizations.

While there’s less activity around the experience concept in long-term care compared to other health care settings—the acute-care world is where the approach has been most often adopted—Wolf feels it is tailor-made for senior living.

“Acute care is still relatively transactional,” he explains. “The staff does their best to provide care for someone who’s there for a few days. In long-term care, nursing homes or in-home care, you have the opportunity to build a true experience for those in your care.”

Doing so is good for the client, who feels validated as a person, and for staff, who find their work more rewarding. The organization itself benefits, too, in Wolf’s view. Resident experience “could well become the major differentiator,” he says, “in how people make choices in senior living” as the elder population grows, competition among providers intensifies, and new governmental policies and requirements emerge.

Clients in the Driver’s Seat

When Marshall became the chief experience officer at The New Jewish Home in mid-2016, it was another step on the organization’s path to innovation. Years ago, The New Jewish Home shifted from a patient-centered care model (the organization chooses what it thinks the patient needs) to a patient-directed model (the patient is the driver of his or her care).

The New Jewish Home also has embraced the Green House model, in which a dozen or so nursing home residents live together in a home environment and have control and flexibility in their daily routines. Yet another pursuit was organization-wide education in the Comfort Matters® concept. (More on Comfort Matters below.)

All of this set the stage for moving toward a focus on resident/client experience. Marshall emphasizes, though, that this approach works in any senior living setting, not just in Green Houses. The New Jewish Home applies the concept to all clients, including the 80 percent who live in their own homes and receive in-home care.

The client experience approach plays out in multiple ways. For instance, those who live on one of the three campuses run their own programs, such as the Hand-in-Hand Program, in which residents take charge of organizing everything from blood-donation events, to charity fundraisers, to a project that produces crocheted hats for at-risk premature babies.

In day-to-day routines, clients are in control, whether they’re living on campus or in their own homes. For instance, they decide when to rise in the morning, what they want for breakfast, whether to shower today or wait until tomorow, which outside community groups they choose to join and so on.

“If we’re changing the carpet or the soap in our buildings, the residents are involved in the choice,” Marshall says. “That wouldn’t have happened before. Those used to be back-office decisions made primarily from a budgetary standpoint.”

Another key element of the client experience approach is giving employees decision-making authority. “You can’t give clients power without also empowering the workforce,” Marshall points out.

For instance, if a resident’s or client’s scheduled bath day is Tuesday but the person wants to put off the bath until another day, the employee has to feel he or she can honor that preference, schedule the bath for another day (and thus perhaps a different caregiver) and not get admonished for failing to follow prescribed procedures.

For help in bringing the client experience concept to life, The New Jewish Home invested $1 million to work with Just Think Hospitality to train staff in all job categories, including management.

So far, about 800 out of a total of 2,500 employees have gone through the “hospitality and empathy” training that focuses on deeper listening, better communicating and putting oneself in someone else’s shoes.

“The changes they want to make at The New Jewish Home are phenomenal, not only in the elder experience, but also the employee experience,” says Michelle Szmajda Villatoro, founder and president of Just Think Hospitality, New York, NY. “That’s the sweet spot because happy employees equal happy patients.”

Finding the Joy

Phoenix-based Beatitudes Campus has long been putting “experience” into practice, even if not using that terminology in the past. The organization has gained national mainstream media coverage, in such outlets as The New York Times and The New Yorker, for its Comfort Matters® program for people with dementia.

But Comfort Matters “grew out of fertile ground,” says Tena Alonzo, who is director of research and education, as well as the director of Comfort Matters® and a member of the Patient Experience Advisory Board for The Beryl Institute.

“We already were focusing on the individual’s needs, wants and desires,” she says. “We have created a culture in which flexibility, autonomy and personhood all exist” for all residents and for people receiving in-home services.

Beatitudes Campus
Beatitudes Campus helps residents define successful aging for
themselves, even having a think tank, Design Studio, in
which residents develop programs themselves. Photo courtesy
of Beatitudes Campus.

This approach is in line with the patient experience concept, which manifests at Beatitudes Campus in numerous ways. For instance, the Design Studio is a think tank in which residents develop ideas for successful aging. “After all, our residents are experts in what it means to age,” says Michelle Just, Beatitudes’ president/CEO. “So we take many of their ideas and run with them.”

In one program launched through the Design Studio, residents teach English to local refugees, especially to the older adults in that population. Plus, nearly 90 other resident groups “are tackling several issues,” Just says, “whether it’s social justice issues or designing their own activity programs. Everything we do here we try to make resident-led, and then the staff supports them.”

In short, Beatitudes Campus residents call the shots, whether they’re designing group programs or making personal choices about when to eat, sleep or engage in other daily routines.

To some outside the organization, this arrangement may seem to be a recipe for chaos and inefficiency. Quite to the contrary, points out Rod Bailey, senior vice president of marketing.

“When you deliver this kind of service,” he says, “the incidence of turmoil goes way down. When people have too much time on their hands without having self-determination, that’s where the trouble lies. But if this approach is part of your DNA and you change the way you operate, and not just pay lip service to it, ultimately it’s so much easier.”

Still, it takes work, staff education and commitment across the organization to make the resident/client experience a central focus in senior living. The payoff is worth it, contends Alonzo, who educates other organizations how to adopt this approach.

“This is a win not only for residents and people we serve in their homes, but also for staff, families and everyone who comes here,” she says. “There’s a sense of purpose and achievement. A lot of joy grows out of this work.”

Dianne Molvig is a writer who lives in Madison, WI.