Osler’s journey toward service excellence

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Like every other hospital across the province, William Osler Health System (Osler) is continuously striving to make life better for patients and their families. With thousands of patients walking through our doors each and every day, we are steadfastly committed to ensuring that each and every one of them has positive interactions with our staff, physicians and volunteers.

I think my hospital colleagues would agree that while this sounds like a reasonable goal, it is unbelievably challenging to put into practice. A negative impression can be formed even if the care that was provided at the bedside during a stay was excellent. This impression may form in any number of places away from the inpatient floor – locations like the parking lot, the cafeteria, or even in the elevator. These impressions can also be extremely difficult to identify and address if mechanisms aren’t in place to capture the information.

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As one of Ontario’s largest hospitals, we serve a population of over 1.3 million people living in one of the fastest growing and most culturally diverse regions in Canada. Osler’s emergency departments (ED) are among the busiest in the province and our labour and delivery program is one of the largest in Ontario.

With our growing and diverse community always top of mind, we have made service excellence a key driver behind everything we do. At Osler, service excellence represents the softer side of healthcare – the human touch that makes a significant difference to patients and families during a hospital stay. Service excellence was made a significant component of our 2013-2018 Strategic Plan and called out as our first strategic direction – stating that we will improve how we communicate with patients and families, listen to what they are telling us, and take action so that we can better serve their needs.

Long before the launch of our Strategic Plan and following a period of time when patient satisfaction scores were at an all-time low, Osler identified the need for more timely information about a patient’s stay in order to better understand where it needed to improve – and to then be able to feed that information back to our clinical units for quick action.

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Recognizing the tremendous opportunity to make a difference for our patients and their families, we launched a ‘Service Excellence Call Centre’ in 2011 that conducts outbound calls to inpatients 48 hours after discharge for the purpose of gathering feedback on their hospital stay. The call centre is staffed by modified workers (nurses who may need to be off their feet), college students (who need practicum hours to complete their diplomas) and volunteers, and is able to collect rich feedback through what we like to call, ‘the voice of the patient’.

Over the course of the call, patients are asked a few short questions about their satisfaction with their stay, if they were treated with respect and dignity, if they would recommend the hospital to family and friends, and if they have any suggestions for ways we could improve. All comments are immediately documented and stored within a secured hospital database.

This feedback is then shared with hospital staff on the front-lines where it is used immediately to help us better understand and evaluate each patient’s experience, celebrate success stories and identify where staff and physicians can focus their energies to further improve the patient experience.

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With establishment of the call centre, we soon recognized that we needed a means of feeding information back to the front-lines where it could be used immediately to influence behaviours and improvement strategies. As a result, we implemented daily ‘performance huddles’ across all clinical areas in the hospital in early 2012. These huddles are short, 10-minute sessions where managers and front-line staff come together to discuss their performance against four key metrics.

It has also been extremely effective in identifying outstanding services and giving us an opportunity to recognize good work. The ability to immediately collaborate on solutions and share patient stories has positively influenced staff satisfaction. Recent survey results show a 10 per cent improvement year over year.

In just three years, our call centre has provided us with more robust knowledge to better inform the care we deliver, impact decision-making, identify areas for improvements, and acknowledge our high-performing areas. Given the diversity of our community, it also helps to ensure that we continue to deliver quality care that respects the traditions, religion and culture of our patients and their families.

With such a diverse community, we incorporate our interpretation services program into the operations of the call centre to ensure staff are able to communication effectively with every patient. A number of call centre staff are also multi-lingual, so they are encouraged to speak in different languages to ensure we are being as inclusive as possible.

Some of our successes to date have come in the form of an award from Accreditation Canada and even national and international attention with requests to speak about our call centre and service excellence program at a number of conferences. In April, we will be presenting at the Beryl Institute’s Patient Experience Conference, and in May, we will be speaking at the Cleveland Clinic’s Patient Experience Summit.

While it’s safe to say we still have some work to do on improving the patient experience, we are enthusiastic that the tools we have put in place will guide us on this journey.