Cep Presentation For Ops Summit 24 Nov 09

The Apple CEP Journey

3rd Operations Summit

Tuesday 24 Nov 09

Overview

Remembering the Apple Framework Communication & Learning Measure Drill Down Improve Visualise Energise Moving Forward

Remembering the Apple Framework

5. Energise

1. Measure

- Harvest Day - Awards & Recognition - Walkabout

- Surveys - Feedback - Audits - Patient & Staff Advisory Group

4. Visualise - Compliment / Suggestion Wall - Achievement Board - Apple Cards

Core Attributes Treating patients with Empathy, Care & Professionalism to ensure Healthy & Satisfied Patients Enabled through 7 Habits

3. Improve - People - Service & Process - Environment

2. Drill Down - Patient Experience Map - Patient Focus Groups

Communication & Learning Communicating the CEP CEP Note Pad

CEP Posters

Learning Apple Basic (CEP Standards)

Apple Intermediate (Service Habits to WOW)

New Staff

Existing Staff

Orientation with Apple Basic

Refresher (through rollcall)

Service Recovery

Service Recovery (through roll-call)

CEP Cards

Supervisors/ Managers Reinforce through audits and roll-call Roll call (Learn from complaints & compliments)

Training (Practicum based on role play and case studies)

Measure: Background

Media Research Consultants was commissioned by TTSH to conduct 2 cycles of Customer Satisfaction Surveys and Patient Focus Groups in Jan 2009 (762 patients) and Jul 2009 (1,053 patients) Objectives are – To assess the level of patient satisfaction so as to fine tune the level of service provision – To obtain a baseline ratings to be used as a benchmark against similar surveys conducted by MOH Following each survey, a group of patients surveyed were invited to attend a focus group. Valuable insights were obtained after each session.

Measure: Overall Satisfaction – TTSH % Excellent or Good

Q: On the whole, how satisfied are you with TTSH? 60.0

53.3 48.7

47.8

40.0

31.4 26.8 20.0

25.7

19.5

15.9 3.7

1.1

15.1 4.2

3.3 1.7

1.7

0.0 Jul 09 (n=1,053)

Excellent

Jan 09 (n=762)

Good

Satisfactory

MOH 08(n=791)

Poor

Very Poor

Measure: Key Service Factors

86.4

90 .0

80 .0

70 .0

78.6

78.3 74.5

73.7

71.2

76.9

81.5

68.6

60 .0 F acilities C are K & S of C oordinationD octors

J u l-0 9

K & S of Nurses

C & C of D octors

J a n -0 9

C & C of C lear K & S of A lliedC & C of Nurses E xplanation Health A llied Health on procedures & care

M O H 08

Drill Down: Patient Focus Groups Almost concurrently, 3 focus groups discussions were held to gather feedback from patients about their TTSH expectations. Respondents were recruited from the then ongoing Customer Satisfaction Survey. A mixture of satisfied and unhappy patients from A&E, SOCs and Wards were invited to attend the session.

I waited for nearly 2 hours and was crying from the pain.. I hid in one corner because I don’t want anyone to see me crying…even in all these pain, they must ask for payment first… they didn’t even offer a wheelchair

…I waited from 12pm to 2pm…it was the first time I am seeing him.. I went in, I just sat down, and he told me –” I can’t look at your illness, you can go see someone else better, don’t waste your time” – he never checked me.”

...the nurse ask me “Why are you outside? I thought you are sponging your grandmother?”…I was like “am I working for TTSH?”…I told her, “its your job, Im not there to do it”, she just walk away without doing anything.

The nurse asked me if I need a ward, I told I had to make a call first, ask my parents about it… she just stared at me and rolled her eyes…

Drill Down: Patient Focus Groups

Almost all of the lapses could be attributed to the breakdown of communication in one or more of the following forms: •

Communication between TTSH and the public on processes : for example, on - Why do you have to wait? (Public communication efforts)

•

Communication between doctor and patient

•

Communication between doctor and medical team

Improve: Recognising Your Efforts Specialist Outpatient Clinics - Names of staff (PSA or nurses) be placed on the door of the rooms that they are serving - Billing Staff to use signature board when returning change or credit card - LCD Picture frame with Staff picture and name on running slide show – can be used to flash Patient Service Survey Scores of clinics as well - Feedback card will be given to patient immediately upon service rendered - Service Ambassador

Wards - NOs doing daily rounds to identify and flag problematic cases for enhanced communication and care by team - Nurses doing daily communication updates during visiting hours - Nurses doing post discharge call to all patients the day after discharge

Non Subsidised Services - Service Improvement Boards for staff improvement ideas - NSS Patient Satisfaction Survey - Teambuilding Retreat on 31 Oct 09 - Improvement of NSS Amenities and Ambience - Establishment of NSS call Centre (in progress)

AHS & CSS - Bi-weekly audits

-Training of managers to motivate the team using different modes of persuasion: pathos, ethos and logos - Internal service quality audits - Role plays - Individualized self motivating quotes - Service role models

- Mystery Shopper Audits

AHS

- Walkabouts - Fun & creative roll calls

CSS

Improve: Sharpening Your Saw Roving CEP Quiz - To proactively spread the Apple Philosophy and CEP standards to more frontline staff - 32 frontline units covered: SOCs, AHS, CSS, Wards, ED

Apple Bites Newsletter - Monthly newsletter to share snippets of service related information with the staff - Contents include: Service messages penned by TTSH staff, audit findings, service activity updates etc - Recommend using it as a roll call material to keep up the momentum of good service

Doctors’ Service Kits - Kit consists of a personally penned letter from a patient and a thumb drive containing CEP messages - Content of letter contrasts the different levels of service experienced by one patient - Adds a personal touch and element of reality – good service does make a difference to patients’ overall well being

Visualise: Embracing New Media Be Exceptional Intranet: http://beexceptional - CEP Training Materials - Best Practices - Chat Roll - CEP Blog

Be Exceptional Facebook Account - Set up on 2 Oct 09 - No. of Friends: 38, No. of Fans: 18

Be Exceptional You Tube Account - To upload videos taken during Apple Activities - CEP Activity Videos Uploaded: 17 - Video Views: 2,214

Visualise: Our Service Commitment

Wall Mural - Puts forth the hospital’s service commitment to the patients and NOKs

Lift Decal - Constant reminders to our staff to give way to patients - Inculcate a “patient first” value

Visualise: Show That You Are Good! TTSH Service Quality Challenge 2009 - Aim to boost staff spirits for the MOH CSS Survey scheduled for 26 Oct 09 – 6 Nov 09 - A fun and energising activity to inject some positive competition and variety in the staff’s daily routine work - Total of 10 246 compliments received over 2 weeks

TTSH CEP Roll Call Video Contest - Aim to encourage and reward frontline units to conduct their service training in fun and creative ways - Total of 14 submissions from: SOCs, AHS, CSS, Wards & NSS - Engaged hospital wide participation through: - Social Media: Videos posted on YouTube - Intranet: Videos on YouTube linked to the Intranet for staff to view - Staff Voting: All staff can vote for the “Most Popular Video” on the Intranet Total of 8256 votes gathered

Energise: Time to Celebrate! Apple Refresh Launch: - Reinforce Apple Philosophy following first launched in Oct 08 - Gear staff up for the MOH CSS from 26 Oct – 6 Nov 09

Apple Refresh Launch – The Roadshow: - Road show activities are planned with CEP standards in mind: • CEP Exhibition: know more about CEP • CEP Quiz: test your CEP knowledge • Makeover by Jean Yip: how to look good • Origami: follow through instructions from your buddy • Wii: exercise to feel good • Spot the Smiles: differentiate between the real and fake smiles

Active & Harvest Day - Celebration of both Active Day & staff’s achievements in service quality - Rationale: Apart from keeping up their strength and energy to take on a demanding patient workload, they are also professionally fit in upgrading their skills and raising the bar of their service quality standards, as well as fit in balancing family, social community and personal responsibilities - Awards for CEP Roll Call Video Contest & TTSH Service Quality Challenge were given out

Moving Forward Measure and Benchmark • More frequent and systematic feedback and audit framework • Real time feedback solutions • Patient Feedback Survey on Consulting Doctors Training and Improvement • “Exceptional Service Habits” by HRD • Learning Trips to Service Leaders of various industries Reward and Recognition • Formalise and standardise Service Award Systems • Service Competencies to be incorporated into Total Performance Management • Accreditation with National Standard Body Collaborations Across Units • Service Day

Moving Forward Service Training Certification for Doctors • Uses the handwashing certification approach • Set up the basic process of what is minimum service standards and expectations

Sharing Focus Groups Recordings Through Podcasts • Using Be Exceptional Intranet as a platform • Can be shared through training sessions, Hospital Conferences etc

Clinician Participation in Focus Groups • Engage clinicians more actively in listening to patients