‘Coach’ Seeks Solutions for Ideal Patient Experience
One in an ongoing series
Patients at Einstein Medical Center Montgomery may never meet Timothy Pugliese. But he’s there, in the background, trying to make sure that their experience is a good one and that their voices are heard.
Pugliese, the Patient Experience Coach for Einstein Montgomery and Einstein Physicians Montgomery, works to improve patients’ perceptions of their care.
You know those satisfaction surveys patients are asked to fill out? Pugliese is the one who reads them to gauge how patients feel about their experience.
Are doctors, nurses and others treating them with courtesy and respect? Are medications and discharge instructions carefully explained? Is the hospital or patient room quiet and clean? Does the provider listen to them and respond to their questions or concerns? Would they recommend the hospital, or practice?
Collaboration Is Key
If Pugliese sees a trend, or anything that limits an optimal patient experience, he reaches out to the appropriate individual or team, and the collaborative process begins.
It could be touchy, of course. Who likes to hear that their interactions might not be received as well as they thought?
Pugliese says he looks for ways to help individuals understand and improve how their communication style and treatment of patients are perceived. There is no clinical aspect to his input.
But Pugliese is quick to point out that his job is not to be critical or judgmental or to dictate change but to share insight from a different perspective. “It’s really a collaboration; the interactions are mutually advantageous.” he says.
“I work with providers one on one,” he says. “I join them in rounds while they’re visiting patients, and then I share feedback. We have a robust dialogue about what I observed in parallel to what is reflected in their patient feedback.”
Process Barriers and People Barriers
Pugliese says there are process barriers and there are people barriers, and quite often the needed change is tightly intertwined.
One process barrier was revealed when a survey showed that some patients weren’t sure how to reach out if they had questions or needed assistance after a visit.
“We created a QR code that would direct patients to the Patient Portal and systematically posted the QR code in waiting rooms, treatment rooms and check-in/check-out desks,” he says. Discharge instructions also were updated.
“A frequent opportunity,” he says, “is intent versus impact, in which something said is intended to mean one thing but it’s being interpreted another way.”
For example, he says, “Something as small as saying ‘Do you understand?’ is intended to gauge level of understanding with the plan of care. But instead it can come across as insulting to an individual’s intelligence.”
How to overcome such a misunderstanding? “In a situation like this,” he says, “I would suggest focusing on open-ended questioning to determine the individual’s level of understanding. Such as, ‘What are your thoughts about what we discussed?’ or ‘How do you feel about the plan?’”
Patients’ views about their care also can be influenced by body language or tone of voice, and a provider may not be aware of how these factors are perceived.
Pugliese says there are many ways to measure “success.” He tries not to define the outcome solely based on the survey data.
“The true success comes from the engagement and transparent dialogue that starts to foster minute changes.” He says these minute changes have a large impact on the way patients perceive their care.
Pugliese’s career grew out of his previous role as a patient advocate. “A patient advocate deals with real-time complaints and grievances,” he says. “A patient experience coach finds a theme in the complaints, is pre-emptive and helps develop processes so those complaints don’t keep happening.”
Pugliese was inspired by his job as an advocate to get a master’s degree in organizational development and change. Then he joined Einstein a year ago as an experience coach.
Pugliese says his jobs have always been about “guest experience” in one form or another – including his nine years as a bartender and his jobs in restaurants and retail. He says his “people experience” was influenced in part by the time he spent in foster care when he was an older teen.
“It wasn’t a good or bad experience,” he says. “I think it gave me a different perspective on people as a whole and meeting them where they were with an open mind.”
Pugliese’s job at Einstein Montgomery is gratifying because “I’m a numbers person. I like to be able to quantify what I’m doing. I’m also a people person. I like to work with people and see them succeed.”