Company: Baystate Children's Hospital
Timeframe: 2006, ongoing
There are good reasons why the words "health care" and "fun" are rarely found in the same sentence. Hardly anyone loves visits to the doctor, hospital stays or diagnostic
testing, and this is particularly true of children. But PR teams can play a strong role in improving how a medical facility is perceived, starting with the staff.
Baystate Children's Hospital in Massachusetts embarked on a journey to create a new patient experience - one that embodied the "Spirit of the Child." The hospital's
leadership saw a need to teach the "caregiver principles of practice" to its staff.
That's where the Spirit of the Child Passport Book came in. The Passport Book was created to educate each employee on how they can create imaginative ways to care for kids
and their families. The intended audience was the 500 employees in inpatient and outpatient pediatric areas in the areas of Baystate Children's Hospital Neonatal Intensive
Care Unit, the children's and infants inpatient unit, the adolescent inpatient unit, the Pediatric Intensive Care unit, the Emergency Room Just For Kids, the Children's
Surgery Center, and pediatric clinics.
The book incorporated the Line of Sight technique, which the hospital designed to improve the patient experience by empowering its front-line employees, who have the most
direct "view" of the patient experience. Baystate had examined programs implemented at other top hospitals in the nation, and developed this technique to enable employees to
make decisions to improve care and quality.
"It's not the manager making decisions and saying 'You are going to do this,'" says Pat Gagon, senior communications specialist at Baystate Children's Hospital. "The
employees know what's going on, and they can make the decisions."
The Passport Book brings the Line of Sight technique to each employee, whether it's the nursing team, the doctors, environmental services or food services. One objective
was for each employee to understand the principles of practice and implement them during their day. Those principles include:
1. Make each family's encounter with Baystate Children's Hospital a positively memorable experience.
2. Convey respect and preserve the dignity of each child and family.
3. Earn and be worthy of the sacred trust extended by families who rely on us to care for their child.
4. Acknowledge and support the individuality, strengths, and culture of each child and family.
5. Work to the best of our ability to solicit the wishes, fears, and concerns that patients and families have and address these in a supportive and empathetic manner.
6. Ask about child and family preferences, priorities, concerns, goals for treatment, and how we as caregivers may add value to each family's Baystate Children's Hospital
experience.
7. Facilitate the family's participation in decision-making for their child's care and wellbeing.
8. Recognize that emotional, spiritual and family supports are essential components of outstanding patient care.
9. Coordinate and integrate contributions from different disciplines into the plan of care.
10. Provide care according to the Institute of Medicine's Six Aims for Health Care: Care that is safe, timely, effective, efficient, equitable, and patient-centered.
"We wanted it to be something special that employees could carry with them and use to include patients and their parent," says Gagnon. "We thought of children's books -
the graphic designer and I have small children, and we read to them every day. We also made it a workbook employees could write in. The tear-out pages had employees document
examples of how they would accomplish each principle of practice, identify barriers, brainstorm how they would overcome them, and record a specific interaction they had that
exemplified the principle. Employees were told to bring this page to the next staff meeting to share with fellow employees."
The Passport Book was styled as a passport, which would translate into an important document employees could keep with them as they traveled through the hospital and their
workdays. Inspired by children's books and in keeping with the "spirit of a child," the team used bright colors, whimsical illustrations, and cut-out icons that lead the
viewer from one page to the next.
Gagnon was part of the team that wrote and designed the book in-house, only going outside for printing. The team used quotes from patients, asking them "if you could
design a children's hospital, what would it look like?" Each page lists one of the ten principles along with a flip-out/tear-out page for each principle that asks caregivers
to think more about the principle and document on the page and how they could implement it in their practice. After they have torn out the page, the principle remains on the
page and the book remains intact as a resource.
But, as they say, Rome wasn't built in a day. "One of the challenges the team faced was how the elements would work together," says Gagnon. "We wanted to have the
principles in a book form, but it had to be a workbook that would not be easily destroyed. When you get to a principle, that page flips out and can be torn out and brought to
a staff meeting, but the book remains intact with the principles. That was a creative approach to a challenge."
In addition, "the printers, when they first sat down with us, had not done a project like this before," Gagnon recalls. "There was a lot of hand work, and we had to work
that into the time frame. There were folds, spike-ups - lots of elements. You couldn't just staple, stitch and go."
Beyond the logistical challenges of creating the book, the team needed to find ways to incorporate the spirit of the child concept - a phrase that is used internally to
guide the work of the overall care-giving team - into the daily work lives of the staff. "Everybody was on board with what it meant," says Gagnon. "But we struggled with how
overwhelmed the employees were with all the work they do. The book worked well to challenge individuals to think about their particular jobs and unique ways of doing things.
It challenged them to give it more thought to it, to break down the principles and think about how they could personally make them happen for their patients."
One way the team brought the initiative home to employees was by asking them to try to remember what it was like to be a child. " We had an exercise to have them remember
an illness or a hospital experience they had as a child, to remember those feelings and events and record them," says Gagnon.
To meet the challenges, the team took several approaches. Gagnon says, "We started with clinical and administrative leaders, who saw an overlap between high-quality
clinical outcomes and patient satisfaction. We needed to make a breakthrough in the area of patient experiences. If we made it a magical thing, our clinical outcomes would go
up." Among the many initiatives that have accompanied the Spirit of the Child Passport Book are new children's menus, an adolescent unit with its own menu, and a play deck
area.
The hospital's food services conducted a taste test to let kids tell them what they thought. One eight-year-old girl who had a lot of ideas actually sat down with the
staff to talk about it. Changes to the normal hospital routine took into account the fact that teenagers don't usually wake up at 8 a.m., which is when food services used to
bring the breakfast trays. Now, the teen patients are allowed to call for food when they wake up.
New menu options for children featured such items as dinosaur chicken nuggets, and a nutritionist worked with the team to make sure foods were still meeting the hospital's
standards. And the facility created such new positions as ambassadors for the children and teens.
In any initiative that involves patient care, Gagnon says, "It all starts with what you are trying to achieve at a basic level, what are your goals, who is your audience,
what will move or motivate them. You have to have a product that represents the spirit of that project, like a children's book, that hits home with a lot of people." For
Gagnon, the Passport Book was an easy, natural project because it involved childcare, a topic near to her heart and one that is conducive to creativity.
Once the initial concepts are in place, the creativity flows. "Three of us sat down with our goals and audience, and I brought to the table the idea of a children's book,
and everyone started throwing out ideas," Gagnon remembers. "It wasn't just one person's idea - the brainstorming worked well."
Inspiring Results
The efforts overall appear to be going well, too. The Passport Book now serves as a pilot model for a system-wide passport, and it the Children's Hospital staff is
actively using it. It was also shared at a Children's Hospital retreat for key internal stakeholders, and at a regional business strategy conference as an example of a
passport supporting a Line of Sight pilot project. In addition, the campaign recently won the IABC Heritage Region's Silver Quill award for Customer Relations.
But possibly the most telling evidence of success is the enthusiastic participation of the patients and their families. Because the staff members know the families
provided the quotes that appear in the Passport Book, it really hits home. "You can talk about concepts, but once it comes from the patients and families, it shows their
creativity and the spirit they have. It makes it really personal," says Gagnon.
One patient, Cory, was asked what he would incorporate if he could design his own hospital for children. At first, Cory's ideas came out slowly. But, says Gagnon, "Once he
started to think about it, and realized we were asking what he would want if he could do anything, Cory said he wanted a roller coaster that would go 200 mph and take him
anywhere he wanted to go in the hospital." Cory's idea appears in support of one of the ten principles in the book. So much for gurneys ...
Another young patient, Brian, said his favorite food in the cafeteria was bacon and maple syrup. That's depicted on another page of the Passport Book, designed in colors
that reflected his culinary choices.
And one boy, Joseph, inspired a page that shows a big illustration of a cherry ... because that's what he wants all "yucky" medicine to taste like.
Contact: Patricia Gagnon, 413.794.7648, [email protected]
Quest For Good Patient Care
Health care is a tricky business, confronting a host of patient fears and sensitivities. When Quest Diagnostics wanted to overcome patients' anxiety about medical tests,
it sought innovative approaches to get all 40,000 of its employees onboard to foster a positive experience for its patients. The multi-year "Employee Ambassador Initiative"
indoctrinated employees into the corporate vision. Insidedge - agency GolinHarris' global employee communications group - helped develop an interactive training session: "The
Patient Experience." Teaser posters, a video and resource kits enhanced employees' understanding of the patient's experience at Quest, underscoring empathy.
A quiz show-style computer game pitted teams of employees from locations across the country against one another in real-time competition, engaging their interesting and
providing an element of fun. A 2005 employee satisfaction survey reported that 85% of employees said they had pride in the company; and 98% said that, after the training
session, they felt better prepared to be an ambassador for the company.
Similarly, when the New Jersey Department of Health and Senior Services wanted to reach out to women who were at risk of contracting HIV/AIDS, it turned to venues and
ambassadors that would make those women comfortable: salons. Among the target group, African-American and Hispanic women between 20 and 49, there was little recognition of
the risks they faced, so Fleishman-Hillard worked with some 300 hair and nail salons that were willing to participate in the sensitive project.
Says Janet Johnson, the senior vice president at Fleishman-Hillard who spearheaded the "20-minute Test That Could Save Your Life" campaign, "We wanted to reduce the
stigma, the fear of talking about HIV/AIDS, but we didn't have any way of measuring the attitudes about it. The more often people see things -- whether it's brochures,
bulletin boards, articles, ads on busses, or community areas in the cities -- the more it helps. As more people talk about it, it becomes less of a taboo."
Posters and magnets drew salon-goers' attention, and brochures, branded emery boards, condoms and counter display boxes brandished a helpline phone number and Rapid HIV
test information. Calls to the help line increased by 90%, with nearly every caller asking how they or a loved one could be tested. Close to 5 million media impressions were
created, as well as more than 220,000 positive impressions among the Latina and African-American audiences.
Contact: Janet Johnson, 212-453-2488, [email protected]