He says CHCW took last year to define what type of culture the organization wanted to have. Employees were placed into six groups and asked to come up with ideas. From those sessions, four key words emerged that Schaffrinna says are getting pushed out into the organization continuously: helpfulness, encourage, team, and accountable. Staff members receive a coin to acknowledge their demonstration of those attributes with patients. The coin says "roundtuit," referring to the phrase "You got around to it."
"It's acknowledging staff for taking the extra time," says Schaffrinna, who says the coins are a first step to getting nurses, physicians, and other staff engaged in the extra effort it can take to make a patient aware that they are an equal partner in their care. "Mental health issues, overweight patients, chronic disease—these are opportunities we'remissing because we haven't engaged early enough."
CHCW has only just begun handing out the coins, which can be exchanged for a vacation day. Schaffrinna says he is determined to change the culture at the organization, not because its providers aren't doing a good job, but because he thinks they can do better.
"Every one of our locations is a patient-centered medical home," he says. "When an organization gets to that level, they're better than they were, but it's too low of a bar. Engaging a patient is more than giving them information. They have to trust you. If we don't take control of this ourselves and make it better, our patients are going to suffer."
CHCW has made small improvements in its care of the 30,000 patients its providers see annually. The rate of women receiving prenatal care has improved from 78.5% in 2011 to 80.5% in 2013, and the rate of childhood immunizations increased from 72.9% to 84.2% over the same time period.
Patient engagement is activation
Healthcare organizations have a variety of ways to measure patient engagement. They may look at health outcomes over a period of time, or measure patient satisfaction, or encourage and monitor interaction with the organization's online tools. But a researcher at the University of Oregon put a finer point on the definition of engagement and developed a statistically validated and peer-accepted method to measure a patient's activation level.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.