Case Study detailing the unique details of the patient experience and what it should be at the Orthopedic Sports Institute in Appleton, WI. Miron Construction Co., Inc's Steve Tyink used the C5 process to define the goals of what OSI wanted the patients to experience during their stay, and the building was constructed around those definitions.
1. Reimagine The Patient Experience
A Miron Construction Case Study
AttAchment – it’s the new measurement for patient and staff success in today’s highly competitive health care environment.
Attachment leads to a deeper, more meaningful connection between patients, providers, and staff members that results in lasting
and prof itable relationships.
Orthopedic & Sports Institute physicians and administrators understand that the winning differentiator is no longer
the product or service, but the level of patient attachment – the extent to which an organization creates an intimate,
enduring relationship with the patient. Research shows that attached customers are important to the life blood of any
organization.
In a recent survey, 79% of executives state that customers who are engaged or attached recommend products and services
to others, 64% say engaged customers are frequent purchasers, and 61% believe they provide frequent feedback on products
and services. In addition, almost 55% of executives claim that engaged customers are less price sensitive. 1
1 The Economist Intelligence Unit, March 2007
2. Reimagine The Patient Experience
Three Tough Questions Were Asked
“Are patients ever attached to a Are we proud of the patient experience The Institute provides?
building? At Miron Construction, Are we confident that we are the provider of choice in our community?
we realize that simply to build is not Do we provide the experience we would want for our family members
enough. For our projects to be highly
or friends if they were hospitalized?
innovative and supremely successful,
they must transform how people feel,
Together, The Orthopedic & Sports Institute and Miron wanted to answer
take their thoughts and emotions to
these three questions. To assume we knew the answers was simply not enough.
an entirely new level.”
To guess, was living in the past. We realized that in an emerging age of change
David G. Voss, Jr.
within the healthcare setting we needed to reexamine the traditional practices
President, Miron Construction of Orthopedic care and provide greater sensitivity and responsiveness to our
services. Reimagining the experience was our only choice.
This case study draws lessons from the experience of a highly innovative
Orthopedic Clinic in Appleton, Wisconsin. One that illustrates how the
integration of the ideal patient experience and innovative technology is possible.
Outlined are the strategies put in place, the roadblocks they faced and overcame,
and the key successes.
◂2▸
3. Experience Ecology
How do you build a healing environment?
What happens if. . . ?
What happens when. . .?
Experience ecology requires that each and every element of the facility is
designed to create a unified and cohesive environment based on patient and
clinician outcomes. These actions form a greater balance, which is consistent
with the diagnostic and therapeutic activities taking place. More importantly,
this balance must enhance, not tear apart patients, families, employees, and
providers varying self-identities. Ideal patient experiences must trigger, not
close down, creative innovations and identify the purest form of patient feelings.
Environments should sustain positive thoughts and not provoke boredom, anger,
apprehension or apathy.
Three critical elements were required to build this type of transforming healing
environment.
• Physical
• Behavioral “We used the expected emotional
outcomes from process users
• Informational
connected with the optimized patient
flow from functional owners, to create
Each area communicates independently, yet strongly to all end users as they
value for patients, staff members and
join together in understanding and creating the ideal patient experience. These physicians alike. What was once a
elements are often forgotten or executed erroneously. At best, their uniqueness sacred space was up for discussion.
remains unappreciated and separated. In answering the three tough questions Anything was possible.”
for The Institute, all three elements were uncovered, understood, mapped and
ultimately brought to life. Curt Kubiak
Executive Director, The Institute
Physical
Physical elements include all aspects of spatial integration. These include furnishings
with an understanding of the fabric pattern and color, illuminations, textures, scents,
temperature, flora, sounds, taste and apparel worn by participants. Is the physical
space creating the desired outcomes?
A Miron Construction Case Study
4. Reimagine The Patient Experience
Behavioral
Behavioral elements include all movement sequence interactions between the patient
Physical and clinicians determining how they advance through the space and the time
required to do so. Are the behavioral elements aligned to the outcomes desired? Is
there transparency throughout the setting, between departments, from one day to
another?
ECOLOGY
Behavioral Informational
Informational elements include all forms, documents, communication collateral,
spoken words, gestures, posture, impressions, signage, technology, or other forms of
Informational media exchange. Is there integration between the informational elements and the
behavioral? Are the informational elements based on the patient or the clinic?
“Patients and staff need to work
collaboratively to reimagine and design
the ideal experience based on all three
elements – without this understanding,
the unique and personalized patient
experience will be lost. ”
Steve Tyink
Vice President Business Innovation,
Miron Construction
◂4▸
6. Reimagine The Patient Experience
Just Imagine
A friendly concierge at reception smiles and welcomes a patient by first name.
Boutique, hotel-style amenities including flat-screen televisions, which can be
used to access the Internet, patient-education materials, water features, natural
“Much like great art, colors, fabrics and elements, and even room-service menus. All overnight rooms have wireless
style can represent a different feeling phone systems and monitoring devices so that patients can have direct contact
for each participant. We do understand
with their caregivers rather than going through the reception desk. With less
that if the patient experience comes
phone calls and overhead paging, patients and overnight guests experience a
first, positive patient sensations
better night’s sleep. Each room has a wireless laptop computer so that nurses
will be brought to life; enabling the
and caregivers retrieve patient charts only steps from the bedside. Since family
participants to feel completely special
within their healing process. What is
members often stay for long shifts, why not offer day beds for ease of rest.
the overall experience attempting to Patients enjoy pre-selected music and movies from iTunes (asked by their
represent? Like a great novel, you are physician in the last consultation before surgery).
compelled to keep reading.”
The bottom-line is this: People from all walks of life have an innate desire to
Angie Laux, R.N. feel a part of something special, to believe and understand that their thoughts
Administrative Coordinator, and feelings matter. At The Orthopedic Institute they do matter. Patients can
The Institute enjoy the following, everyday, every time, without fail- this is our vision...
Prescriptions - Filled immediately through physician interaction.
◂6▸
7. Concierge - Services to assist every step of the way (including elderly
guidance).
Flex Room – Nurses move patients less often when all rooms have equipment that
folds out to provide critical systems such as anesthesia gases, and heart monitors.
This design feature cuts down on noise and the infections that may pass from
patient-to-patient in shared rooms.
Recovery Room – Private pre and post-surgical patient rooms for comfortable
and seamless recovery, enhanced infection control and greater privacy. Modeled
after a Ritz-Carlton hotel room.
Atrium - Visitors enjoy comfortable surroundings to remain connected to their
family and friends being treated.
Hospitality Center – Institute concierge assist you in preparing the coffee of the
day. Juices, coffee and snacks are available as well.
“Health care delivery needs to change.
The Institute Room Service - Patients order their meals through a 24-hour The old thoughts that helped to create
staffed room service department via telephone or by request. the patient experience of the past are
no longer valid. From the beginning,
Therapeutic Bodywork – Feature a variety of alternative medical services our extended stay process must be
such as yoga and palates. designed in a unique way, based on
how our patients feel with outcomes
In-room Scheduling – Rather than sending the patient to another sub-waiting that exceed industry standards.”
area, patients are scheduled for diagnostics and imaging in the exam room.
David Eggert, MD
Soundscapes – Personal choice of music is offered and available through
Orthopedic Surgeon, The Institute
headphones.
Institute Gowns - Designed with the patient, not the clinic in mind. Easy to use
‘tear-away’ pants and shirts that create comfort, ease of use, warmth and respect.
Blissful Bedding – 300 count thread linens, choice of pillow softness.
A Miron Construction Case Study
8. Reimagine The Patient Experience
Reverse Outcome Modeling
So how do you reimagine the patient experience?
How do you build an ideal healing environment?
What should happen if. . .?
What should happen when. . .?
Miron, along with 52 staff member of The Institute identified the experience
areas, attachpoints, outcomes and actionable items that realign and transform
how patients experience and feel Orthopedic care. Incorporating the patient
experience Reverse Outcome Modeling process, evidence-based design can be
achieved. The objective of ROM is to translate the design elements established
to directly impact patients’ physical and psychological health, thus reducing
patient stress and promoting rapid recovery. Without beginning with outcomes
in mind and working backwards, the behaviors required to ground swell change
would not have realized.
The Miron healing design process focuses on three primary ways in which the
“We started with the outcomes –
how a patient feels – and moved
environment can influence patient outcomes:
backwards. Very non-traditional, but
incredibly important. The key to a Medical Care
healing environment involves every The environment can support or impede caregiver actions and medical interventions.
aspect of the The Institute.” Is the environment easy or diff icult for providers to do their jobs facilitating helpful
or harmful impacts?
David Ritzow, MD
Orthopedic Surgeon, The Institute Miron Experience Tool: Rapid Access Prototyping
HealthCare Example: 23-Hour Stay Process
“We realized that many of our patients wanted to avoid the traditional stay
for partial knee replacement” commented David Ritzow, MD, Orthopedic
Surgeon of The Institute. “In fact, once we began asking, we became aware of
the possibilities.”
From the beginning, The Institute utilized Miron’s unique experience tools,
systems and methodologies to create the extended stay process. “We started with
the outcomes – how a patient felt – and moved backwards. Very non-traditional.”
◂8▸
9. said Ritzow. To create this revolutionary new process, the experience tool of
Rapid Access Prototyping was implemented. The Miron experience based design
team challenged traditional thought processes.
Health Status
An environment has the ability to strengthen or impair a patients’ health status by
reducing or encouraging existing conditions and feelings.
Miron Experience Tool: Barrier Observation
Health Care Example: Patient Greeting & Way finding
Typically very little thought or experience based design energy is focused on
issues related to the patient greeting. In understanding the current flow and
barriers to the ideal experience, 5 experience barriers will exist.
What are the physical barriers to the ideal outcomes?
What are the communication barriers to the ideal outcomes?
What are the sight barriers to the ideal outcomes?
“Just as evidence-based medicine is
What are the spatial considerations to the idea outcomes?
revolutionizing health care treatment,
What is the movement sequence (behaviors) to consider? evidence-based design is transforming
the healthcare environment. We now
In many hospital or clinical settings, barriers to the ideal experience must have at our disposal proven methods
for improving patient outcomes, safety,
be identified, understood and corrected. We recently discovered that the
attachment, as well as staff retention
average greeting and patient way finding time was reduced by over 4 minutes
and service efficiency.”
through the integration of the barrier observation tool. This tool resulted in
the understanding and need for a pre-surgical welcome packet. “Our patients
Dennis Lynch
were often confused, lost and frustrated. Although we assumed they understood, VP Health Care Services,
the opposite was often the case,” commented Angie Laux, ASC Coordinator. Miron Construction Co., Inc.
“Due to the protocols established long ago, the patient outcomes of feeling
cared for, welcomed, respected and acknowledged were lost and patient anxiety
increased from the moment they entered the facility. It had to change.” Due
to this process, patients now understand how to enter the building and where
A Miron Construction Case Study
10. Reimagine The Patient Experience
to go and look for their patient services representative, a familiar face from our
pre-surgical conference and welcome packet.
Causes of Illness
The environment can protect patients from, or expose patients to their subsequent
healing.
Miron Experience Tool: Impression Areas & Attachpoints
Health Care Example: Sounds Heard During Postoperative Recovery
What are the main impression areas that affect a patient’s experience?
What are the specif ic attachpoints that make up the impression area?
W hat ar e the outcomes that you want the patient to f eel about the
attachpoints?
“By simply altering processes, By identifying the main impression area (postoperative surgery center) and the
modeling impression areas and attach
many attachpoints associated with the selected impression area (recovery room),
points, understanding outcomes and
patient feelings and outcomes can be determined. Without this breakdown, the
shifting behaviors, the experience
task is unmanageable and generally focuses efforts on the transactional portions
at The Institute now closely reflects
of care. Outcomes become integrated within the behaviors of the providers,
our vision and commitment to
patients. The Result? An experience
creating a transparent delivery system.
that is unforgettable. The ultimate
healing environment and ideal patient What if a caregiver raises their voice, receives a cell phone call or a recovering
experience have been created and are patient hears an overhead page? Patient recovery time is extended and the
well underway.” healing environment of the patient is not ideal.
Chris Weinlander, MD By simply altering processes, modeling impression areas and attachpoints,
Anesthesiologist, The Institute understanding outcomes and shifting behaviors, the experience becomes
unforgettable. The ultimate healing environment and patient experience is
created and underway.
◂ 10 ▸
11. Experience Innovation
When we were able to identify what to change – when, where and how – The
Institute was then capable of designing a unique experience filled with efficiency
and effectiveness. With the assistance of the experience-based design team, the
tools allowed The Institute to:
• Observe the current employee and patient experience through fresh eyes
• Enhance the current experience to achieve desired patient outcomes
• Intentionally orchestrate experiences which achieve business results.
Innovation comes to life through the eyes of the patient and helps to ensure
desired outcomes happen every time, everyday, without fail, no exceptions. The
statement “that’s the way it’s always been done,”
...is simply no longer acceptable…
…reimagine the experience with Miron Construction.
Steve Tyink, VP Business Innovation
Miron Construction Co., Inc.
☎ 920.969.7047
� steve.tyink@miron-construction.com
A Miron Construction Case Study
12. 1471 McMahon Drive
Neenah, WI 54956
P 920.969.7000
F 920.969.7393
www.miron-construction.com