Patient experience: Where does it actually begin?

We found this article very interesting. While it is not about medical travel, it supports one of GHA’s core beliefs – that the patient experience extends beyond the clinical setting (both before and after). This is a clear instance of the medical travel industry being ahead of the curve and offering valuable lessons for healthcare providers to follow even if they are not involved in medical travel. Click here to view the article.

GHA Advisory Board Meets in Los Angeles

On Monday, October 2nd, GHA held its inaugural advisory board meeting in Los Angeles. The board meeting provided a platform for GHA leadership and board members to express their unique perspectives on the current trends, challenges, and opportunities in the medical travel industry and to discuss GHA strategic initiatives for the coming year. The advisory board members who attended were:

• Noam Baruch, Head of Passport to Healthcare, AETNA International
• Larry Boress, President & CEO of Midwest Business Group
• Chip Burgett, Managing Director of Quandary Healthcare Solutions
• Dr. Erik Fleischman, International Medical Director, Bumrungrad International Hospital
• Aileen R. Killen, Global Head of Healthcare Risk Consulting, AIG
• Laurent Pochat-Cottilloux, Global Head of Health Reinsurance Partnerships, AXA
• Dr. Omar Shalabi, Division Head for the Central & Western Regions, Management Population Health Division, Johns Hopkins Aramco Healthcare (JHAH)
• Dr. Nizar Zein, Chairman, Global Patient Services, Cleveland Clinic
• Joseph Zhao, Deputy General Manager, Beijing Saint Lucia Consulting Pty Ltd

Also present were GHA regional representatives Abdallah Hindawi, Global Healthcare Travel, Jordan and Somporn Kumphong, HealthCare Expert Group, Thailand as well as members of the GHA leadership team: Karen Timmons, CEO, Mary Miller Sallah, Chief Quality Officer and Bill Cook, Director of Business Development.

GHA leadership thanks our advisory board members for their participation and enthusiastic support in this year’s meeting and we look forward to benefiting from your insight and expertise in the months and years to come.

GHA Makes an Impact at the 10th World Medical Tourism Congress – Los Angeles, California

The Global Healthcare Accreditation® (GHA) program made its presence felt at the 10th World Medical Tourism Congress held in Los Angeles, California between October 2 – 4, 2017. The event is the most prestigious international healthcare conference and tradeshow in the industry bringing attendees from across the world to collaborate and advance the industry. Healthcare providers, insurance companies, governments, employers, wellness companies, and medical tourism facilitators are just some of the many stakeholders who came to network, learn and share best practices in medical travel, employer benefits and corporate wellness.

4 Healthcare Facilities on Three Continents Achieve Accreditation by GHA

On October 3rd, Karen Timmons, CEO of the GHA Program presented one of the opening keynotes: “The Clarion Call for Excellence: A New Era of Health Consumers,” which focused on the new era of consumerism, propelled by rapidly evolving technology which has dramatically impacted consumer experience. According to Ms. Timmons, “The seamless level of service that consumers have begun to expect has expanded to healthcare, providing greater demands and opportunities for payers and providers to go beyond the expected “satisfaction” to deliver patient experience excellence. Healthcare organizations must focus on ensuring the patient experience is seamless throughout the entire medical travel care continuum, including pre-admission and post-discharge, and that business functions that support medical travel are designed with this in mind. GHA accreditation validates and facilitates excellence in patient experience and sustainable business practices.”

Immediately following her keynote, Ms. Timmons presented award plaques to representatives of three healthcare organizations attending the congress whom had recently achieved Global Healthcare Accreditation by the GHA Program, and announced a fourth. Dr. Erik Fleischman, International Medical Director, accepted on behalf of Bumrungrad International Hospital (BIH) in Thailand; Dr. Nizar Zein, Chairman Global Patient Services, accepted on behalf of Cleveland Clinic Ohio; and Mr. Rafael Carrillo, Managing Director, accepted on behalf of My Spine Center of Clínica Santa Clarita, in Mexico. St. Catherine Specialty Hospital of Zagreb, Croatia, also achieved Global Healthcare Accreditation for Medical Travel Services by the GHA Program.

The GHA Program also sponsored or hosted a number of sessions at the congress including:

The 6th Medical Director Summit “Destination Medicine”

This three-hour summit was an invitation-only event attended by approximately 50 Medical Directors and Chief Quality Officers representing hospitals from around the globe, as well as several insurance companies. Ms. Karen Timmons and six expert speakers presented on the latest trends and challenges in destination medicine and the development of global medical networks. The summit began with a brief welcome by Ms. Timmons, followed with a speech by Mr. Sammy Refua, President of Prive Care, Co-sponsors of the Medical Director Summit.

The first invited speaker was Dr. Peter Angood, President & Chief Executive Officer, of the American Association for Physician Leadership. Dr. Angood gave a lively presentation titled “Developing Physician-Leaders in Medical Travel.” Highlights included managing change, medicine vs. leadership, and leveraging leadership competencies. Dr. Ziad Abdulhak, Senior Medical Advisor, United Arab Emirates Embassy, followed with a discussion on “Key Strategies for Building a Quality Global Medical Network.” Among the strategies he highlighted were factors such as quick access to treatments, international office efficiency, medical center dedication to international patients and servicing their medical needs, cultural competency and the ability to coordinate logistical support. Nizar Zein, MD, Chairman, Global Patient Services, Cleveland Clinic offered a candid look at “lessons learned” from Cleveland Clinic’s recent expansion to Abu Dhabi including impact on population health and challenges related to quality management, partnerships and safeguarding brand reputation. Dr. Eric Fleicshman, International Medical Director, Bumrungrad International Hospital, outlined how Bumrungrad’s efforts to provide Western level medical care resulted in: reverse brain drain, extreme advancement in surgical techniques, rapid advancement in cancer treatment capacity and implementation of Western Quality Assurance programs and certifications. Dr. Ron Leopold, Chief Medical Officer at Lockton Benefit Group provided an insightful and change of pace with his topic: “Five Trends in Health & Wellness and How Employers Should Respond.” Dr. Leopold’s presentation dealt with trends in medical costs, wellbeing, productivity and healthcare delivery. The last speaker was Dr. Omar Shalabi, Division Head, Central & Western Regions Population Health, Johns Hopkins Aramco Healthcare. Dr. Shalabi provided attendees with a detailed look at the unique challenges faced by Jordan in its quest to deliver a high quality patient experience in medical travel. In closing, Ms. Karen Timmons commented on some key takeaways from each presentation and then concluded with a brief overview of the GHA program.

In addition to the 6th Medical Director Summit, GHA leadership participated in several other sessions including:

Driving Quality and Savings with Employer Direct Contracting

Moderated by Ms. Karen Timmons, this session looked at buyer and provider perspectives on direct contracting as well as future trends, opportunities and challenges. The exceptional panel consisted of:

 Mr. Rob Stall, Executive Director of International Operations at Cleveland Clinic,
 Mr. Jerry Fiala Director, Sales & Marketing at Cleveland Clinic and
 Mr. Chip Burgett, Managing Director at Quandary Healthcare Solutions.

Mr. Rob Stall began his presentation with a summary of Cleveland Clinic’s global footprint and international initiatives – particularly in the United Arab Emirates. Mr. Jerry Fiala followed with a look at Cleveland Clinic´s direct contracting initiatives in the U.S., focusing on the benefits to providers which included “offering top-ranked heart care to employees, access efficiencies and savings, predictable bundled case rate, and avoiding variability in outcomes.” Mr. Fiala also highlighted the patient experience as a key component of Cleveland Clinic’s value proposition to employers. Mr. Chip Burgett closed the session with some recommendations for employers considering direct contracting. Mr. Burgett emphasized focusing on “quality measures,” “member engagement” and “minimizing reliance on Preferred Provider Organizations” as important factors to consider when direct contracting with providers.

Medical Destination Reputation Management: How a Single Interaction Can Impact Your Brand

Moderated by Ms. Karen Timmons, the expert panel included Dr. Erik Fleischman, International Medical Director of Bumrungrad International Hospital; Dr. Maan Fares, Vice Chairman of Global Patient Services for Cleveland Clinic, and Mr. Mohammed Al-Hameli, Director of International Patient Care Division of the Abu Dhabi Department of Health. This session focused on how the patient experience and good outcomes lie at the heart of a successful destination strategy in medical travel and what key components provide successful risk management. Transparency, focusing on patient-centered care and having a plan in place to deal with unexpected public relations’ emergencies were some of the key points highlighted in this session. Ms. Timmons stated, “As we have witnessed the past year in the airline industry, reputations can be tarnished instantly in this age of 24/7 social media. Healthcare organizations cannot be complacent and must be prepared to proactively manage their reputations through a keen focus on patient experience, good clinical outcomes and risk management strategies.”

Accreditation in Medical Travel and its Impact on Operational Excellence

This session gathered a panel of representatives from healthcare facilities recently accredited by the GHA Program to discuss their unique perspectives about the GHA Standards, the accreditation process and the value of earning Global Healthcare Accreditation. Mrs. Mary Miller Sallah, GHA’s Chief Quality Officer, moderated the session and began by highlighting GHA’s focus on the patient experience across the entire medical travel care continuum and sustainable business process as key differentiators of the GHA program. She then encouraged panelists to discuss specific ways in which the accreditation process had impacted their organizations. Dr. Erik Fleischman, International Medical Director of Bumrungrad International Hospital commented, “GHA was particularly fitting for our institution as it is the only accreditation that helps assure quality care from the time a patient leaves their home to the time they return after medical care. We are a great hospital. We are even better after GHA.” Dr. Vanessa Felix, Medical Director of My Spine Center of Clínica Santa Clarita stated, “GHA has helped prepare our clinic to anticipate our traveling patients’ needs and expectations, ensuring we provide an exceptional experience before, during and after their visit.” Mr. Kevin Edwards, Nurse Practitioner at Cleveland Clinic, Ohio said, “No matter how great your healthcare facility or positive the procedure outcome, if you mess up on the cultural sensibility required of medical travelers you risk degrading the entire patient experience.” Towards the end of the session, Dr. Somporn Kumphong, CEO of Healthcare Expert Group of Thailand (and a Regional Representative for the GHA Program in Thailand and Japan) spoke about his interactions with hospital leaders in Thailand and discussed the gap in the patient experience, particularly before and after treatment as a challenge for internationally accredited facilities in Thailand.

Final Thoughts

During the congress, GHA Program leadership met with representatives from many healthcare facilities and governments interested in learning more about the GHA program. There was much curiosity and interest in understanding how GHA fit within the context of other international accreditations. GHA Program leadership explained that “GHA Standards complement existing national and international clinical and quality accreditation programs. While these programs traditionally focus on the clinical aspects of care for the entire organization, GHA conducts a deep review of a medical travel program, such as an International/ Global Patient Services program).” There were also some keen discussions regarding key challenges in the industry which GHA strives to address, such as consensus on definitions, data collection and engaging diverse stakeholders to ensure an optimal patient experience for medical travelers.

Mrs. Karen Timmons summed up her impressions about the 10th World Medical Tourism Congress with these words: “Through the sessions we hosted and the many one-on-one meetings with healthcare providers, the congress provided an ideal venue for the GHA Program to showcase its value proposition to a wide international audience. We are very enthusiastic about the interest expressed in the GHA Program and working with the many organizations we met in Los Angeles who expressed interest in streamlining their medical travel care continuum, enhancing patient experience and improving sustainable business practices.

Four Healthcare Providers on Three Continents Awarded Global Healthcare Accreditation

PALM BEACH GARDENS, Fla., Oct. 4, 2017 /PRNewswire-USNewswire/ — Global Healthcare Accreditation (GHA) announces the accreditation of four healthcare providers: Bumrungrad International Hospital, Thailand (Accreditation with Excellence); Cleveland Clinic Ohio, USA (Accreditation with Excellence); My Spine Center of Clínica Santa Clarita, Mexico; and St. Catherine’s Specialty Hospital, Croatia. All have three-year terms of accreditation from the GHA Program. Representatives of each organization received a plaque recognizing their accreditation at the 10th World Medical Tourism & Global Healthcare Congress in Los Angeles, California on Tuesday, October 2.

The GHA standards address a hospital’s performance in three core competencies: Patient-Focused Clinical Processes, Patient Experience, and Sustainable Business Processes. In preparation for the GHA on-site evaluation, each organization completed a comprehensive review of policies, procedures, and services related to the medical travel care continuum and prepare to improve any areas that did not comply with GHA standards. GHA also embeds a business solution for accredited institutions designed to help improve an organization’s operations and bottom line.

According to Dr. Erik Fleischman, Medical Director International of Bumrungrad International Hospital, “The secret to creating the best patient experience is in the details of management– not only in clinical care management but in the other important aspects of patient care. These start when a patient chooses our facility and ends when they arrive back home. GHA is the only accreditation that has ever examined these points and elevated them to the importance they play in patient satisfaction and successful care. Even a top international hospital like Bumrungrad had much to learn from GHA. We were a great hospital. We are even better now.”

“It’s crucial to ensure patients’ needs are met, especially those who travel for care. Each year we receive patients from all 50 states and over 125 countries. We chose GHA as it conducts a deep review of the entire Medical Travel Care Continuum, beginning when the patient first enquires about our services all the way through their arrival back home, including the patient experience at all touch points. Additionally, GHA reviews those sustainable business processes and practices related to medical travel and have helped us identify areas of opportunity to enhance the patient experience and improve operational performance,” stated Dr. Nizar Zein, Chairman Global Patient Services, Cleveland Clinic.

Rafael Carrillo, Managing Director of My Spine Center by Clínica Santa Clarita said, “State-of-the-art equipment, advanced medical procedures, and top-notch doctors are only a part of what makes My Spine Center by Clínica Santa Clarita so attractive to traveling patients. More importantly, it is our goal to build a trusted and life-long relationship with our patients, local and international. GHA has helped prepare our clinic to anticipate our traveling patients’ needs and expectations, ensuring we provide an exceptional experience before, during and after their visit. By choosing a GHA accredited institution, our patients will find clarity and understanding of what to expect from their treatments, our medical specialists, and how our staff will deliver the safest and best care experience.”

Jadranka Primorac, COO of St. Catherine Hospital stated, “Our hospital has an international reputation for providing excellent patient care and meeting high clinical and educational standards. We are a renowned teaching hospital and research center in Croatia and regionally, always striving to be on the cutting-edge of new medical technologies that will benefit our patients. Even so, the GHA process taught us new strategies to improve the patient experience for medical travelers and refine our operational procedures. We are extremely proud to have achieved Global Healthcare Accreditation as it validates our commitment to improving patient care and safety for traveling patients.”

“The continued increase in medical travel has necessitated healthcare and dental providers to acquire new organizational and staff skills to support a positive, safe, and patient-centered experience in their facility. GHA standards are the foundation of a systematic and objective evaluation process of an organization’s approach to the management of medical travel services. Each standard is part of a comprehensive framework that creates awareness towards meaningful management and quantifiable performance regarding medical travel in order for organizations to improve over time,” stated Karen Timmons, Chief Executive Officer, Global Healthcare Accreditation®.

The Impact of Language Barriers on Healthcare Delivery

Dialing the phone number on her screen, Naomi feels a surge of excitement as her mind races with possibilities. Looks of wonder from her family, compliments from co-workers; actually enjoying the thought of passing in front of a mirror, and best of all, her health would improve and she would finally be able to spend time outdoors with her two kids. She had been morbidly obese for nearly four years – ever since the birth of her second child – and dozens of failed diets later had left her frustrated and depressed.  Recently she had considered bariatric surgery but did not have insurance coverage or the funds to cover the cost – that is, until a friend mentioned “medical travel” and gave her the name of an overseas hospital.

Naomi immediately goes to the hospital’s website, locates a phone number and calls. After two unsuccessful tries her third attempt is rewarded with what sounds to Naomi like a machine gun tat-tat-tat of monosyllabic babble. She requests to be transferred to someone who speaks her language but instead is passed from one department to another until finally landing at the hospital’s pharmacy where she is helped by a kindly pharmacist who is able to communicate with her and manages to connect her to the right department. Though the conversation is a little awkward at first, Naomi manages to convey her needs to the hospital’s representative and is promised a quote as soon as her medical history and requested diagnostic tests are received.

Three weeks later Naomi arrives at her destination and is met outside the airport by a uniformed driver who leads her to a modern, air-conditioned minibus. Arriving at her hotel, she is warmly welcomed by a smiling attendant and accompanied to her suite. The next morning she is picked up on time and taken to the hospital. Her international patient center contact warmly greets her at the door and takes her to a comfortable reception area to brief her on the day’s schedule. 

Naomi’s appointment with the surgeon starts off well, but little by little she gets the sinking feeling that “fluent in English” has a very flexible meaning here. Fortunately, through the use of an interpreter, Naomi gets most of her questions answered before being prepped for surgery.

The first thing Naomi notices is the cold. It chills her to the bone and makes her shiver almost uncontrollably. Through parched lips she calls out for someone to turn up the heat, but all she manages is a raspy mumble. Her mind is vaguely aware of a rhythmic beeping, while at the same time a low murmur of voices signals the presence of humans nearby. Though comforting, Naomi suddenly realizes that she doesn’t understand a word that is being said. Flashes of an in-flight movie and colorful outdoor market dance before her eyes. The fog dissipates and memories start flooding back as a warm hand clasps her arm and a voice says in clear, if not perfect, English, “Ms. Naomi, Dr. Rhone says that your surgery went perfectly. He will see you back in your room in a couple of hours.” Although barely awake, Naomi still manages to break a smile.

Once in her room though, Naomi immediately senses that communication is going to be a problem. Nurses come in and out, inserting IV’s and changing her medication without giving her a glance or much less explaining what they are doing. When Naomi asks one of the nurses what medication is being administered, the nurse timidly backs out of the room waving her arms as if to indicate that someone else will be there shortly to explain.

Later in the day, experiencing severe pain Naomi is unable to get a response from any of the nurses regarding the whereabouts of her surgeon. In desperation she loudly calls the doctor’s name and this finally elicits a response. The surgeon arrives fifteen minutes later and orders additional pain medication. Communication problems continue for several days and culminate in Naomi acquiring a respiratory infection which he feels is the result of less than ideal communication by the nursing staff.

Put yourself in the shoes of the traveling patient

The goal with the above hypothetical narrative is to put you in the shoes of a traveling patient dealing with language barriers. As you may have noticed, language barriers can impact the perception potential patients have of healthcare facilities. Even more worrisome, language barriers may result in increased psychological stress and medically significant communication errors for already anxious patients. [1]

Numerous studies have shown a strong correlation between language barriers and a poor patient experience or even bad healthcare outcomes. In one study in the Philippines, almost one fifth of the participating nurses thought that healthcare outcomes (i.e., nursing care, understanding patients’ needs, communication, healthcare errors, having trust in nursing care and feeling satisfaction) were USUALLY or ALWAYS affected because of language barriers. A fourth of foreign patients in the same study reported communication difficulties and decreasing satisfaction, respectively, as usual or always experienced because of language barriers.[2]

There is also evidence that miscommunication is more likely to occur when clinicians are not fluent in a particular language and cannot correctly convey certain nuances of risk and certainty.[3]

Design and support cultural appropriate services

Understanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. [4] While it may not always be realistic for a healthcare provider’s staff to speak all the languages of medical travelers receiving treatment, healthcare providers are encouraged to design and support cultural appropriate services and processes that meet the identified needs of the target population groups served by the medical travel program. Some key examples include:

  • Employ a diverse, culturally, and linguistically competent workforce.
  • Provide new staff orientation, ongoing in-service training and professional development activities for all staff to ensure understanding and acceptance of values, principles, and practices governing cultural and linguistic competence.
  • Hire on-site interpreters or use bilingual clinical and non-clinical staff.
  • Staff in charge of communicating with prospects should have a good grasp of your target market’s language, both spoken and written.
  • Use multilingual wayfinding and signage.
  • Print materials in various languages and in easy-to-read, low literacy picture and symbol formats.
  • Educational materials should be developed and tested for specific cultural, ethnic and linguistic groups.
  • Translation services including those of legally binding documents (e.g. consent forms, confidentiality and patient rights statements, release of information, and applications).

Healthcare providers caring for medical travel patients must be especially sensitive to the needs of their different patient populations and must be willing to adapt their services and protocols to ensure language barriers are eliminated or minimized. Moreover, they must strive to reduce or eliminate language barriers across the entire medical travel care continuum including the communication prior to the patient’s arrival, interactions at the airport, hotel, and once the patient is discharged from the facility.  Ensuring that language-concordant encounters happen across the medical travel care continuum will ultimately help to improve the patient experience as well as healthcare outcomes.

[1] Bowen S. Language barriers in access to health care. Ottawa, Ontario: Health Canada Ottawa; 2000.

[2] Sameer Al-Harasis. Impact of language barrier on quality of nursing care at Armed Forces Hospitals, TAIF, Saudi Arabia. http://www.me-jn.com/August%202013/language%20barriers.htm. Retrieved 10/26/14

[3]  Roberts GW. Nurse/patient communication within a bilingual health care setting. Br J Nurs. 1994;3(2):60–7.

[4] Renata F. I. Meuter, Cindy Gallois, Norman S. Segalowitz, Andrew G. Ryder, and Julia Hocking. Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566365/#CR5. Accessed 9/24/17

International Hospitals & Medical Travel Magazine Features Interview with Karen Timmons

The latest issue of International Hospitals & Medical Travel Magazine features an indepth interview with GHA CEO Karen Timmons. Karen touches on many topics including the evolution of healthcare, challenges in medical travel, the imporatmnce of the patient experience in medical travel and key differentiating factors between GHA and other international accreditation bodies. Click on the link below to read the entire article.

Karen’s interview in IHMT

Judging a Book by its Cover – The impact of the physical environment on patient perceptions and wellbeing

Patients often judge the quality of a provider’s medical services based on their perceptions of a hospital’s physical environment. Walk into a hospital with stained walls and trash scattered along the floors and you’re likely to do a one eighty and head back out the door. Anecdotal evidence suggests that medical travelers and their companions may be even more sensitive about a healthcare facility’s physical environment than local patients, consciously (or unconsciously) comparing destination facilities to those in their own country or region. “Blemishes” that may not garner a second glance at home can stand out like a sore thumb and engender doubts about the quality of your hospital’s services.

Several studies, including a well-known one by Professor Jerry Gotlieb of Western Kentucky University, have shown that patients’ perceptions of hospital infrastructure can influence their perceptions of hospital quality. 1 While “dirty” spaces are an obvious way for a healthcare facility to cause a bad first impression, there are many other elements that can affect how traveling patients perceive your facility. The positioning, design, layout, and signage of the treatment setting are crucial factors in the way patients feel about their care environment. Even lighting and sound have an impact on the care experience. Using sound-absorbing material on ceilings, floors and walls, for example, will reduce noise, which has been shown to increase stress in both patients and staff. 2

There is also an increasing body of evidence showing that patients recover quicker in aesthetically pleasing healing environments. According to a recent New York Times article, The University Medical Center of Princeton tested a new “model room” with nice views, a sofa for guests and no roommates; it found that patients asked for 30 percent less pain medication. Reduced pain has been linked to a quicker recovery, leading to shorter stays and reduced costs. 3 The same conclusion was reached in a seminal 1984 study published by architecture professor Roger S. Ulrich that compared two groups of patients recovering from Gallbladder surgery. Patients with a nice view left the hospital on average almost one day sooner than the other group. 4

While any patient population deserves to be treated in a clean and pleasing environment, medical travelers are arguably more likely to suffer from the effects of stress and anxiety due to the unique combination of travel and treatment and associated factors such as jet lag, language barriers and having to navigate cultural differences in an unfamiliar environment.

Granted, while most healthcare facilities do not have the budget to make sweeping changes to their infrastructure, there are small and relatively inexpensive steps that can be taken to improve the healthcare environment for patients and staff. The Center for Health Design, a think tank and advocacy organization whose goal is to “transform healthcare environments for a healthier, safer world through design research, education, and advocacy,” recommends that hospitals consider the following factors when designing or upgrading their physical spaces:

Access5

1. Use simple (as opposed to medical) terms to indicate locations and provide information in multiple languages (depending on target patient populations served) and use universal symbols supplemented with text and numbers when designing signs in a multicultural setting.
2. Consider using integrated wayfinding strategies that communicate information to patients and families from different cultures.
3. Create welcoming environment for patients, families, and staff by reducing environmental stressors, providing positive nature distractions, and improving amenities.
4. Cleanliness along access areas should be monitored continually.
5. Color palette chosen for walls and furnishings should be harmonious and soothing
6. Reinforce community commitment through the selection of interior aesthetics, such as artwork and color preferences relevant to multiple patient populations represented in the clinic.
7. Use zoning to separate public, treatment, and staff functions to improve internal circulation and privacy.

Waiting areas/admission6

1. Consider acoustic properties of materials selected for waiting, check-in, and communal spaces to aid in minimizing noise.
2. Create welcoming environment for patients, families, and staff by reducing environmental stressors, providing positive nature distractions, and improving amenities.
3. Cleanliness in waiting areas should be monitored continually
4. Identify clear spacial boundaries for waiting areas that are distinguished from adjacent circulation paths.
5. Color palette chosen for walls and furnishings should be harmonious and soothing
6. Provide a variety of lighting options—controlled, natural, skylights.
7. Provide Wi-Fi and/or internet accessible computers within waiting areas.
8. Create patient spaces that also accommodate accompanying family members.
9. Provide positive distractions for patients and families in waiting areas including culturally relevant art work, reading materials in different languages, television, and information kiosks.
10. Use televisions and/or monitors as a positive distraction outlet.

Examination areas7

1. Consider sight lines into and out of rooms for visual privacy.
2. Create welcoming environment for patients, families, and staff by reducing environmental stressors, providing positive nature distractions, and improving amenities.
3. Lower the power differential between provider and patient within the exam room through furniture selections and adjustable features on technology equipment.
4. Cleanliness of consultation/exam areas should be monitored continually
5. Hospitals and clinics should strive to feature up-to-date technology and equipment
6. Color palette chosen for walls and furnishings should be harmonious and soothing
7. Create patient spaces that also accommodate accompanying family members.
8. Provide positive distractions for patients and families in waiting areas including culturally relevant art work, reading materials in different languages, television, and information kiosks.

Patient rooms

1. Consider offering private rooms and suites
2. Availability of safety box
3. A sofa bed for the companion
4. Wi-Fi internet access
5. Nurse call button accessible to the patient
6. Temperature controls accessible to the patient
7. Noise level near room should not be disturbing
8. Color palette chosen for walls and furnishings should be harmonious and soothing

Many of the recommendations stated above are advocated within the GHA standards in competencies such as care management, physical environment, cultural competency, patient advocacy, infection control, and technology. Given that patients may be tired from traveling, feeling disoriented, or experiencing cognitive or physical difficulties, every effort must be made to make access to services easy in a stress-free healing environment.

Frontline Staff – Critical to the Medical Travel Experience

Around the world, healthcare consumers are becoming more savvy, payers are demanding high-quality care, and research groups have found more and more convincing evidence as to why the ability to prioritize and manage the patient experience is so important to a positive overall healthcare experience. There is also a growing body of evidence that a great patient experience improves financial performance. According to a recent report by Accenture, a well-known strategy and consulting organization: “A superior customer experience doesn’t just strengthen patient engagement — it also correlates to 50 percent higher hospital margins.”1

Enhancing the patient experience is especially important in medical travel due to the hospitality and travel components that must be managed across the medical travel care continuum. A hospital or clinic may have great healthcare outcomes but still fall short of delivering a high-quality patient experience. Potential potholes on the road to achieving a high-quality patient experience in medical travel include:

• Prospects or patients getting lost on your website or not finding relevant information
• Slow response times to patient inquiries
• Poor communication and education due to language barriers
• Lack of cultural sensibility among staff
• The hospital lacks established care paths and protocols for medical travelers
• Poor follow-up after a patient travels home
• Staff have not been trained to understand and manage a medical traveler’s expectations

One of the most important steps you can take to improve the patient experience is to train your staff. Doctors study for years in order to diagnose and treat patients. Nurses undergo intensive training and certification. Even a hospital’s cleaning staff follows certain protocols to perform their jobs well. The same principle should apply to every staff member responsible for caring for medical travelers. Don’t underestimate the impact your staff has on your medical travel program, both positive and negative.

Staff who are the first point of contact with your organization, which includes but isn’t limited to call center employees, international office staff and receptionists, are among the most important positions in your organization and should be supported as such. They are on the frontlines delivering first impressions and in a position to detect potential problems before they escalate. To ensure staff are well-equipped to manage medical travelers, they should be trained to:

• Anticipate international patient needs and expectations
• Understand the necessary services, both clinical and non-clinical expected by patients
• Use proper communication techniques
• Practice cultural and emotional sensibility
• Implement risk management protocols when accepting and attending patients
• Apply critical thinking skills to proactively mitigate risk and enhance the overall patient experience
• Properly manage the continuum of care process

Avoid the temptation of saying, “Juan from marketing can handle international patient requests…or we can move Susan from admissions, she speaks Spanish pretty well.” Give your staff the knowledge and tools to proactively impact the patient experience at each stage along the medical travel care continuum.

Join us August 21st at 10 am EDT to learn about the Global Healthcare Accreditation ® (GHA) Program, an independent accrediting body that seeks to improve the patient experience and excellence of care received by patients who travel for their medical care. GHA represents an innovative approach towards the importance of achieving medical travel accreditation while focusing specifically on operational excellence and the patient experience, a business strategy that will impact organizations across all services provided.

This Free Webinar will also feature Mercy Hospital Springfield sharing their perspective on the value of GHA accreditation. In 2016, Mercy Hospital Springfield – one of the largest Catholic health systems in the US, became the first organization accredited by GHA.
Click here to register for this Free Webinar.

Mayday, Mayday! What Hospitals Can Learn From Recent Events in the Airline Industry

The sight of a 69-year-old physician being physically assaulted and dragged off a United Airlines flight recently took social media by storm, with United’s terse response in the immediate aftermath roundly criticized. Their CEO first defended the airline and described the passenger as “disruptive and belligerent” before publicly apologizing days later and vowing to do better.1

Unfortunately, this was just one in a series of customer service fiascos that have recently plagued the airline. Other incidents include a man threatened with handcuffs if he did not give up his first-class seat to another passenger,2 a mother forced to carry a toddler in her lap for a 3-hour flight when the seat she had paid for was given to a higher status standby customer, 3 and a 10-year old girl denied boarding because she was wearing leggings.4 In all these incidents the airline eventually apologized to the affected passengers, however, not before suffering serious damage to their brand and reputation.

What is the takeaway for healthcare providers?

While healthcare is certainly a lot different than flying, healthcare providers can learn many valuable lessons from United Airline’s experience.

1. One negative incident can impact your brand

It doesn’t matter if it is an airline passenger, hotel guest or a patient, in this age of Facebook, YouTube and Twitter, any incident or interaction has the potential to go viral and impact your brand reputation. This is especially relevant in medical travel where patients may actually be engaging with airlines, hotels and hospitals as part of the medical travel care continuum. While you cannot completely eliminate negative interactions from occurring – especially outside of the healthcare setting, you can significantly reduce these incidents and their fallout by: 1. Ensuring proper training of staff and promoting a top-down corporate culture that is patient-centered and empathetic to the needs of medical travelers, 2: Providing appropriate oversight and setting expectations for any contracted services the hospital has that may impact medical travel patients, such as facilitators, hospitality organizations and ground or air transportation companies, and 3: Having a clear plan in place to quickly deal with negative incidents before they become PR nightmares. While this can be a scary thought, it should be comforting to know that the knife cuts both ways. A positive interaction can also go viral and have a beneficial impact on your brand.

2. Exceed patient expectations by turning a negative into a positive

Unfortunately, when things go wrong and patients complain, we sometimes have a tendency to get defensive or blame someone else. That’s human nature. Mistakes and misunderstandings happen even in the best situations and to the best of people. The important thing is not to make things worse by arguing or pointing fingers, this will only make the patient angrier.

When bad things happen we have two choices, we can argue about whose fault it was until we’re blue in the face, or we can sincerely apologize and, if deemed necessary, compensate the patient for the inconvenience suffered. Perhaps you can give your patient or companion a free skin-cancer exam, a complimentary meal, or even a short sightseeing tour. The important point here is to show your patients that you value them as people, as well as customers and that you are truly sorry for the problems they may have experienced, regardless of whose fault it was.

3. Use a bad experience to drive positive business change

After the unfortunate incident highlighted at the beginning of this article, United instituted several new policies including no use of law enforcement to remove overbooked customers from planes, a pledge to reduce the amount of overbooking, improved training for its workers and offering higher monetary incentives for customers willing to volunteer to take a later flight. 5 Mistakes and bad interactions must generate reflection and provoke action, otherwise, they will keep occurring. We should:

• Reexamine our policies and procedures to ensure they are aligned with our patient’s wellbeing in mind.
• Figure out the root cause of a patient complaint and address it.
• Identify processes that aren’t working and change them.
• Inspire a connection to the cause by clearly articulating to staff the reasons for the change in policy.

Ultimately, a negative customer interaction – regardless of whether it is publicized or not, should motivate us to learn from our mistake(s) and make positive changes that will benefit our patients as well as our organization.

For a another very interesting perspective on the United Airline’s incident and parallels to the patient experience in healthcare, we recommend reading, “What United Airlines Can Learn from Cleveland Clinic.”

The Challenges of Achieving Ethically Responsible Care in Medical Travel

There is a perception that ethical issues most commonly arise at the limits of medical care. For example, deciding whether or not to take someone off life support or making a decision about continuing treatment for someone with a terminal condition. While this may be true to some extent, the reality is that ethical considerations will come up frequently during all phases of healthcare delivery.

The subject of ethics is especially relevant in medical travel due to the unique circumstances and challenges facing patients traveling for care. Ethical concerns may arise if healthcare providers are not transparent with traveling patients about the potential risks and safety concerns in medical travel and the implications of this for patients’ abilities to achieve informed consent.1 For example, flying after surgery can increase the risk for blood clots. Additionally, if medical malpractice occurs, patients may not have the same rights to seek legal redress as they would in their own country. Medical travelers could also fall prey to unscrupulous facilitators or intermediaries whose primary motivation is the referral fee rather than the patient’s best interests.

Traveling patients may be unaware of these concerns due to lacking familiarity with the destination health care system, language or cultural barriers to adequate communication between medical tourists and health care workers, and/or lacking transparency regarding quality of medical facilities or health care workers.2

How do healthcare providers ensure that traveling patients are adequately educated about the potential risks associated with medical travel? Are there steps we can take to assure that the integrity of care is maintained across the medical travel care continuum? These are legitimate questions that should be carefully considered by healthcare providers caring or seeking to care for medical travelers.

Promoting ethically responsible care

Fortunately, healthcare providers can take specific steps aimed at promoting ethically responsible practices. The first step is to acknowledge the uniqueness of medical travel and set guidelines and protocols that address the challenges medical travelers face. These should include:

  • Employee orientation and education: Ethics, like most other disciplines, must be learned. New employee orientation and all educational programs should include ethics content, with specific examples of how to apply theoretical principles to concrete issues,3 including those faced by medical travelers.
  • Demonstrating transparency: This occurs by providing honest, accurate information about the risks associated with surgery and travel, medical outcomes, your medical staff’s qualifications, the effectiveness of the medical equipment you possess, pricing (and situations that could lead to additional expenses) and even legal or financial claims against the healthcare institution. Far from hurting you, being open and transparent with patients – even in situations where you may have made a mistake – will foster trust and respect. Patients will be genuinely impressed with your courage and willingness to put their interests ahead of your bottom line.
  • Respecting Patient Rights: This occurs when the healthcare organization provides the patient with written patient rights documentation that is explained in a language and manner that the patient understands and that these rights are respected during the entire treatment process. Patients should be informed that they have the right at any time to seek assistance from the healthcare organization whenever they believe that their rights have not been respected.
  • Improving patient communication and education: Healthcare providers should evaluate whether or not their current education and communication platforms are serving the needs of medical travelers. Is your website available in the language or languages of traveling patients? Does your staff – clinical and non-clinical – have the skills and tools to communicate effectively with traveling patients? New technologies such as patient portals, telehealth technologies, and mobile apps are supporting communication between providers and patients anytime and anywhere.4

We hope that by creating awareness of the ethical concerns that impact medical travelers, it will motivate healthcare providers and other stakeholders in the medical tourism industry to prioritize transparency, respect for patients’ rights and effective education/communication in the treatment and care provided to traveling patients.