There was once a time back in 2015 when a veteran would walk into a large Veterans Affairs (VA) medical center, feeling anxious, not knowing how to get to their appointment, and not being able to obtain the information they needed. This prompted then-U.S. Secretary of the Department of Veterans Affairs Robert McDonald to launch the MyVA Transformation to rebuild trust with veterans, their families, and the American people by establishing the Veterans Experience Office (VEO). The VEO produces tools to highlight important moments that veterans experience during their healthcare journeys and identifies measurement opportunities to assess how veterans experience VA healthcare service delivery.
Building and Deploying Tools
According to Jennifer Purdy, LCSW, executive director of patient experience at the VEO, “In 2017, the VEO deployed patient foundational toolkits across 147 healthcare systems.” Among these toolkits was the Red Coat Ambassador Program, which involved employees or volunteers in red coats welcoming veterans and their families at VA medical center entrances and directing them to their appointments. Another was the WECARE Rounding Program, which involved medical center leaders speaking directly with staff and visitors about the care and services they received. A third toolkit, “Own the Moment,” involved a mandatory customer experience workshop to encourage VA staff to connect with, understand, and help guide veterans through the moments that matter on their VA journey.
“We wanted to meet veterans where they’re at,” says Purdy, who is co-chair of the Veterans Health Administration (VHA) Governance Board’s Patient Experience Committee. “When you’re face to face with a veteran, how do you create a connection to show that you care for that person, understand what their issues are, and will respond to their needs? When we built ‘Own the Moment,’ we wanted to make things easy and effective for patients and their families so that they get what they need, as well as make an emotional connection.”
“Anytime you do a system change, you are going to have early adopters,” says Purdy. “What helped this movement was that in 2018, then-U.S. Secretary of the VA Robert Wilkie challenged the VHA to improve the patient experience. At the VA, we had frontline support, which helped to make the initiative more easily adoptable.”
According to Martina Malek, who was the associate director at the Minneapolis VA in 2020, her facility was able to use the tools created by Purdy and her committee to determine what worked and what didn’t. One key to success at the Minneapolis VA, Malek notes, is that the radiology department was already focused on transforming the patient experience.
“The radiology department understood that veterans get nervous when they come in for testing,” says Malek, who now serves as deputy director for patient experience at the VEO. “Sometimes they have to have an IV of contrast, or they have to be in a strange machine. The department had employees come up with different tools and resources to make sure they were meeting the veterans where they were at. They stood up their own committee, did a lot of process improvement, and even rearranged the layout of the furniture in the waiting room to make the space more welcoming. I took Jennifer’s recommendations to the facility level, but the radiology department took it to the boots-on-the-ground level.”
Malek adds, “Minneapolis is just one example, but countless other VAs across the country have addressed what the patient experience truly means and how it can impact someone’s journey — not just in their health, but in their life. Healthcare diagnosis and treatment can be life-altering and a lot of the VHA staff really recognize that and are supportive in making it an exceptional experience.”
Minneapolis is just one example, but countless other VAs across the country have addressed what the patient experience truly means and how it can impact someone’s journey — not just in their health, but in their life. Healthcare diagnosis and treatment can be life-altering and a lot of the VHA staff really recognize that and are supportive in making it an exceptional experience.
Ian A. Weissman, DO, FACR, chair of the ACR Patient- and Family-Centered Care Outreach Committee and chair of the ACR Commission on General, Small, Emergency, and/or Rural Practice Network Veterans Affairs Subcommittee, agrees. “At the Milwaukee VA Medical Center, where I am a staff radiologist, we instituted a program called Hello Rounds,” says Weissman. “When we see patients in the hallway or in the waiting area, we always make it a point to acknowledge them and say hello.” Once Weissman started making the rounds, he immediately saw how even this small interaction could have a big impact on the patient experience.
“Acknowledging these patients brings them back into the moment and makes them feel better,” he says. “This is something anyone can do to show patients that they care about them.”
During the 2019–2020 fiscal year, Purdy and her team developed facility patient self-assessments so that medical centers could use the qualitative and quantitative data, feedback sessions, and staff meetings to understand what could be improved. “Once we got the energy, focus, and leadership commitment for improving experience and developed tools on what matters to our patients, we did start to see the numbers move,” says Purdy.
In 2018, the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) — a patient satisfaction survey required by CMS — found that the VHA underperformed in patient experience quality metrics. In 2020, the VHA was improving patient experience at a faster rate than the national average for HCAHPS for Inpatient Care. The average improvement year-to-year for the private sector was 0.5%, while the average improvement for the VHA was 1%.
“The VEO is leading the way in developing initiatives to help improve the patient experience,” says Weissman. “It is developing strategies that we can all bring into our radiology practices whether we work for the VA, academia, the military, or the private sector. The ACR Commission on Patient and Family-Centered Care is tasked with developing strategies to improve patient care, and we can all learn from how the VEO is innovating and developing initiatives to improve patient care.”
Purdy agrees. “The VHA is continuing to deepen the culture of what the patient experience should look like by identifying what makes the VA unique,” she says. “What makes us unique from another medical center is that we have the honor of serving those who served.”