At Foch Hospital, a living lab dedicated to the patient experience

The Foch Hospital was the first French healthcare establishment to create a Patient Experience Department. Could you tell us about it?
Valerie Moulins: It all started in 2017, when I met Amah Kouevi, founder of the French Institute for Patient Experience (IFEP). I was already interested in this concept, both part of a humanist and hospitality approach, and therefore joined the board of directors of the IFEP before participating, in the spring of 2018, in a congress on the Experience patient organized by the Cleveland Clinic, USA. It was a real revelation: not only were the discussions exciting, but there were also many ideas potentially applicable to Foch. Our director, Jacques Léglise, was also of this opinion. In September 2018, we therefore created the Patient Experience Department, to establish this function and legitimize it with healthcare professionals and users. It was indeed a first in a French health establishment.

How to define the patient experience?
According to the Beryl Institute, which is today the benchmark in the field, the patient experience designates “all of the interactions and situations experienced by a person or those around them during their health journey. These interactions are shaped both by the organization of this journey but also by the life story of the person concerned.. To sum up, this notion therefore makes it possible to move from the traditional identity of a relatively passive patient to a patient who is active in his care pathway and who participates in the decisions concerning him. It splits, in a way, to be both at the center of the course and a link in this course.

Let’s go back to September 2018 and the creation of the Patient Experience department. What was the next step?
The first months were placed under the sign of observation: I mainly listened to patients and caregivers talk about their experience – whether positive or negative. This approach continues today, with the recruitment of an employee who, each week, goes to the departments, waiting rooms, etc., and lets patients unfold their experiences. The verbatims are then sent to the heads of departments, department managers and members of the hospital’s management committee, so that everyone can participate in improving our practices and our organizations. To come back to the sequence of events: some time after the creation of the Patient Experience Department, we realized that we needed a dedicated, central location, easy to access and permanently open. In September 2019, we therefore inaugurated the “Living Lab Foch”, where patients and their carers “passing through the corridor” – but also healthcare professionals, as we will see – are welcomed every day, from 9 a.m. at 5:30 p.m. It has now become essential.

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Exactly, why did you associate health professionals with this Living Lab?
In the spring of 2020, during the first Covid wave and confinement, the hospital was no longer accepting patients. Our Living Lab, which is by vocation an open place, has therefore begun to receive health professionals, which has also allowed us to broaden our thinking by working on the symmetry of attention. There is indeed no patient experience without caregiver experience; the two notions are closely linked, and this philosophy materializes today through our Living Lab. Although from the outset it adhered to an open innovation methodology, driven by patients and based on usage, the Living Lab Foch also benefits from non-“natural” collaborations, by facilitating meetings between caregivers and patients. to develop, together, a new way of living the hospital. All the tools designed by Hôpital Foch now go through the Living Lab and its collaborative workshops, whether they are classic materials such as the welcome booklet, or solutions aimed at meeting the needs expressed by patients. themselves.

Could you give us some examples here?
Maternity mothers, for example, came to see us because they lacked information when they left, about cord care, bathing, etc. We therefore created a “Parents” working group to co-develop the Baby Foch application, which is now downloaded by all parturients. In the same way, patients wished to have more precise information before an intervention. We then created a channel of podcasts where, for example, the head of the digestive surgery department explains inguinal hernia surgery and its postoperative course. Today is the 11th national health channel, and its fame now goes beyond the borders of France – we even have listeners in Germany!

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A recurring query relates to boredom in waiting rooms. How did you address it?
Patients have offered to put books there. But organizing a collection of second-hand books can pose hygiene problems. We therefore approached the major publishing houses for endowments. With each new collection, we now receive unsold items and make them available in the rotunda waiting rooms, so that they can be read and taken home. Another request concerned the organization of discharge after hospitalization, where there is often a wait between the different sequences. This spring, we therefore opened an exit lounge, with a hostess, luggage lockers, a catering service, a TV corner and a work area (electrical outlets, internet connection, etc.). That said, time is often long during a hospital stay. For many patients, participating – completely voluntarily, of course – in the work of the Living Lab allows them to break this monotony, to feel valued and to put their skills at the service of the hospital, which is a common good. I am thinking in particular of a patient proofreader in a fashion magazine, who wanted to work on the “Room service” booklet. Many of them also wish to continue their participation after their hospitalization.

This approach is of interest to several other health establishments. What advice would you give them?
I would recommend that they start by working on “small” projects, for which it is possible to find an immediate and therefore directly visible solution. But also to involve managers in discussions with patients within the care services, for the sake of trust and transparency. And above all, not to ignore the symmetry of attention, and therefore to take care of both their patients and their caregivers. I would also raise a point of vigilance: the patient experience should not be confused with quality. It serves it, of course, and as such has been integrated into the new certification process for healthcare establishments. But the approach is not the same. For example, we have developed a questionnaire to collect, and potentially measure, the patient experience, the i-Satis indicator seeming to us to be unsuitable here. In the end, we are not convinced by the need to measure it precisely to differentiate it from a Quality approach. After all, its benefits are clearly noticeable to everyone.

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What are they ?
On the clinical level, we are seeing better compliance with pain and depression, as well as positive results for certain pathologies. We also observe organizational gains, on the simplification of routes and the reduction in their duration. Without forgetting the social benefits: prevention of burn-out, reduction of turnover and absenteeism among caregivers who rediscover the meaning of their vocation by recreating links with patients. And, of course, the ecological advantages, with a reduction in unnecessary acts, in particular with regard to unsuitable and therefore wasted communication media and tools.

What will be the sequence of events for the Foch Hospital?
We are in the process of launching a project around the lack of attitude on the part of our employees, all professions combined: we have developed a “Foch Attitude” training course, which will be given to all our employees over the next two years. We will then co-construct a charter that everyone will agree to respect. Next September, we will also create a “Patient Experience Challenge” for our teams. The winner will be able to visit a European hospital working on this subject and, of course, benefit from support to implement his project. We are also working on a wider dissemination of the concept of patient experience: in addition to the courses that I already give to students of our IFSI, we have just created a training course open to all health establishments, and provided by the Foch Hospital Training Institute. It is after all a challenge for the future, which meets the expectations of patients and their families while strengthening the attractiveness of healthcare professions.

Article published in the May 2022 edition of Hospitalia to read here.